Recent Updates

This year has really been the start of a new and very different life. Graduating from school, starting an 8-5 job, Larry moving from Tulsa to Oklahoma City... lots of new and exciting things have happened in the last few months/weeks. It is finally starting to feel like things are settling. And it feels sooooo good!

A few new things are going on this semester that I am really excited about! Four in particular:

First, Larry got a job in Oklahoma City a few weeks ago and moved here last weekend. It has been an adjustment having him so close! We are both really enjoying seeing each other more and the stress of driving back and forth between OKC and Tulsa is gone. Such a blessing from the Lord...

Next is a Latin exercise dance class I joined called Zumba. Its so fun! I am still learning all the songs and steps but it includes everything from salsa, merengue, tango, bolero, and mambo to latin hip hop. The class is fast paced and centers on having fun and getting a great work out.

And I have also started training for a 5K this semester. I realized sometime ago that I hate running long distances, but really love to sprint. So for the last few years, I haven't run anything longer than 5 miles. As an intermediate level runner, I have really enjoyed starting to train for speed instead of distance. I honestly don't know why I ever tortured myself when I didn't like distance running... interval training is fun and a great workout! My goal is to run a 7 minute mile this summer, and eventually to run an 18-21 minute 5K. Sprinters, unite!!

Lastly, I recently found out about two Afghan families living in the Oklahoma City area and an organization called Spero:Voice that works with refugees. Tomorrow night, I will go to one of their ESL classes and hopefully get to meet some of these families. Very exciting!! I have really missed the Afghan refugees we worked with in Fort Worth and am very much looking forward to meeting some Afghans in this area.

So... its been nice in the last few weeks to start getting settled into a routine. If you are in the area and interested in Zumba, 5Ks or refugees give me a shout out!

A Curious Thing

So, I've noted a curious little phenomenon of late. Something I've never really encountered in the last 27 years, and I have to admit it has me somewhat bewildered.

I started a brand new job at Children's Hospital on January 13th, as their newest general oncology provider. It has been great, and I've really enjoyed it. Almost every day as I'm walking through the halls of the hospital or clinic, I have to pinch myself and ask if this is real- do I really have one of the best jobs in the world?!?

However, something I have noticed. People are reacting to this so differently than I'd expected. I say the words "kids" and "cancer" and... most people don't really say another word about it. Most just completely drop the subject. Family, a few close friends ask, sure... but still. This is just weird.

Never in my life have I felt like people in general were so disinterested in something. I understand a little, that people think it is sad... but I've been all over the world and this is by far NOT even close to the saddest you can encounter! Quite the opposite... It is such a joy to go to work there every day! These children are so precious and lovable. So resilient, too, and I am finding how much I truly love being with them and helping make such a difference in their lives.

One of the older, wiser PAs told me today, "Erin, you'll find its better to just say you work with children. Over the years I've learned that most people really don't want to hear about kids with cancer. It just makes them sad. And, its harder for you and I to understand because we don't have children."

I guess I can understand that. But I'm glad that for now, those little chillins give me JOY!

DONE

DONE! DONE! DONE!!! I passed the board exam last Monday and have already applied for my medical license. HAAAAAALLELUJAH...!

Now its Christmas, vacation, time to relax.

Fa la la la la, la la la la... Merry Christmas, everybody!

Four Days Left

What jumps and turns red with joy all over when Thursday comes?

If you do not know the answer to that I don't think we have hung out in the last- ummm, two years. Wow! I cannot really believe that it is November 15th. And we have less than 96 hours until PA school is over FOREVER!!!!!!

True, there's a board exam to be taken on Nov. 30th. But, no more classes! No more rotations! No more new jobs, new places, new bosses, new nurses, mean nurses, dirty jobs, dirty looks like "you're just the student," no more bottom of the rung. I am moving on up, baby.

AND ONE MORE THING FOR ME: No more white coat. No more seasonal dressing while keeping in mind there will be a white, long sleeved, might-as-well-be-a-straight jacket wrapped around me. Ah, I have been wanting to get rid of that darn thing for so long. Now the time has almost come! Plus, now I can put pens in my pocket again and not worry about all the marks. Sigh. So much to look forward to.

Maybe we can have a White Coat Bonfire. Hmmm.. all the festivities have not yet been planned. It could be added.

I do know, ma soeur et moi are going to Cancun on December 9th!

*Ahhhhhhhhh* (angels sing)

To go from swimming in patients and paperwork to riding dolphins is, hmmmm let's see. Only my wildest dream come true! (Really, I did dream about riding dolphins all through PA school. On the darkest days, I mentally pictured my glory day in the hot sun, riding dolphins. It may have been the only thing that kept me going. Well besides the Lord.)

And heeeeeeeere it comes!!!!!!!!!!!!!!!!!!!! Oh, THANK YOU LORD!

Humanity and Heme/Onc

Due to an unexpected and very unusual twist in end of rotation plans last week, it turns out I am doing the very last rotation, the last 28 days, the LAST TINY LITTLE PIECE OF SCHOOL OF MY WHOLE ENTIRE LIFE with...

Kids with cancer. And blood diseases. (Also known to us as, hematology and onocology or- as everyone prefers to skip most of that- heme/onc.)

It is kind of sad.

I don't like any of the stories these patients have. All of their stories, so far, are very sad. These children are the living examples of the weakness of humanity. They are so innocent and sick.

My two patients are:

Sweet little M, 2 years old, with a big hard tumor in her belly and metastases to both her lungs. She hasn't been in the hospital long enough to know that not everything we do hurts so she has a raging case of White Coat syndrome. Take the white coat off and she is one sweet little pea. Approach her in the white coat and you will wish for a fate worse than death!

Today we heavily sedated her and punched holes in her hip bones to get some bone marrow. Ouch. Luckily, there was no cancer there so most likely she'll never have to have that done again- unlike kiddos with leukemia, who get it done weekly.

And little Mr. R... is an 11 month old baby who has a recently resected very rare brain tumor. Actually, they haven't even been able to diagnose it exactly yet. So, he's going home tomorrow while things get figured out. He has an 8cm scar across the top of his skull and a lop-sided little smile that would outcharm Elvis Presley. This little man may have to have chemo that would irreversibly scar his kidneys and he may not and end up leading a perfectly normal life.

Its this dichotomy of good and awful that seems to follow us around our whole lives... we can hardly enjoy the one without the other popping up and looming over our heads, threatening to destroy everything.

Or maybe that's a lie, and there are some things that cannot be destroyed... even by death. Give us peace in our hearts Lord. Let it be a long, long road with a good, good end.

A Transplanted Heart

My cardiology rotation really started off with a bang.

On Monday, we were chilling in the cath lab, and had just finished a right heart cath that showed a woman had a pulmonary capillary wedge pressure of 47. That, my friend, is heart failure. Dr. H is the only heart failure cardiologist in Oklahoma and he is pretty darn amazing. I had no idea when I was assigned this rotation just how freaking cool it was really going to be. When an organ donor in Oklahoma dies, Dr. H is the main person who decides who will receive the heart. And that is a pretty gigantic responsibility. He is a pretty amazing man and I am lucky to get to learn from him this month.

Keep in mind, there are only between 9 and 13 heart transplants a year in Oklahoma and the surrounding areas including western Arkansas and southern Kansas. So when Dr. H told me that a donor heart was available on Monday morning, and that I could go watch the transplant, I had no idea how special of an experience it actually was.

One common myth about organ transplants, including hearts, goes something like this: "I don't want to be an organ donor because if I'm injured in a car wreck, they might see and then not try as hard to save my life." In reality, organs are never harvested "on the scene" of accidents. If the person dies in an accident, their organs don't receive blood and the tissue dies- and you can't put dead organs in a living person.

Organs are almost entirely harvested from people who receive brain injuries and later become brain dead on respirators. In the hospital, after it becomes apparent that the person is completely brain dead and never coming back, doctors talk to families about wishes- and that is the time when organ donation becomes an option. Usually, organs are harvested while the person is still on the respirator. That way, the organs receive a maximal amount of blood before being removed.

Circling back... so on Monday, I got to watch a heart transplant. This was definitely the most amazing thing I have seen all year, maybe ever. The doctor who performed the transplant was a little grouchy that day because he had already opened up the chest of the person receiving the heart when they found out the heart was coming by ambulance, not by plane. So basically, the man laid in the OR for and hour and a half with his chest wide open, just waiting for his new heart. I watched his old heart beat for about 30 minutes of that.

Kind of strange, just watching a heart beat. It looked sick and worn out, and you could tell it really needed to be replaced. How lucky he was. Although so incredibly sad that someone else- an 18 year old in Tulsa- was so unfortunate.

About 30 minutes after I arrived, Dr. Elkins received a call that the heart was only 10 minutes away. So, he proceeded to cut out the man's heart. Cutting a heart out takes about ten minutes, and isn't as complicated as you would think; I mean, there are only four vessels to sever.

Right after he finished, the OR door opened and simultaneously, a man yelled, "Heart's here" and a blue cooler flew across the threshold and slid about 10 feet before slowing to a stop at the foot of the operating table. It literally looked like it had just been taken camping. One of the nurses grabbed the cooler, and dragged it over to a big bucket of ice. I made my way closer and saw that the cooler said in big letters, "PLEASE, PLEASE RETURN TO HEART TRANSPLANT COORDINATOR OR THERE WILL BE NO HOSPITAL PICNIC THIS SUMMER."

