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.