It. Is. A. Cat.

Have you ever taught someone to read?

Somehow, one of the things that never made my list of 'Fifty Things To Do Before I Die' was teaching someone to read. Lord only knows how it got left off the list... but now that I'm in the process of doing this very thing: man, it belongs there. Those of you with children get what I'm talking about.

I have been teaching Nasri, my Afghan friend, to read for about 12 weeks now. We have lessons every Monday night and by golly, if that woman- smart cookie that she is- isn't reading phonetically already! I can't believe how ecstatic it makes me feel to see her putting it together and figuring it all out. To see how reading opens someone's world up- Wow! Its a speechless feeling!

I have been thinking back; when did I learn to read? Its hard to remember exactly, but I do have a few vivid memories of my Dad and I, nestled in the big blue recliner in our living room, sounding out big words in Larry Niven books. I am so grateful to my parents for the many ways they opened up my world.

So if you're listening, my two cents on the matter: Find someone who doesn't know how to read and... teach them!

(If you're having trouble finding someone, I know a whole apartment complex full of refugees who could use your help!!)

Humans and Hospitals

A few observations about humans and hospitals...

Overseas, I was saddened and sickened by the care people received in hospitals. Mirwais Hospital, where I observed for a few days in 2006 still remains one of the worst memories of my entire life. Two separate but distinct events- one in which a baby was killed out of ignorance, and another in which a nomad woman giving birth was treated (literally) like an animal- cemented in my mind that if I got sick in Afghanistan, the hospital was the LAST place I was going to go.

I am beginning to think the only difference in Mirwais and hospitals here in the US might be blank checks. In the last 2 years, I have seen little kids come to the hospital and die, almost die, loose some brain function or become brain dead because of 1) first and foremost, their disease process and 2) mistakes doctors and other health care personnel made while trying to save them.

Maybe this is so real to me because once as a student, I made a huge mistake during a code, too. Luckily someone else caught my mistake, and fixed it. I had to try to remember for a long time that you can't kill someone during a code; they are already dead. Whatever you are doing can only possibly bring them back to life, Lord willing that they live.

It seems to me that the problem with hospitals is not always the amount of education instilled in their workers or the resources available to them, but the simple fact that they are run by humans. Human people; regular, imperfect, mistake-making people.

Would those children have died or been seriously hurt if nothing had been done by medical people? Some yes and some no. I can guarantee you that EVERY doctor has made mistakes. Its up to chance and fate whether those mistakes cost someone their life.

I don't know how many parents I have seen get angry with the doctors... but I don't hear any of them jumping to let us know what dose of dopamine they think we should have given their child to maintain the correct mean arterial pressure. Its easy to get frustrated when you aren't the one doing the procedure or prescribing the medicines. Of course it would be wonderful to have the best of the best, but don't forget that medical caregivers are just people. They forget things. And having an expectation that you or your child will receive perfect care and be fixed on demand is a little too lofty an ideal for such a fallen race as humankind. I guess my only thought is that if you don't want any mistakes made, you should try to find a hospital run by another species.

A Bike Is A Beautiful Thing

I bought a bike, about seven years ago. Back in the days of the college ministry house, when International students ruled the scene and Evie and I spent many late nights deep in the throes of Guitar Hero. Ahh... sometimes I long for those days again.

However, upon graduating from college and moving to Texas, I lent the bike to my dear, dear Japanese friend Eriko. Now honestly, I realized upon giving it to her and moving to a different state that it was probably the last time I'd ever see that bike again. Eriko later returned to Japan and gave the bike back to the Ministry House, in whose garage the bike dwelt long after I had completely forgotten about its existence.

Then sometime not too long ago, I heard there had been a giant garage sale at the Ministry House; I remembered the bike but also saw there was little chance of recovery; and thus, decided against attempting to hunt down my former wheels. So, true to my womanly intuition, since that day I have seen neither head nor tails of the little blue bike.

Enter the present day: Something suddenly motivated me, two weeks ago Saturday, to ask my Dad to take me and his bike rack to Wal-Mart to buy a bike. (I think it was realizing that moving out meant I could no longer borrow Ashlie's bike.) Anyway, we spent about thirty minutes looking and finally decided on one, the color of which I was not really all that thrilled about: Purple. Ugh. Anyway... most of the bikes were on sale but when we got up to the counter, the lady rang it up and I realized this was like, the only bike in Wal-Mart NOT on sale that day. So, we went all the way back to the back of the store to look again.

Suddenly, waaaaaaaay up on the top rack I noticed another 26" bike (all the girly ones were 24"- too short). An orange bike, no less. That had not really crossed my mind but when we got it down, I was really starting to warm up to its sanguine nature. (Anything is better than purple, right?) A few minutes later and we were back at the counter, ringing it up: $88! Yep, it was also one of the cheapest mountain bikes in store. And, I am convinced, the coolest as well. Not too shabby...

After getting this bike home, I started going on rides and realized, I love this bike. I love to bike. Basically, if you have been a runner for any length of time and then switch to biking, you will be hooked because biking is so inherently easier for the distance you can cover. (Not that I'm switching, mind you...) If it were not 95 degrees all summer and I did not work 14 miles away on a highway, I would bike everywhere.

I.
Love.
Biking.

So, long post but: The Orange Bike Rules. I think I see a duathalon in the future. More about that line of thought to come.

Moving, Again.. But for the last time for the foreseeable future PTL.

What a huge bum I have been updating the blog this year. However, I vow now to keep it up a little more this summer! Don't expect a lot but I will now try to write every other week or so (cross my fingers...)

***UPDATES***

#1.) I moved! Am moving. Are in the process of said move. Still moving, get it? However one can only lift heavy things for so long before needing a break, hence the blogging! And for all you lovers out there...

157 Stonebridge Blvd. Apt #1518
Edmond, OK 73013

Sound familiar? That's because I've been there before. These are the same apartments I lived in at the very beginning of PA school. Come visit me! I'll be living alone all summer until a friend from Children's moves in with me in the beginning of August.

#2.) My mom had a heart cath that showed the pressure in her lungs is NORMAL, PRAISE THE LORD!! We were very worried that she had high enough pressure to merit intense therapy or even lung transplant, thank God he has healed her pressures from what the ECHO showed last December. So exciting for us!

#3.) I no longer live with two cats that made my house dirty for a year. Now I only have one sweet little short haired cat (although who can say if a kitten is in the future or not?). Amen.

#4.) The last few months have seemed like a blur. Write some chemo. Clean the bathroom. Make little sausage and cheese balls. Suture someone's finger at a baby shower after an accidental near-amputation. (Can't believe I even remembered how to suture, actually.) Climb some rocks. Read My Sister's Keeper (unbelievable, if you ask me, but then I'm used to non-fiction). Kiss Larry. Run in the rain. Vacuum the car. Zumba, zumba. Dream about multiple kidnappings and murder (weird). Talk about going to Haiti this summer. Put on clean warm socks and curl up in bed. Listen to Nasri read syllables phonetically, in amazement- smart girl.

#5.) I have so much unpacking and cleaning left to do. More updates soon. Peace out!

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!