No- just kidding. It said, "PLEASE, PLEASE RETURN TO HEART TRANSPLANT UNIT." The nurse opened it up and grabbed what, in comparison to the big ugly broken heart just removed, was a most beautiful heart, completely unblemished. After dunking it in ice a few more times, Dr. Elkins sewed the new heart in.

For a few seconds after it was reanastamosed, the blood pump was still on- meaning that blood was being diverted away from the heart. No blood was actually flowing through the heart yet. And yet, the oddest thing ever... the heart started to quiver. (Or, in fancy medical terms, fibrillate.) Like, somehow it actually realized it had been reattached to a person. Crazy.

The heart quivered on and off for a few seconds and then the blood pump was turned off and the heart began receiving blood. At this, it really started fibrillating. Then, the surgeon took two tiny paddles and shocked it with just 10 joules. Also crazy- normally you shock someone with 300 just to get through their chest wall! The heart would probably explode right there on the table if you shocked it directly with that much electricity. However, the tiny paddles did their job and the heart started beating. Beautifully beating.

Eventually, the sternum was wired back together. (Watch that from two feet away and nothing that happens to you will ever seem that bad.) And with that the surgery was over.

Three days later, in the clinic, Dr. H looked sternly at a pretty 23 year old girl, his intense gaze nearly boring holes through her skull.

"There are certain things you are going to have to do to show me," Dr Horstmanshof paused-

"...to prove to me that you can take care of the incredible gift of a transplanted heart."

The girl just sat there, speechless. Incredible gift indeed.

Ob-la-di, ob-la-da, life goes on, brah...Lala how the life goes on.

I've been thinking a lot lately how life flows on and on. Whether you want it to or not... Sometimes it seems like its not the decisions we make that decide where life takes us, but rather that we're being carried along in its current-

"In his heart a man plans his course, but the Lord determines his steps." -Proverbs 16:9

I went to Lifechurch tonight after feeling deeply sad. While there a song played with the refrain, "Its all because of Jesus I'm alive- its all because the blood of Jesus Christ." I'm reminded that my life doesn't have anything to do with graduating from school or getting a job or making decisions about the future. The Lord has a plan and he knows what it is. The important thing is that because of Jesus my heart is alive. And I don't need all those other things- He is enough.

A few nights ago, Ashlie and I went for a run at Mitch Park. About a mile along, it started to downpour. And as we ran in the rain, drenched to the bone, I looked over at her and knew,

An alive heart is what life is all about.

118 Days

Th July rotation was great. Dr. Wiens was awesome... I liked him a lot. The drive to Shawneee was not so great. He offered me a job at the end of the rotation- no call, mostly closing operations and doing central lines; not too shabby. I'm thinking about it.

Now I am with a kidney specialist, Dr. Carter, at Baptist in OKC. He is awesome. I love internal med docs cause they don't expect anyone to do their work, they just expect you to learn. That's no cause for complaint on my part.

In other news, there was a sailing birthday party for Meagan last night and my cat cuddles with me every morning. Tao milktea and tapioca are abundant and there are flowers on the porch. Sally is not coming back from California. I've been exhausted lately and worried but trying to remember life is good. Please be praying that the Lord will help me finish the last three and a half months of school well and show me what to do after that. Love & miss you all...

Nighttime Rambling

Last night I dreamed about Afghanistan again. A mob gathered outside our house and the Afghan National Army had surrounded us to keep them from getting in. Jirah, Julie and Kate were there and a US helicopter came to rescue us. I'm only worried because its the one time I brought my violin to that darn country and this female officer made me leave it in the house because there was no room in the helicopter. Somehow we always end up in an armored car with the windows rolled down on the Kandahar highway, headed to Kabul. Jirah is crying. I'm thinking about how the violin would have fit in the car. And it ends stopping at a little buffet-style restaurant in Ghazni to eat.. I've had that dream before.

Why was the crowd mad? Why weren't we on the helicopter? Why were the windows in the armored car rolled down? Why was there an Afghan version of Furr's in Ghazni? Most importantly, why did I ever bring my violin to Afghanistan?? I'll never make any sense of it.

Turn, Turn, Turn...

Seems like there has been a lot going on this year and a lot of change taking place in many of our lives. God knows there is a time for everything, and a season for every activity under heaven.

A time to be born, a time to die
A time to plant, a time to reap
A time to kill, a time to heal
A time to laugh, a time to weep

A time to build up, a time to break down
A time to dance, a time to mourn
A time to cast away stones, a time to gather stones together

A time of love, a time of hate
A time of war, a time of peace
A time you may embrace, a time to refrain from embracing

A time to gain, a time to lose
A time to rend, a time to sew

To everything, turn turn turn
there is a season, turn turn turn
and a time for every purpose under heaven

WANTED

Have you seen this man?


He was seen last Saturday afternoon with daisies in hand, ringing a woman's doorbell in Oklahoma City.


Then later he was spotted taking her to dinner and dancing.


He has been known to frequent wooded areas where young PA students may be found.


You might also catch him hanging off the side of one of these.


Warning: THIS MAN MAY APPEAR HARMLESS.


He is wanted in Marlow, Oklahoma. If you have any information concerning his whereabouts, please contact the proper authorities immediately.

Sweet Baby Lovin'

My precious friend Keri's baby, Gracie. And below is Summer's little munchkin, Colton.



I'm thinking summer wedding. Lilac and olive tones. Something simple, without too many frills. Perhaps around, say... 2029.

Moving Back to Edmond

This rotation in Marlow is almost over. On July 2nd, I will move back to Edmond... until December! Yaaaay! I will be living with Ashlie and her other roommate, Jenny, in a little house just off Boulevard and Danforth.

I spent the night there last night before coming home to Marlow today and there were fireflies zigzagging all over our backyard at dusk. And we have a porch swing. AND it is just a 10 minute walk to the nearest sno cone stand.

I think my life is complete. And now, for a short rendition of "Ice, Ice, Baby" (lyrics modified by Meagan Labay):

Ice, ice baby
flavored ice makes me go crazy
fun in a cup and i don't mean maybe

Or, there is this version, sung to the tune of "Billy Jean":

Cold sno cones
are not my love
they're just a treat
without any vit-a-muns
so, i just eat them for fun

Vitamin K and the Faux Hawk Baby

Last Sunday, a baby was delivered. Delivered by a very small PA student (who had gotten approximately 8 hours of sleep in the last 2-3 days) to a very large and umm.... unhygienic mother. That is all I will say about that. But imagine. Delivering. An. Unhygienic. Person. Vaginally.

Ahem.

The next morning, I could not have been more relieved to see the baby was cleaned up. And, best of all, he had quite bit of hair that one of the nurses had styled up into the most awesome faux hawk ever. So. Incredibly. Cute.

Then, Dr. King let me circumcise Little Mr. Faux Hawk. This was really such an interesting procedure. There are several different methods for circumcising babies- you can use Plastibells, the Mogan, or Gomco- I got to do a Mogan. Really, to me the most interesting thing about circumcision is that in today's world, we can do them the day after a baby is born.

Why is this, you ask? Well, have you ever wondered why we give babies a shot of Vitamin K after birth? Circumcision first appeared in the BIble when God told Abraham to circumcise Isaac on the 8th day after his birth. Seems weird that he told him to wait, eh? Unless you know that babies, left to themselves, do not begin producing Vitamin K- a clotting factor necessary to clot blood- until they are about a week old. So, cutting into a baby before then without giving them Vitamin K will most likely lead to them bleeding to death. (However, if you invented babies you may have been aware of this small fact.) The End.

136 Hours in 9 days

I just finished a hellish little run of 12 to 16 hour days... oh sweet holy mother of my goodness. One more tomorrow. Then- 3 DAY WEEKEND!!

Endangered Love

"Endangered Love" is one of my favorite children's songs. Its a song about two manatees who are in love, however, one wants to go to a ball in her new manatee lipstick and the other wants to speak French, go into the world and do noble things. In the song, they even almost break up. However, luckily for them, love finds a way.

Barbara: "Bill, I've learned French."

Bill: "You have?"

Barbara: "Mais, oui. Je suis Manatee. See?"

Bill: "Oui, oui mon amie!
I always knew you could,
I really hoped you would.
Now can we go into the world and do noble things for the good of all?"

Barbara: "Yes, but first, will you take me to the ball?"

Lesson for today: Have your cake and eat it too!

Come Live With Me, and Be My Sweet Fluffy Ball of Love

Every month in my life right now is a new beginning. Every month, I start over at a new job. Every month, I get a new boss, a new workplace, a new kind of work, a new population of patients, a new boyfriend. And usually, a new place to move.

Just kidding about the boyfriend.

However, not this month! This coming weekend is, truly, a free weekend! I continue my rural rotation for another month and have only one thing to study for... a drug list for Dr. King and I'm golden.

The main priority for today is to search for an apartment. One thing has been blatantly missing from my life these last few months: my cat. For the previous year she had been my constant loving companion; the last few months, she has been living with Ashlie and Lewis as I move all around. Which she loves.. :/ But I miss her and I'm ready to cohabitate with her sweet fluffy little ball of goodness once more. And, as it seems everyone I know has a pet-free lease, it appears I'm going to have to find something by myself for at least the next 6 months.

