Estoy quemando el aceite de la noche.

I seem to be getting less and less sleep.  At the same time my desire to get more sleep seems to be diminishing in perfect inverse proportions.  I stay awake at night and do things like blog post!! ;)  However, a good thing about working days is that it's basically guaranteed to be too busy.  I assume therefore that I  can rely on the resultant excessive release of catecholamines to fuel me through each day and hence....I just gave up trying to get to bed on time.


Today was my last day for the month.  Pretty cool!  I can officially say I made it through my first rotation! And with perfect timing, I was able to finally discharge two of my patients today as well.  They were two traumatic brain injury patients that have been in the TICU with me for almost the entire month. And today they both got picked up and left; ready for the next stage of their recovery in acute rehab.  I got to hug their families as send off, but at the same time it kind of felt like my own send off.  It was a good time, the ICU. :) I'll be back there for another rotation before long!

For now, I'm moving to Bridgeport, CT. I have a general surgery rotation at St. Vincent's Hospital in Bridgeport, which is over an hour away from me.  And considering I often struggle with a 20 min commute....longer is just not really a smart move.  So I therefore will be paying rent x 2.  Money wise very inefficient.  But time wise very efficient.  Time costs more than money in this instance.

Much Love.

Estoy trabajando.

Went into the City today.  The 5th World Congress of IFHNOS* and Annual Meeting of the AHNS** is underway at the Marriott Marquis Times Square.  The research that I've been working on with Adam Luginbuhl from Philadelphia was accepted for a poster presentation at the Congress.  So I got permission to attend just the one day and Adam sponsored me!  I have sooooo much to pay forward some day!

Our research: Management of the External Auditory Canal in Free Flap Reconstruction of Total Auriculectomy Defects.

We were a little more than halfway through the day and I received a message from the research coordinator back at Westchester.  Deadlines are too quickly approaching and my help was needed.  So the day in the City ended prematurely.  Caught the next train back up North and drove in to the hospital.  Spent a couple hours working until Marini told me to go home.  I think I would have preferred to just stay and get more done, but acknowledging the risk of being unnecessarily excessive I did call it quits for the night.

Much Love.

*International Federation of Head and Neck Oncologic Societies
**American Head and Neck Society

Estoy responsable.

I got home from the hospital this morning and decided I'd fix myself a cup of coffee.  Try to blaze on through the day as it's time to switch back to days again; better that I sleep tonight rather than right now.

And now I sit down to say that residency.......is everything that you've ever heard. It's all true.  All of which I knew before.  I knew it to be true before.  But there is one thing that is never factored in when it's talked about.  Although it is possible, that I choose to ignore it.  I stuffed it in the back of my brain and choose to leave it there.  It's the responsibility.  Everything I do at the hospital leaves a mark.  My every action can be tracked.  My every action IS tracked.  They need to know who is responsible.  They need to know who to blame.  I never factored in dealing with the responsibility.

That, however, is not the reason for my lack of relating any anecdotes of my days/nights....at the hospital. It is, instead, my inexperience preventing me from categorizing what is happening.  What should I laugh at? What I should be upset about? How do I move on from this or that?  Really, just how do I deal? And then extrapolating from that....deducing what gets to be posted to the world wide web.

A week ago, Friday night, two of my co-interns (Bravo and Dzeba) and I got together after work.  The three of us kind of hit it off during orientation.  In a way, I think we already knew at that point that we would need each other.  Friday night was the first time we'd made the effort to hang out since residency started.  We sat in Dzeba's living room until about 4am talking.  VENTING. Not out of a desire to be malicious and not to complain.  But venting to release.  And this is going to sound very dramatic, but in a way, venting to survive. (In the book, The House of God, one of the interns tries to handle it alone.  He jumps off the roof of the hospital.)

Now.  After I've said that.  How do I end on a brighter note? :)

It's amazing.  It all is.  I am incredibly humbled that I get to be doing this.  I know that no matter what faces me this year, there is a source of Love that is greater than it all.  A Love unending and offered freely to me.  On which I can rely eliminating the need to rely on myself alone.  I just can't stop smiling sometimes.  I can even get the grumpiest nurse to smile back....sometimes.  She's NOTORIOUSLY grumpy. ;)

Much Love.

P.S. I know I referred to The House of God.  I am in no way endorsing that book.  It's an awful book.

Estoy buscando ritmo.

The switch back to working days wasn't as smooth as I had hoped, but have transitioned nonetheless. As with working nights and days anywhere, there's pros and cons to both.  Haven't decided yet if I actually prefer one or the other. 