So, the apartment search begins. Once it is completed, the job search will begin. As the Indian man on the plane said with a smile... the world is my oyster. I hope cats like oysters.

Marlow Is Busy

Apparently, Marlow isn't as slow as I'd thought it might be. All the old folks are getting sick in their nursing homes, high school girls are needing their sports physicals, everyone in the hospital has to be followed, oh then there's the free clinic; and did I forget to mention Dr. King's clinic where we work 40 hours every week?

Marlow is definitely where its at. It being the work.

Mr. Lucas Strikes Again

I'm always forgetting to put new pictures of us up. Here we are a few weekends ago at Quartz Mountain. He went for a climbing thing and I was there for a women's retreat. Here he is in action, making me breakfast. What a sweetheart!

Beautiful Marlow

Well, time is flying. The spring has come and spring in Marlow is one beautiful thing. Everything here is green and the trees lining Main Street are old. There are gorgeous multicolored wild flowers all along the drive from the hospital in Duncan to the clinic in Marlow. Bright little flowers and old, beautiful trees lining the street of your new town in the rain... I'd say its a treat.

I got here on Sunday night after a not-small detour which included me getting to visit the Wichita Mountains once again. They are beautiful at sunset if you are driving in from the north. I hope I can go out there a lot on this rotation, but we'll see. Supposedly the hours for this stint are somewhere in the 9:30am to 9:30pm area. It looks to be no lie, so far.

I think I like small towns. The people here seem almost the exact same to me as everywhere else that I have been so that's no different. The hospital I get to live at is nice. Dr. King, my preceptor for May and June, is a great person and a good doctor. More good news... there might be someplace to go horseback riding around here that lets you gallop on the horses. People in small towns seem like they might be more likely to let you gallop on their horses than just make you stick to boring old trail rides. I'm keeping my fingers crossed and looking into it.

On a more personal note: I need a break. I feel worn out.

Creep, Creep, Creep...

There is something that has been creeping up on me like a sneaky little insect. Something I have been thinking about a lot lately but trying not to. Something that is much more difficult to be rid of than brushing a bug off your leg on the Fourth of July. And that thing is... graduation.

Supposedly, we are to start looking for jobs this summer. Supposedly, I am to fill out applications and ponder salaries and paid vacation. Now I grow up and start deciding what I actually want to do. In someone's mind, I am an adult, and have even the remotest idea where I want to live and settle down. (And in some far away fairy tale land, I am also studying for our board exams.)

Reality: I am laying on the couch eating an ice cream sandwich and watching Sahar take a little spit bath.

Its kind of like having two lives. One in which I go to the hospital every day, do histories and physicals and patient care plans with some traumas thrown in; the same one in which I graduate in 8 months, settle down with a great job and have a very good life surrounding by loving family and wonderful friends.

Then there's the other life, in which I continually think of being back in dusty Kandahar, riding camels in the desert and laughing with nomads under tar-colored tents. Or Ecuador, treating brown-faced little children in a medical clinic by day and riding rusty old bikes on the beach by night. Or Haiti, sleeping on roofs, delivering babies on the clinic's dirt floor and hiking to waterfalls; petting purple sea urchins then riding to islands on ancient, patchy-sailed boats.

Ahhh... I still have no idea what to do.

Happiness. Flowers. Mountains. Lederhosen.

This is Mr. Lucas. He was pumping water while calling himself Lars in a German accent and talking about lederhosen. And so you can see why Mr. Lucas brings my heart pure joy. :) When I'm with him, I'm just about as happy as I can ever remember being. He is a genuinely thoughtful man with a cheerfully contagious disposition. You would really enjoy meeting him.

We went to the Wichita Mountain Wildlife Refuge last weekend. We did a little trail run out to a tall thin rock with two large boulders balanced on top- aptly named Crab Eyes- and climbed up on top. Its one of the most beautiful views in the whole park, or so says Mr. Lucas. Then we grilled out shishkabobs and later hiked to a waterfall with a couple of his climbing buddies. Then watched the sunset on Mount Scott- which I have concluded is THE prettiest view in the whole park. If you live in Oklahoma, and you haven't been, you have no excuse- the mountains are only an hour and a half away from the city. It is worth it.


Our delicious lunch. Yummy sweet potatoes not pictured.




He even brings me flowers.

A Lot Going On

Seems like there has been a lot going on recently. My brother had appendicitis again and a second surgery to take out his appendix again (strange, right). I went up there this past weekend to spend some time with them. Now he's still having some problems and laid up at the hospital in Des Moines so be praying for him.

The ER is still going great! I love it there so much. Its really a joy to get to go every week. This week I traded one day of ER for a clinic day Friday, so no four day weekend. That has been one of the huge blessings of this rotation- lots of free time! Which, I am finding, is very fun to spend with my architect friend. More on that later.

So, the schedule is going to be a little odd until August, so here it is one more time:

March- Oklahoma City
April- Edmond
May- Marlow, OK
June- Marlow, OK
July- Shawnee, OK

Marlow is in the middle of nowhere. About an hour and 45 minutes from the city. So, I will be a little nomad for the next four or so months. Ahh... its been nice to be settled for so long. Now its time to uproot and migrate again.

Psalm 19

The law of the Lord is perfect,
reviving the soul.
The statutes of the Lord are trustworthy,
making wise the simple.
The precepts of the Lord are right,
giving joy to the heart.
The commands of the Lord are radiant,
giving light to the eyes.
The fear of the Lord is pure,
enduring forever.
The ordinances of the Lord are sure,
and altogether righteous.

'In his presence is fullness of joy, and at his right hand are pleasures forevermore.' -Ps 16

Awake Late

Sometimes it is hard to sleep at night.

Especially if you stay up until 7:30am roughly 42.857% of the week. I am not complaining though, because the Job is wonderful. I couldn't be happier at the ER. Tonight at our girl's group, someone had a word for me. And the word was, concerning the Job and the hospital and the patients:

"You have been tailor-made for this."

I know that it is true. I have often thought that myself.

8 Years Is a Long Time

Yesterday, the sweetest guy in the world took me out. Its been a really long time since I went on a date on Valentine's Day... eight years to be precise. This person is just simply amazing. We went out to a place called Red Rock Canyon and he taught me to rappel. Being a mountaineer for the last 16 years he is pretty good at it; I can't believe how much fun we had.

If you have run out of ideas for dates, I suggest finding a strong, good-looking architect who loves to climb and ask him to take you to the mountains.

Saying Goodbye to Griffin

The cute Italian resident was nice enough to give me today off, so my psychiatry rotation at Griffin is officially over. I was surprised at how much fun and how enjoyable this rotation was. I'm a little sad (not because of the resident :) but because I really became attached to some of those patients. I'm going to miss them and all their crazy shenanigans which brought so many laughs over the last month!

I will miss Miss T, whose only criteria for discharge was that she take a shower. She thought there were demons in the 4th stall to the end so we were always trying to convince her to take a shower in the first stall. But, after weeks of antipsychotics and psychotherapy she told us, "Basically what I'm telling you is I'm never going to take a shower at Griffin Memorial Hospital." Okay, Miss T...

I will miss Mr. J, who left his nursing home because he was "going to follow the train tracks to Egypt."

I will miss "Wolfvy," who first thought he could predict and pinpoint anything happening anywhere, at any time, all over the world, and email the people involved to warn them. And that his wife had sextuplets that all died within 15 minutes of being born. And that he'd had hundreds of surgeries to replace all of his bones with titanium, which is the reason he now gets struck by lightening so gosh darned frequently!

One person I will not miss is Miss L, who was the most annoying patient on the face of the planet. When she came in, she saw the treatment team and we asked her if she knew why she was at Griffin. She gave us THE meanest look in the world and said, "You want me to tell you again? They... ripped... my... ARM... OFF!!" She also constantly hallucinated children and believed that her residential care facility was using them to hand out the medicines. So she definitely wasn't going to go back there until they instituted some safer distribution practices. And that the owners were castrating all the male residents and then throwing the remnants at all the other patients. And that was just completely unacceptable. She was a tortured woman... who will no longer be torturing me. :)

One Year Later: A Tribute to Cyd

It was exactly one year ago today that our dear friend Cyd was abducted in Kandahar. One year, and we have still not had the opportunity to hold a formal memorial service or funeral for her. So I would like to take this opportunity to write out a memory of Cyd I have, that no one else ever knew.

My first trip to Kandahar was in 2005- I stayed with Cyd and her two roommates for about a week. We had great fun during that time and there are many memories impressed on my mind from that short period; however, one stands out.

Every night of the summer, Cyd slept on the roof, on a small cot, under a mosquito net. She loved to sleep under the stars. I loved that roof, because it had a view of one of Kandahar's strange mountain formations just off to one side. Most nights that week, we went up to the roof and looked at the mountains and the stars. So it wasn't unusual that my last night in Kandahar, we again found ourselves on the roof after sunset; but this time we sensed the time was precious. So we lingered there for hours, talking and praying and singing together into the early morning. Cyd had a beautiful, resonant voice that rang out like a bell. We cried and talked over so many things. Sometime after one she finally left me up on the roof and went downstairs to sleep, because the first chill of fall had just arrived. I knew I was leaving for Kabul in the morning, and didn't know if I would ever come back. I stayed up on the roof for a few more hours, singing softly and basking in the beauty of the Kandahari night, staring at its millions of stars. After drifting off sometime later, I was suddenly startled out of sleep; and freezing, went downstairs to bed.

I have never forgotten that night with Cyd. What an unusual woman! That she cherished and found beauty in such a place, and somehow instilled it in my heart too. I will always love you Cyd; I wish we could sing on your roof tonight.

The Cute Italian Resident

So... there's a certain very good-looking young Italian doctor that happened to have a PA student assigned to him for the month of January. He immediately intrigued this student with his kindness and dark head of curly brown hair. Which she stared at the back of most of last week. However, since she has absolutely no idea how to attract a person of the opposite gender, (and possibly due to some rule about preceptor relationships the program made up pointlessly, without single students in mind) she admired him quietly from approximately two feet away in her chair as he interviewed crazy patients. I know because she's a really close friend of mine.

Then this week, just before lunch she began texting someone. He immediately looked up and said with a grin, "Who are you texting, your boyfriend?" She just smiled and said no. And sort of blushed because those are exactly the types of questions savvy females are able to take advantage of without replying in monosyllables. Although, she felt a twinge of hope because that's one of the first questions someone asks when they are interested, right?

Then his phone rang, and after he hung up, she decided to make a joke and said, "Who are you calling, your girlfriend?" But then he said, "Yeah."

*Sigh* .... nevermind.

A New Roommate

It has been over 2 years since I last had a roommate. However, following a short hiatus in Edmond due to a flooding incident right before New Year's, I now again live in downtown OKC. The days of Deep Deuce are over; my lease was up on December 31st. I am now staying with a friend until my rural rotations start.

My new roommate is awesome! I just love this sweet girl. She is a pediatric resident I met on the PICU rotation. She's also from Pakistan. Because she basically works 90 or more hours a week, unfortunately there's a lot she has never done in Oklahoma. For example, while on the prowl for food tonight and she pointed at a store and said, "What is a Braum's?" Needless to say, she was soon eating some Oklahoma dairy cow produced ice cream. This is going to be fun. And also will be a good transition- since she isn't home too much and I am not used to having someone home.

In other news, two of a greatest people on earth got married last night. Congratulations Danae and Nao!

Baby Jonah

Beware: a very long story follows.

Due to HIPPA, no one is allowed to share medical information together with a patient's name. So the following story is true but the sweet baby has an alias. This story is one I have been thinking about for the last month and one with which I am just now coming to terms.

I had been at Children's Hospital a little over two weeks when I showed up to work one Wednesday morning and was greeting by our sweet, smiling upper-level resident, Kim. I'd had two asthma patients the day before who had both been discharged, and so was coming in with nobody on my plate. Immediately upon entering the residents' office, Kim informed me that she had a baby for me to follow. He would be the only patient I saw that day, as his case was complicated. His brief history is as follows:

Jonah was born seven days previous to his admission to the PICU. When he was four days old, his mother took him to the doctor, because she was concerned about constipation. The doctor noticed that Jonah had a low oxygen level on room air. He admitted him to the hospital in Lawton where he was started on some antibiotics.

That afternoon, Jonah's mom noticed his eyes crossing, lips puckering, and legs stiffening while his oxygen levels continued to fall. That evening, he had an episode that the mother recognized as a seizure. One and a half hours later, he had a second seizure lasting approx 3 minutes. Medflight was called to transport the baby to our hospital in OKC. Upon arrival, the paramedics found that his heart was not beating. They proceeded to intubate him and gave him chest compressions. He had another seizure en route to the hospital.

Then Kim paused and she said, "This is the part of the story that is so sad."

Kim was the resident on call the night Jonah came. Upon arrival at the PICU, Kim examined him, wrote an admission note, and was about to leave the room when Jonah's mom mentioned to Kim that she had painful, vesicular lesions on her right breast. Kim examined the lesions and realized that they were a primary outbreak of herpes.

There are only a few reasons that a person should not give birth vaginally. One of them is if the mother has a vaginal infection, because as the baby goes through the birth canal, it will mostly likely contract the infection. If it is a bacterial infection, like gonorrhea or chlamydia, it can be treated. However, if it is a viral infection, there is very little that can be done. Tiny infants also have virtually no immunologic defense against infection, and therefore, when they contract viral infections, it is very easy for the infection to get into their blood and spread to all their organs (called sepsis). It is very serious and frequently ends in death.

So that is how it came to be that Jonah contracted herpes from his mother. The mother had no idea.

Kim immediately got cultures of eye, skin, nose, trach aspirate, blood, urine, and rectum. And also of the mother's lesions. We already had a pretty strong suspicion that Jonah had sepsis due to disseminated herpes; when the cultures came back a few days later, the suspicion was confirmed. Everything was positive.

I went in to see Jonah that first day and he didn't look too bad. He weighed almost seven pounds and had little tufts of blonde hair. He did have some bruising from where they'd put IVs and lines in him- mostly around his umbilicus and thighs. With a blanket on, you could almost think he looked normal. (Apart from the tube going down his throat.)

However, when I got to his chart... wow. This baby was complex. Most of my other patients had their vitals and other stats monitored every hour. Jonah had everything normal plus more monitored every fifteen minutes. His chart was blackened with tiny little numbers. This was going to be complicated.

He also had every lab known to man done every four hours. The main things that concerned us were his kidneys and his liver. Here is why:

If your liver stops producing certain proteins your body needs to make blood clots, you bleed easily. When you have a lot of IVs and lines, you need the your blood to clot quickly. If it doesn't, you receive a LOT of blood products. Cells, plasma, and all these clotting proteins. Your medicines can also only be concentrated so much. In other words, you get a LOT of fluid going IN.

If your kidneys stop making urine, its very hard to get rid of the fluid that you take in and that your body naturally makes. What do we do for people who have kidney failure? We give them dialysis. Dialysis, however, requires a big hole. And its pretty easy to bleed a lot out of big holes, so if you are going to have kidney failure, you need your liver in good working condition, making all the clotting proteins it is supposed to make.

So, either your liver or your kidneys can fail, but it is really bad news if both stop working. So basically, my job every day was to do all the math on Jonah's intake (all the fluids, medicines, etc going in) and his output (urine, blood, vomit, etc), as well as looking at all the labs every four hours and all the medicines he was on and figure out if his liver and kidneys were going to start working.

So initially, we knew he was in liver and kidney failure. He wasn't producing any liver proteins, and so we had to continually replace all of them, so that he wouldn't bleed out of his lines. However, this meant that that in the first 24 hours of his hospital admission, he was given almost a liter and a half of fluid. That was equal to half of his dry weight. However, his urine output was practically zero (hence the kidney failure). So, lots of fluid going in, nothing coming out: Jonah began getting puffier.

So although his liver was shot, we knew the one chance he had to live was if his kidneys began working again. Throughout his 9 day stay in the ICU, each day I went into work wondering whether the Jonah had peed at all overnight. If so, he was going to have a chance to get rid of all the fluid we were pumping into him, and have a chance to survive.

However, every day, when I got to Room 8236, the chart that awaited me had bad news. Each day, the first thing I raced to was the urine output column: 40 milliliters in 24 hours. Ouch. His daily input was hanging around 900 to 1,500 milliliters- he was gaining around a liter of fluid a day.

By the end of nine days, he was bigger than an overweight 9 month old.

The thing that killed me was that none of the doctors ever really told his parents how bad it was. One day, they were taking a much-needed break down in the lobby and saw me leaving. His dad pulled me aside and asked hopefully how he was doing. That particular day, he had been bleeding immensely out of his umbilical line and we almost could not stop the bleeding. I had no idea what to say. Shouldn't the doctors have let them know how close to the edge he was?

Each day, Jonah looked worse and worse. My second to last day of the rotation, one of the attendings told me that Jonah had the worst case of edema he had ever seen. Jonah's whole-body edema was so bad that he even had chemosis, a condition in which the water accumulates under the whites of your eyes and makes you look really freaky. Not that his eyes were open; his swollen lids spared his parents from seeing it.

The last day of my rotation, I showed up almost 30 minutes late due to the OU parking office accidentally shorting me one day of my permit, hence leaving me without a parking spot and scrambling to find one on our cramped campus. After I walked into the resident room, I grabbed an exam sheet and headed over to 8236. He had looked so ghastly and awful the night before. Did he pee??

As I approached the room, I saw a huge crowd of crying family members gathered around the doorway. I turned around, threw the sheet into the trash and walked back.

Over night, the attending had informed Jonah's parents that after 8 days of liver and kidney failure, the chances that he would recover were basically zero. Although he was on a lot of pain medication, he was probably still suffering. That kind of edema would be incredibly painful. And so, they took him off all his drips and the ventilator early that morning. He lasted on his own for almost five hours before my arrival. After I'd seen the family crying, I sat down in the resident room for a moment to think. Jonah died less than five minutes later.

I went in to hug his parents. After coming in to see him every morning of his stay, I had a lot of internal emotions toward the parents and had prayed for them a lot. They looked awful and were sobbing. Although Jonah was so swollen, I grabbed his little hand. You could still see the softness of his little tufts of golden hair. Oh...

And so my very last duty on that rotation was his death summary. And so, this is why I can never work in a children's ICU and also... why I continue to eagerly anticipate the day when there is no more suffering.

A New Year, 2009!

Isn't a new year such a refreshing feeling? I have written 2008 at least a couple of times already. Stopped and realized.... it is 2009 now! Ahh... mostly, its a chance to start again. And who doesn't love that?