For me, this switching back and forth, is proving to be the roughest part about the ICU rotation.  It prevents one from developing any sort of rhythm to their life.  Sleep when you can.  Eat when you finally realize your blood sugar has dropped. Make sure you've found time to study. Have to study. For the past two weeks I've been looking for rhythm in all of this.  A way to tell breakfast from supper.  A way to tell Sunday from Tuesday.  I've most recently been thinking, "next rotation.  after the ICU, I'll figure it out."  And I'm just being delusional with that thinking.  The next rotation won't be any different, and before long I'll be back in the ICU for another rotation.  So I've decided to stop.  Stop looking for this nonexistent rhythm. 

Instead, simply praise God each time I get to go to work again.  Thank God for each new opportunity to learn.  Thank Him for the rest when it comes.

For even if I can't feel a rhythm, the sun is still rising and setting.  The minutes loyally follow one after another.  And through it all my heart beats its own rhythm of life.  So maybe if I can stop looking for the sort of rhythm created by humanity, I can instead find the rhythm originally created by the Creator.

Maybe......
For now, I'll just work on letting go of my desire for a socially dictated sort of rhythm.

Much Love.

Estoy patinando.

The healthcare at the hospital which I work is dictated by politics (and very little with the actual patient), and as such is riddled with horrible inefficiency.  A fact I was not unaware of prior to starting residency.  But does not change the frustration that accompanies such inefficiency.

I make that statement specifically so that I can make myself aware of the situation. And therefore acknowledge my need to approach this with prayer for recognition of my frustration in real time allowing me to learn from such situations as they arise. Otherwise, I can recognize the danger of my own unrecognized frustration.  It can very quickly turn me into the kind of person I don't want to be.

Just came off the last of my nights.  Will switch to days tomorrow, meaning.....I get to sleep tonight!  Pretty pumped!  By the end of the week I had adjusted fairly well to working through the night.  We'll see how the switch goes.

Much Love.

Estoy tomando té.

Rough night.  Traumas were overflowing the TICU.  The guy with a bullet in his brain was of the least of our worries.

In med school I was told that a temp of 105 was really incompatible with life.  I saw a 107.9 last night.  I didn't know a body temperature could get that high!!!

By the time the fire alarm went off and firemen showed up to investigate (electronic misfire of the alarm).  We could only laugh about the irony of the timing.  If something could go wrong it did.

Much Love.

Estoy aprendiendo ser nocturna.

After my first day there was a schedule change.  I was moved to nights.  Unfortunately for the past nights and again tonight there is no fellow scheduled for the night shift, so my chain of command goes first to a chief resident and then the attending.  But for all appearances I'm alone in the TICU all night.  I find it rather annoying because I'm at the stage where I have questions about everything.  Why and how questions. And you can't bother the chief, let alone the attending for a why question in the middle of the night.  Tonight the other resident for the other half of the TICU is going to be a surgery second year and seems willing to answer those types of questions so I'm hoping to make use of that!!  I'm a bit worried what I'm going to find when I get there this evening. As I signed out to the anesthesia resident rotating in the TICU this morning, he could not have been any less interested.  And at the end when I asked if he had any questions the only thing he came up with was, "Yeah, can you stay?......So I can go?"  To top it off the nurses, the other TICU residents even family members of the patients have complained about him.  I'm sure everything is going to be fine.  The nurses are all amazingly self-sufficient, that I'm confident even a dead-beat of a resident can be trouble-shot and overcome.  Forgive me. That was harsh....let's just go with lazy, a lazy resident.  Either way, it still makes me uncomfortable, the feeling that I don't trust him.

My nephew, Lincoln Grey Blunier, was born Wednesday, July 2. 

Aunt Christy love you Lincoln.

Much Love.

Estoy cansada.

One of the new ortho residents has started his first rotation in the ICU with me.  At the end of today, when we gathered to sign out our patients to those coming on for the night...

Me:  Hey.
Ortho: Hey.  How was it?
Me: ....It was good.  How about you?
Ortho: Yeah, it was good......(long pause).......fun.
Me: mmmmmm, I wouldn't quite call it fun.
Ortho: No. No it was not fun.

As I left the hospital tonight, I walked out to the car appreciating the warm summer evening. And I realized, that this is going to be loong.

So Jesus and I rode home with the windows down and singing at the top of our lungs. Because long doesn't matter where time doesn't exist.

Psalm 113:3 From the rising of the sun unto the going down of the same the Lord's name is to be praised.

Much Love.