2008 was full of kindness and good things, but it was all mixed with a lot of sadness. I can't say I am sad that this year is over. I am so excited for the new!

I did some research on New Year's resolutions on the internet and I am now planning to stop smoking and lose 50 pounds. Anyone else with some New Year's Resolutions?

Cast It Into the Fire: Part II

Ever since our cardiology test finished last fall, there is a phrase I use to refer to times of incredible stress which are quickly followed by periods of immense relief. These are Cast It Into the Fire moments. In my mind I always see Frodo laying down, panting on the rock when its all over.

This year's award goes to: the Children's ICU rotation and its ensuing termination. P. T. L. this month is freaking over. Now if only I could mindlessly stagger over to some deserted alley and collapse in an irresponsible heap for the next month...

26 Will Be More Fun Than 25

Thanks everyone for being so sweet on my birthday!

I haven't even sat down to think about goals for the next year, because there's one Very Big Goal I have been working on for the last year and a half. Its only just now we are reaching the cusp of the calendar year this goal is to be accomplished: 2009. (Cue sound of me panting like a dog...) Oh, the pure ecstasy!

In other news: sometimes, even when I am incredibly tired or should be studying or doing any number of other things that would be wiser investments of time, I spend an hour or two reading the blogs of random strangers. It is truly one of my favorite pastimes and definitely the main reason I am grateful that Al Gore created the internet. So the other day I was reading one of the most hilarious blogs *ever* and... I realized that part of the simple allure of this girl's writing was that she didn't take herself too seriously and was able to accept her own flaws gracefully.

As a true Type A who has only become more rigid with the passage of time... I confess I am envious of this girl. To be able to accept my faults effortlessly and with grace and humor; ay ay ay. Help me Lord! I suppose that is a big enough goal for 26.

She Got a Hippopotamus for Christmas

My mom used to tell me the craziest things. My sister and I thought she made them up to entertain us. As an adult, I've found out she was usually right. She told me the following story awhile ago and I always wondered about it; turns out Wikipedia confirms her love for the strange-but-true once again.

"I Want a Hippopotamus for Christmas is a Christmas novelty song written by John Rox and performed by Gayla Peevey (10 years old at the time) in 1953.

Peevey was a regional child star of the Oklahoma City area. According to legend, this 1953 hit was recorded as a fund-raiser to bring the city zoo a hippo. When released nationally by Columbia Records the song shot to the top of the charts, and the city zoo got a baby hippo named Matilda. In a 2007 radio interview with Detroit-based WNIC radio station, Peevey clarified that the song was not recorded as a fundraiser originally. Instead, a local promoter picked up on the popularity of the song and Peevey's local roots, and launched a campaign to present her with an actual hippopotamus on Christmas. The campaign succeeded, and she was presented with an actual hippopotamus, which she donated to the city zoo. The hippopotamus lived for nearly 50 years."

If you saw the hippos at the OKC zoo before 2002, you too saw Mathilda, the hippo Peevey sang about and got for Christmas. Sorry for not believing you Mom...

In His Name All Oppression Shall Cease

The hospital was pretty dang depressing last week. Its just depressing when you only have two patients- and then one goes brain dead and the other you take off the respirator. The world's deepest grief should be reserved for these parents.

But there is another part of it that is actually relieving; when these little chillins are relieved of their suffering. We pretty much see them in the worst physical state on earth. Sedated, intubated, and everything in the world going wrong with their little bodies. Its enough to make you realize how compassionate taking them off a ventilator truly is.

The moment comes when they take the tube out, and then what you see with your physical eyes is a tiny girl, turned a little blue, chest silent, heart no longer beating. The whole family is crying around a dark hospital bed, and she is gone. But if you close your eyes...

She is in a green field and a cotton dress, barefoot, running toward a man ready to scoop her up in his arms. The ribbons in her hair are streaming in the wind and there is a gigantic smile on her shining face, all creamy and pink-cheeked.

You are the one left standing in the dark hospital room, and she is freed.

"The righteous perish, and no one ponders it in his heart; devout men are taken away, and no one understands that the righteous are taken away to be spared from evil." - Isaiah 57:1

Pimping: Crash & Burn

Um... I have a lot of questions. Unfortunately, on my current rotation, I am not even capable of forming the sentences to ask the questions that are in my head. This would be okay except for the fact that the attending (doctor) invariably asks me these very things.

Here are some examples of questions to which I am supposed to know the answers and the types of things that come to mind when asked.

Doctor: "So his residuals are increasing. I want you to refeed the residuals back through his NG tube and then we're D/C-ing the trophic feeds and the sodium benzoate. Why not continue his feeds?"

Me: "... ... ... " (blank stare + absolutely nothing)

Doctor: "ABGs are 7.43 / 20 / 100 / 24 / -2 / 70 and the vent's set on 55 / 25 / 60. We're going to decrease the respirations as well as the tidal volume. What is the most common cause of VALI?"

Me: "Your mother. I am out of this lame unit."

Doctor: "This baby is 3 days S/P failed R heart cath for HTCM. During dye injection he coded with v fib, desat-ing down to 30. (Insert four more sentences of confusing information here.) He's now on diltiazem, propranolol, fentanyl and prn tylenol. What do you want to do with him?"

Me: "Sounds like a hard day. Does he like ice cream?"

Thanks for the Painless Times

There's one really great thing about being around sick people all day, and that is The Moment. I have begun cherishing this hundred and twenty seconds more and more as my first rotation wears on. Its something I have experienced many times in life but I didn't start truly soaking it in until a few weeks ago...

I have to wait for It the entire day. Which is good, because I really have something to look forward to. I wake up around 5:30, cuddle with my sweet kitten, and begin getting ready. After some Ensure, a run and a shower, its onto work. Eight to twelve hours pass in which all kinds of sick people come in and need help, and very often are in some kind of physical pain or mental anguish. Work gets over, and the evening passes with its various activities. I sweet-cuddle the kitten again, brush my teeth, and get back into bed.

The lights are off, my eyes close, and It arrives. The moment in which I lie in the darkness, and relish being 100% pain free. My physical body wallows in utter comfort and contentment, and my mind lays down to rest. Its taken a couple hundred sick people in pain for the last three weeks to remind me of how precious and rare this moment is. Who knows how long it will last? A minor neck injury in a wreck or a friend's death tomorrow could mean tonight will be my last pain-free Moment for a long time. But every night (for now at least) that precious moment is cherished until It, and I, slip away into peace-filled sleep.

The Past, Present and Future

The past: Finishing school was really hard, and really wonderful. Every time I remember that I never have to go to class ever again, a seriously warm and wonderfully fuzzy feeling washes over me and bathes my soul in pure contentment.

The present: Rotations are going really well, and Obama was elected to the presidency. I could not be more ecstatic that God chose to raise him up for this time, knowing also He will depose Obama in His time. Its all up to him. (For anyone interested in reading Obama's stance on faith and politics, jump on over here.)

The future: Well, I've been thinking a lot about the future. My preceptor for this first rotation is pretty dang amazing, a wonderful doc to work with, and he has already offered me a job more than once. Also, some good friends of mine are moving to Colorado Springs, and- having just taken a super fun trip up to the city in the shadow of Pike's Peak- I am thinking about going up there, too. They are opening up a couple new hospitals, which would probably have something open.

Or, there are lots and lots of Afghan refugees in San Francisco and a lot of HIV clinics. One of my favorite things is infectious disease so that is also an option. And, my sis only lives 7 hours from there.

I've also been thinking about going back overseas. Thinking about it a lot. I am considering applying with the Department of Defense to go work with them in a hospital in Germany that treats wounded soldiers on emergency flights coming from Iraq and Afghanistan.

I'm sure there are many more opportunities that may arise. I just like to dream about the future. If you could choose, what would you do and why?

The Political Game Rages On!

Is McCain is so misogynistic that he honestly believes HRC’s base will vote for him on account of a VP who has nothing in common with Hillary but her anatomy?!

Okay, so maybe underestimating female political intelligence doesn't equate you with being a woman-hater. But it does make my blood boil. I truly hope he chose Sarah Palin for a better reason but it seems he is just sexist enough to think this will do the trick and American women will come flocking to his side. Oh, my... I hope that I am not overestimating the women in our country. I hope they truly think this thing through.

Perhaps now she knows what its like to be a token, and some old GOP guys know what its like to be passed over for someone with less experience.

Or did he pick her based on eighteen months of reforming corrupt Alaskan politics? Are we underestimating Palin? I hope so, for goodness sakes. But I'm wondering if she even has a passport- on top of the fact that she recently asked on CNBC, "What exactly is it the vice president does?"

Hmm... Not like Joe Biden's ties to credit card companies are a whole lot better. Politics, ay ay ay!

Oh, and maybe I know what I want to do with my life.

We have now been through every section of clinical medicine except psychiatry, which we just started and I honestly cannot imagine wanting to do. So, my first thoughts on what field to work in are... Emergency Medicine! We'll wait and see how the trauma rotation goes though. I might not be able to take it without being tortured at night or something. But that's the one I like the most so far.

Its the End of the Summer

Those are the lyrics to a great punk rock song I used to love in high school. And every year when early August rolls around, it gets stuck in my head for a few days. This year, I have never been more excited to see the end of the summer come!! We just finished summer finals. Now we only have a really light load (three easy classes with no tests) for the next couple weeks, until August 21st when our fall semester starts.

Then we'll study a few more weeks, take a few more tests, and the didactic year will be OVER!! I am really glad because- well, one of the reasons I never write on here is that exciting things have been few and far between. Hopefully, the uneventful, predictable and reclusive part of life will be over when we start working in the hospitals and clinics, and more interesting things to write about will start happening. ("The new phone book is out! The new phone book is out! Things are going to start happening to me now...")

Here's to the nearing of the end of one of the most difficult 17 months ever.
57 out of 68 weeks finished.
84% complete. 16% left to go. Bring it on! And let us be rid of it!

Rotation Schedule

So, we received our rotation schedules early... and I am BLESSED!!! Not only am I not leaving OKC much at all- but I also was given every rotation I requested (and more). Here is my life until November 2009...

November 08: Primary Care Edmond
December 08: OU Children's PICU/CCU
January 09: Mental Health VA
Feb/March 09: OU Trauma Center
April 09: Obgyn Poteau, OK
May/June 09: Primary Care Marlow, OK
July 09: General Surgery Shawnee
August 09: Radiology Mercy Hosp
September 09: Infectious Dz OU HIV/AIDS Clinic
October 09: Cardiology Baptist Hosp

So here's the word on the street about the ones that have been mentioned to me. At OU Children's Pediatric Intensive Care Unit (PICU) and Cardiac Care Unit (CCU), we are taught to put in chest tubes (thoracostomies) and intubate babies (and much more). OU Trauma is not an Emergency Room- so even though its my Emergency Medicine rotation, its the only Level I Trauma Center in the area, so it sees all the worst trauma (bad MVA's, penetrating trauma, blunt trauma) in the state. Obgyn in Poteau was the first rotation I requested, because I heard we are taught to deliver babies ourselves! Yay! General surgery in Shawnee will basically teach me to first assist, meaning I get to help sew 'em up... and the most prized rotation of all, the AIDS clinic, will be the most eclectic; from fungal horns that make people look like unicorns to TB to cancer, weakened immune systems do crazy things to people.

And, I had to look Marlow up on a map. But I'm sure it can't be that bad... here's to an awesome year. Yahoo!

Something Found Everywhere

Travel is probably the second most freeing thing on earth, if you ask me. And if you're asking, the first is a place that cannot be found on any map... or perhaps is found on every map.

Thank God that worship comes from within and can be practiced in any setting and every geographical location. I have found that the Lord is the same, and the experience of Him comfortingly consistent, everywhere I've ever gone. In the words of Emily Dickinson (whose personal meaning was probably different; but isn't the hallmark of great writing that any individual can find their own experience in the words of the writer?):

Have you got a Brook in your little heart,
Where bashful flowers blow,
And blushing birds go down to drink,
And shadows tremble so—

And nobody knows, so still it flows,
That any brook is there,
And yet your little draught of life
Is daily drunken there-

Oh, Canada! And Oregon and California and Everything Else Completely Wonderful: A Summary.

I am in love. With vacation.

On Friday, June 13th, I passed our last two finals of the semester and became the coveted... PAS2!!! No longer will I be a lowly PAS1. No, we are second-years now.

On Saturday, I flew up to Portland and Tash and Ben picked me up from the airport. Sunday, we drove out to the Oregon coast and went to Cape Perpetua and Yachats. Beautiful, beautiful!! We even got to go to tide pools at low tide and touch the green sea anemones.

Canada! On June 16th I took the Greyhound bus from Eugene up to Vancouver (which was an experience belonging to a blog post all its own) and stayed for two and a half days before coming back. And, those were two of the most wonderful days in recent memory. Canada is AWESOME! From the Capilano Suspension Bridge over the raging river on the North Shore; to taking the ferry from Horseshoe Bay across to Nanaimo and kayaking around purple starfish-covered rock islands with an Australian girl; to staying at a hostel nestled on one of the most beautiful beaches in Vancouver, I was stunned and amazed by the beauty of BC. So THAT'S why they call it Beautiful British Columbia! I also got a taste of Washington on the drive up and now have big plans to some day go back and visit the giant Mount Rainer.

On Saturday after getting back to Oregon, Tasha and I left and embarked on a mini-adventure that included stopping at snowy Crater Lake (breath-taking!) on the way to the Oregon Caves National Monument and an overnight stay at a cozy little lodge nearby. Then we headed down to California and camped for two nights in the forests of Sequoia sempervirens, the coastal redwoods that are the tallest trees in the world. I'd wanted to see these trees for a long time and it was so satisfying to spend hours staring up at them. Our campsite had a giant felled moss-covered redwood at its entrance that was gorgeous, greeting us each night when we returned to camp. It was also fun to be so close to the ocean during that trip.

Now we're back in Eugene and planning some wild river kayaking for this weekend, perhaps in Bend, near the Three Sisters. Waaaa hooooooooo!

Pain and Joy

The last month or so has been pretty intense. There's a lot that could be written- but, our semester ended, and we now have only couple classes at a time until June 13th, when we will get out of school and be free for 17 days!! I am going to take the entire break and visit my sister in Oregon. Upon the schedule of things to do are: camp in the giant redwood forest in northern California, wild river kayak, drive 101 up into Washington, go to Canada, and Crater Lake, and much more. I am ecstatic!

And, Summer had her baby. When they wheeled her out of the operating room, and right next to us, the nurse held him up through the nursery window. When she saw him, dangling there all red-faced and tiny, tears just began streaming down her face. It was such a priceless moment. I felt blessed to have been able to witness unadulterated love pouring out of my best friend's heart.

Driving home from the hospital, tears also started streaming down my face. I've been thinking so much on Cyd since I came home from Fort Worth, having heard more about everything that happened to her. Such a sadness comes to me sometimes when I think of her. But then, when I picture Summer and tiny Colton, all there is- is joy. The sorrow and joy meet in the middle and mingle, neither one willing to leave. And its the paradox of life how they coexist there without ruining one another.

Some Things Remain Mysteries

There are some mysteries I have been thinking a heck of a lot about recently. Some are serious, some are not so serious, and apart from #1, they are in no particular order; but here are my Top Ten Unsolved Mysteries.

10.) If they have fireflies in Nepal.
9.) How on earth I am going to convince the director of my program to let me go to Africa for a rotation.
8.) How God can remember everything in the world. How he knows things like the vectors of every single leaf blowing across the lawn or their weight in grams; or the number of blades of grass they touch along the way.
7.) Why there can't be a grocery store closer to Bricktown.
6.) Why something as horrible and atrocious as the Holocaust doesn't make the beauty of Itzak Perlman playing the theme from Schindler's List any less beautiful.
5.) How an atomic bomb works. I guess this could be googled. But I like to just wonder about it sometimes.
4.) One day, at seventeen years of age, I walked outside to feed my rabbit after being gone for the weekend, and when I got to her cage, everything was locked up as usual. But, there was a mysterious ball of matted fur in front of her feeder, and she was gone. There were no organs, bones, flesh, nothing... just fur. And a locked cage.
3.) As it says in Proverbs, "The way of a man with a maiden."
2.) How something as dark red as blood can make someone white as snow.
1.) What and why on earth this really happened to Cydney.

Some of these, for sure, are going to remain unsolved. And I suppose that's life.

Living the Dream

Sometimes, I realize how blessed I am. I am living the dream I had for my life, and overall... is that uncommon? Common? I don't know. I just feel blessed.

"The Lord is good to those whose hope is in him..."

Utter Insanity and the Skills Lab

The last week or so was complete and utter insanity. Pathophys test, epidemiology statistics test, radiology test, test, test test! But its all over now. Until our pharmacy test Monday.

So today our PA group took its first turn going to the Skills Lab. The Skills Lab is a simulation that the med school does for us to practice on patients without hurting anyone. The patients are paid actors who pretend to be sick! If you think that is awesome, as I did, even more awesome is the knowledge that a tiny little camera in the corner of the patient room is filming your every move, and your professors are watching you... and grading you. Yeah, it was awesome. I think only six out of the nine people in our group hyperventilated and threw up before going in.

No, not really. One girl cried and that was it. Believe it or not, there's something reeeaaally distracting about knowing that every word coming out of your mouth is being videotaped; not to mention that its hard enough to remember everything you are supposed to ask and do when there is no pressure on you to get it right. When you can just walk out of the room, get the PA, and have them figure it out. Yeah... here is the list of what we are supposed to remember and do in- get this- FIFTEEN MINUTES. (Well, we do pertinent review of systems and physical exam, not complete; but its still a LOT!)

Now I know why my PCP is always running late.

Ridiculous Belief and a Shining Heart

Many people are wondering why Cyd ever went to Afghanistan in the first place. They cannot understand why a person would do something they consider so dangerous, if not completely reckless. And now, because of her death, they judge it a shame that she ever went.

But I know that Cyd would much rather have spent her life, even if she'd known she were going to die, in a place like Afghanistan than somewhere easy and comfortable, only for the sake of its beauty. At times her life was extremely physically uncomfortable; but in return, she had the complete and indescribable peace of giving her life up for someone besides herself.

Its sad to me how much people can misjudge the strength and depth of a person such as herself. The service she gave to the Afghan people was, in her mind, more beautiful and valuable than any pain-free life that she could have enjoyed here in the States. Cyd experienced the 'better-ness' of giving herself up for others, rather than the emptiness that comes when we do things only for ourselves. She found this truth in the midst of obedience to Christ. There is a sweetness there that cannot be found anywhere else in the world, that none of the people who condemn her going can ever understand. Many of them are trying to find peace in other things, and failing. What a shame, that they will probably never know they might have found it in a place like Kandahar.

I have thought so much on all this, but the one thought that occurs to me every single day is this: Cyd's beautiful heart shines out to me from her death, and makes me want to be a better person. Her death spurs me on to continue learning to die to my selfish self, and give my life away to others, serving them in justice and mercy.

Lofty ideals are only lofty when we don't pull them down to earth and put them into practice. I know that I will be a better person because of her; I already am. May her life and sacrifice also inspire you to understand the better-ness, and the ridiculousness, of giving yourself away.

Aragorn Is My Middle Name

So, some of us went camping in the Wichita mountains this weekend. Some... 47 of us. It was so fun!! Here is a quick synopsis:

-We camped by a lake, across from a mountain and watched the sun and moon set and rise over it. One word: gorgeous.
-We cooked lots of food, most of it on a gigantic six foot grill that looked really impressive on fire, covered in a hundred pieces of chicken that were being simultaneously basted and turned by nine different people.
-We ran across Mount Elk like we were in the Lord of the Rings. "Come Gimli... we're gaining on them!" This was the most exhilarating run I've done.
-We had two awesome services, for Good Friday and Easter. 30 international students heard about their meaning for the first time! Pretty amazing.
-As we hiked, I jumped across two monoliths and didn't quite reach my friend's hand that was stretched out to help me across. As I was falling backward about to drop down into the crevice, he reached further and grabbed my hand. Here's to being alive, and not paralyzed!
-It was so freezing cold and windy the second night that EB got up while it was still dark and huddled in a port-a-potty until morning.
-We had everything from Nepali folk songs and Korean pop to "Ice, Ice, Baby" performed around the campfire.

To sum it up, I'd say a great time was had by all.

Cyd, Part II

One of the first things that came to my mind the day I learned Cyd was no longer alive, was the realization that not only had Cyd been killed... but someone had actually murdered her. She hadn't just been hit by a car, or gone down in a plane; another human being had chosen, at some moment in time, to commit a cold-blooded act of violence. Against her.

I have tried to imagine that Cyd died painlessly. I hope in my heart that she did. But I have imagined it, for sure. Partly because, recently in our pathophysiology class, we saw pictures of people who had received gunshot wounds to the head, and other trauma. Its very disturbing to see the face of someone who has been shot. Partly, because they are lifeless, helpless. But also because killing, as opposed to other ways of dying, forces the killed to bear the ultimate expression of hatred.

I thought about these people who took my friend's life. I tried to imagine who they were; what they looked like, what they thought of, the moment they were murdering a helpless and defenseless woman. And there was one thought that came to the surface:

I want to quit school. I want to go to Afghanistan. I want to track these people down... I want to find them, and I want to tell them something, in case she didn't get the chance:

Cyd loved them. They were the reason she went to Afghanistan- hopeless people, just like them. That her entire purpose in going there was to bring love, and light, and goodness to a dark place. That they could kill Cyd, but they could never kill what she stood for. That their hate and murder was forgiven, and that love can never be put to death.

That they can change. I want to believe that her death made a difference to them, just as her life made a difference to us. That there is a way to end this endless hatred living in their hearts. As Khaled Hosseini said in The Kite Runner, that "there is a way to be good again."

Ridiculous hope, you might say. But then, its ridiculous to move there in the first place.

Cyd

Two weeks ago, at my housechurch, we prayed that we would get some word on Cyd and her driver. Then last Tuesday, at 11:13 a.m., Ross called to let me know that sometime over the weekend, Cyd and Hadi had both been killed.

As he was saying the sentence, oh, how I wanted the last word to be different. But he was saying it too slowly and seriously for the word to have been, "freed," or "rescued,"- I knew it from the beginning. And entered a state of shock that lasted just about this whole last week. Its been a weird decision, because normally I wouldn't talk about this stuff with very many people, but I decided that I am going to post a lot about her death on here. Because I have been learning so much and its so precious to me, that I want to share who she was and what all of this has meant to me. So this will just be the first of many thoughts on this.

It was such a long day. Questions kept filling my mind.. how did Cyd die? When did she die? How do they- whoever they are- know that she is dead? Where is her body? What was the last thing she ate, drank, saw, thought, prayed?

Romans was a complete comfort to me. Particularly, chapter 6- people only die once, and then death no longer has power over them. Cyd was suffering in the month before she passed away, and evil people had control of her. But they do not any longer. I wish so much though, that I could have spoken to, or communicated with her just one last time.

Just before Ross called, I'd been praying for her. My friend EB and I are memorizing the book of Colossians. And a particularly apt verse for her had been, "May you be made strong with all the strength that comes from his glorious power, and may you be prepared to endure everything with patience, while joyfully giving thanks to the Father."

And I remembered how many times in Afghanistan, when things were just way too hard, God would bring something really good into the day, and bless you with it, and it would alleviate a lot of the pain. So, instead of my normal prayer- that she would be freed, or have a chance to escape and the courage to take it, I prayed that God would give Cyd a really good gift. Something really, really really good. And I was thinking along the lines of getting to play with a little child or getting something delicious to eat...

But instead he gave her a crown of life.

Fourteen Days and Five Tests

Here is another boring post about school. But, since its the only thing going on, its all there is for me to write about. We have fourteen school days until SPRING BREAK! And, unfortunately, five big tests in that time period. So, if you wonder what I am doing until March 14th, I will answer your question with a question. What are you doing over the break?

Other random news:

I saw my first patient in the Green Clinic last Tuesday. Her name was Lala and, she wasn't sick. So who knows what significance that may hold for the future.

Louie, Ashlie's cat who is my cat's brother, stayed with me for nine days while she went to Nicaragua. Louie was one smart little cookie... he taught Sahar all kinds of bad things. Where he learned them, I don't know. The street? Some kind of club for bad cats? Surely not the litter. Sahar didn't know any of it until he showed up. But, Ashlie came back yesterday and then he went home. And hopefully he is never coming back.

My aunt from New York came and stayed with my mom last week. I wish I'd had more time to spend with her, but still it was nice to see Aunt Julie for the time we were able to hang out. She is hilarious and told me all kinds of stories and family secrets. Now I am in the Conger Family Circle of Trust. But don't ask me about the secrets because only the people who keep the secrets stay in the circle. And I will never tell anyway, because family secrets are secrets for very good reasons.

Lunar Eclipse

A total lunar eclipse is projected to be visible with the naked eye in Oklahoma from around 9 to 9:50 tonight.

I Have Finally Done It.

The time stamp has been changed from Kabul to Central Time, a mere 15 months after returning to this time zone. Procrastinators, we are one.

Its Down to 7!

Yay! Okay, we technically have eight months until rotations left; but really its only about seven since we have three and a half weeks of vacation between now and then.

Si, Se Puede!

My biggest weakness, the one that undeniably distracts me the most from studying, was somewhat startlingly confirmed last night. I started thinking it last fall and then it was made obvious for sure last night at the Health Science Center library..

Most people that go to OU go to the stadium in Norman to see our team win, and that's where they jump up and down and scream. But apparently the library is where I go to jump up and down and scream for my team. When I accidentally screamed in the library last night reading about my favorite candidate's weekend victories I knew that there was something more powerful than a mere liking for politics going on.

Barack Obama. No one thought he had much of a chance but there is something to this man. He regularly draws crowds of 10,000 to 20,000 in every state from Nebraska to Virginia to California. He swept the primaries and caucuses this weekend... here's to hoping he sweeps the remainder of the February contests and March 4th!! If you would like insider news on what's going on in his campaign, I love Sam Graham-Felsen's blog.

Redemption: Actual People vs. Powerpoints

Well, after a pretty bad two weeks ago, this week was much better. I am feeling a thousand times better- finally got over that infection so now I have a lot of energy again. And it turns out that I didn't fail the pharmacy test; and I like school again. :)

One of the best things that has happened since school began last June happened last Thursday when I got to see my first patient. As part of our Patient Management Skills class, every six weeks we go out to either OU Children's oncology, Jim Thorpe rehab or the Veteran's Hospital to practice the complete history and physical on a patient. No one else at school was as excited as I was but I couldn't wait and it turned out that it really was a wonderful experience. I can't believe the huge difference there is between class and a clinical experience like that. It was just so fun. Most of the other students have also had a chance to pratice diagnosing and prescribing in the Green Clinic with the PA's in the Family Medicine Center but I won't get to do that for two weeks. Everyone that has been in Green Clinic has said that it is the best part of PA school. They are seeing all kinds of interesting things... so I can't wait to go either.

This too shall pass... it passed. Although we still have absolutely no word on Cyd, so keep her lifted up. Love you all!

Randomly Compiled Thoughts

1.) Still no word on Cyd... after a short freak out on Thursday night, I realized Cyd is probably fine and just locked in a room somewhere; and promptly failed my pharmacy test the next morning.

2.) This really was a weird two weeks. Two Thursdays ago, I found out I had MRSA, which means I've felt like crap ever since. Then on Friday the medicine I was taking started making me paranoid, then in real life my friend was kidnapped Saturday morning. Tuesday I went to a small group and really loved it, because they prayed for the war in Kenya and Cyd for two hours. Then after I started sending Cyd emails, so she would have them when she got home, my gmail account was locked; and then Friday it was unlocked and I failed the pharm test. How do you explain a week like that to the completely normal-looking blonde sorority girl sitting next to you in class after she just described the last episode of Nip/Tuck? Oh, how was my week? Yeah, I'll just start a conversation about the Taliban. That would be completely normal right now.

3.) Yesterday I came to a really freeing conclusion. I HATE SCHOOL. I don't have to wonder why I sometimes break out in fits of anger. I hate school and its that unadulterated despising making its way to the surface.

4.) I still really love medicine. How this works out with hating school I don't know. Most of it has to do with the last three sentences of #2 and realizing that I am there for such different reasons than many of my classmates that I can't even begin to explain it to them.

5.) I am tired of only being able to explain 2 minutes worth of emotion to 50 different people when there's an ocean inside. Holding it back ten times a day, seven days a week... I don't know how much longer this can go on. Breaking down multiple times a day doesn't seem like a very good option either. Oh, that the Lord would give me strength to do his will.

Update

Well, there's no new news on Cyd or Hadi so far. But here is a link where you can get almost daily updates from their organization.

For a Friend

Yesterday morning in Kandahar, one of my former team mates from Afghanistan was abducted as she was driven to work, along with her Afghan driver, Mohammad Hadi.

Please remember Cyd Mizell and Mr. Hadi, who has five children, in your prayers. The Taliban has not yet taken credit or made any demands. Hopefully, they will release her as they have every other woman they've ever abducted. Cyd is the first American to be kidnapped in Afghanistan since the 2001 invasion. Also remember their families and their almost-family, the Kandahar ARLDF team.

Address

Here is my new address. Don't track me down and stalk me. (Unless, you are single, tall, dark, and handsome with innocent motives.)

225 NE 1st Street
Apt 205
OKC, OK 73104

Phone number remains the same.

A New Semester Begins

Wow... the break went by way too fast. But I don't think a Christmas break was ever more enjoyed by a human being before!!! It was really a blessing to be able to move so close to school for the next two semesters. This will definitely save a lot of time, gas, and frustration. I am so happy to be settled in.

We start out 2008 with Radiology, Pharmacotherapeutics and Pathophysiology. I'm only batting 1/3 right now since I don't even know what the last two classes are so its good that we have a whole semester to find out. We also have OBGYN, neurology and nephrology (kidney). I am already afraid. BUT- have also been greatly encouraged to know that, no matter what else happens in the next 50 years... we only have ten months of CLASS left. If I can make it through the next ten months still enrolled, then I will survive to hopefully have a little more free time during rotations.

I thought a lot over the break how there are so many things that I miss getting to do during school. See family and friends, read for fun, volunteer, spend time with little people, enjoy nature on walks with friends, etc... There is a really necessary relational element built into human nature that is impossible to be content without. But this morning at church I really just understood that I only have to forego many of those things until next October, when we go out on rotations. That is really not a long time at all, when you consider the span of an entire life. So I am trying to stem the tide of depression that comes when I think about another 10 months of solitary confinement with books, lectures, forced self-discipline and staring at a computer screen. It is not going to last forever. And, we get a spring break and a two week vacation in June. Nothing to complain about when a lot of people worked in the Gulag archipelago for decades.

Such a cheery note to end on. Here's to enjoying the New Year!

Home to a Whirlwind Move

I am coming home in just a few hours. This trip has been awesome!!! Soo much fun... just what the doctor ordered. REST. I am leaving early tomorrow morning.

When I get back to Oklahoma (which I am ecstatic to hear has warm weather!), I'll be dropped off, drive to my new apartments, sign the lease, and finish moving and packing. The movers will come Thursday afternoon and hopefully the move will be completely finished by Thursday night. I am moving to Deep Deuce in Bricktown, which is just 5 minutes away from school! Yayaaayyy!!

On a more somber note, I have a lot of studying to do because we have proficiency exams for physical diagnosis the first week of school. Be praying that the move will go smoothly and the semester will start out well. I will post pictures of the Utah trip on Facebook, for some reason my computer is no longer allowing me to post pictures to blogger. Not sure what the problem is, I think it has to do with the Mac. Anyway, I'm off through another short whirlwind of change. Hopefully things will settle down a LOT come Friday!

Barack Obama WON!!

I am elated tonight that Barack Obama won the Democratic caucus in Iowa with 38% of the vote- and Hillary Clinton came out in THIRD PLACE with only 29%. He won Iowa, he can win the nomination. OBAMA '08!

I'm in Utah!

Wow- there is a reason the Olympics were held here instead of Colorado. This place is BEAUTIFUL! I went with my friends to Snowbird on New Years Eve to watch a ski parade called Torchlight. All these skiers hold red lights and ski down the mountain. After attempting to ski yesterday, I cannot imagine skiing down the mountain at night holding torches. They did a great job! Afterwards they had fireworks and we got some great pictures I will try to put up on Facebook later.

Then for New Year's Day we went to another ski resort called Brighton. Keri had never skied before either, so a friend of hers who grew up skiing went with us to teach us. She did a great job! The day before it had only been 7 degrees up on the mountain but for us it was 22 and sunny- pretty much a perfect day to learn! I was a little nervous since before coming, I asked everyone in Oklahoma who had been skiing what their first day was like. And some people had really bad experiences. I think because Keri's friend was such a great teacher and we basically got private lessons, for us it was great and so fun! I was really pleased that running the last couple years paid off and I didn't ever get tired on the mountain or feel sore today.

We are going to go back to Brighton tomorrow all day. Yay!!

Since I Am a Slave of a Certain Institution of Higher Education 11 months Out of the Year...

I am making two trips over the break. I leave Tuesday, Dec. 18th for Iowa and will be there until Sunday, Dec. 23rd. I am also going to Utah to visit Keri and Cody Dougless from Monday, Dec. 31st to Wednesday, January 9th.

Oh, The Lovely Goodness!

There is just something GOOD about working hard and being DONE. As Nacho would say, "Really good." !!

I had a long list of all the things I needed to do over the break. And the crazy thing is that I got about 60% of them done just today!! It is AMAZING what a day off will do for your stress level!!!

I also realized that means it really doesn't take that long to do all those little things that bug you and make you feel more stressed out than you really are. So, hopefully they won't contribute so much stress in the future.

The only things left I really need to do over the break are, in no particular order:

1.) Spay my cat
2.) Visit family in Iowa
3.) Write a bestseller
4.) Visit Keri and snowboard in Utah
5.) Watch the entire Lord of the Rings trilogy 3 or 4 times
6.) Memorize the complete physical exam

Yay!! Number three is in case there's a lot of spare time. Number 5 is not.

Riddle

What do the movie, "Mutiny on the Bounty" and Tara's blog, drawingontheceiling.blogspot.com, have in common?

The winner of this riddle will get a can of hominy, as soon as Summer pays up what she owes.

Updates from the Grave

I am dead to the world for the next 12 days- until school gets out on the 14th of December. But, here are some updates from the OU health science center graveyard. I mean library.

1.) I have a new kitten!!! Her name is Sehar and she is a super cute little orange tiger.

2.) I am moving to Oklahoma City!! Woo HOO! This is one I am incredibly excited about because it will mean I will save an hour of driving back and forth to Edmond every day. Since we don't go on rotations until ten months after school starts in January, this move will save me over 200 hours of driving! I will be moving into Deep Deuce on January 10th, right after I get back from Utah and before school starts.

3.) I have a new boyfriend!! Hahahaha. Just kidding.

4.) My 25th birthday is the DAY AFTER school gets out! This is going to be the best Christmas break EVER.

5.) I have to study a lot until our last final is over so please be praying for a good end to the semester! See you SOON!

Alternative Source of Reading

Things have been hectic here and, despite wildly optimistic imaginings, I don't think the last month of school is going to let up any. So instead of actually posting new information, I'm putting my old blog address up here for those who might not have known about it. It has pictures from my first trip to Afghanistan, as well as the stories of how the Afghan ESL class started in Fort Worth, life in Texas, and- of course- some really crazy dreams.

placidstreamlet.blogspot.com

Cast it into the fire!

Do you remember the scene, at the end of the third Lord of the Rings, right after Gollum has bitten the ring off Frodo's finger, fallen into the Crack of Doom, and finally destroyed the Ring? After Frodo and Sam make haste to escape from the mountain before it explodes into the fiery river of ash and lava? Do you remember what Frodo says to Sam when they reach the tiny rock that harbors them until the eagles come?

"ITS GONE. ITS DONE!"

Sitting on that rock; panting, exhausted, near collapsing, and- so darn relieved- Frodo is finally FINISHED with his impossible monstrosity of a task.

And right now, I feel just like him in that moment. Ahhh... the relief is inexpressible. But, for me it was just passing a cardiology test; I was not so fortunate as to have rid the Earth of Evil Forever today. Although apart from the Dark Lord, the Ring, and the end of the world, it was pretty much the same. Though, no one tried to bite off my fingers to take my pencil. Maybe the PA program could add that in... fifty tests, and only twenty-five pencils. Who will pass this clinical medicine test, and who will go home with just nine fingers?? Find out in Spring 2008!

I am deliriously tired and going to bed.