Estoy sin disfraz.

I had the opportunity to go for procurement of organs last night. Donor patient was a dcd donor; much more rare than the typical brain dead donor. (dcd = donation after cardiac death)
Really great educational experience for myself came more from the surrounding conditions involved in handling a dcd donor rather than the actual anatomy in harvesting organs.
Us, the surgeons, were not permitted to even see family members let alone be in the same room as them. All things considered, with respect, it's better that way. Once the donor is taken off life support every second is counted.  Certain organs can only handle a certain amount of ischemic time. In this particular case we were going to be procuring the kidneys, which in New York, legally permits up to 60 minutes of warm ischemic time. The Attending I was with didn't think we'd be able to get the kidneys. But the donor went into asystole at around 45 min after withdrawal of care and 5 minutes later to the exact second skin was opened. Kidneys were out, skin was closed, and we were on our way home again about 60 minutes later.

Once I finally made it back to the hospital I grabbed my bag, excitedly told my colleagues in the trauma bay about the experience then headed over to a friends house for some pumpkin cake before heading home!

I only stayed for an hour (a.k.a. only paid for an hour of parking). Then complimented Dzeba once more on her cake/thanked her and headed home.

On the way home at 1am, to my own chagrin, I found myself in line for a spot police check. My story of 'got off work then went to a friend's house' didn't sound good. My red eyes and tired smile didn't look good. And I knew that if asked...I'd have trouble walking in a straight line, also not good. But I just honestly told the officer I hadn't had any alcohol and he waved me along.

There's something that I've been puzzling over the past couple weeks. What makes someone want to be a police officer?  Not really sure why I first started pondering the subject, but not having any officer friends myself I've no source of an answer, and therefore have continued to ponder. And last night just made me wonder all the more.

God makes all kinds!

Much Love.

Estoy festejando tres décadas.

Google wished me a Happy Birthday today.

 Turned 30 today. Completed 30 years of living. Pretty cool stuff.

I told a co-resident that yesterday to which she responded, "Thirty?! What?!, No way! You still look like you could be a star in High School Musical!!"  

Well, should I stand next to a high schooler it is easy to see how wrong that is, but the idea behind her comment was appreciated! ;)

Either way, whether I look it or not, I don't feel like I'm 30.  Although I've never chronologically been 30 before so I suppose this could be exactly what 30 is supposed to feel like.

I feel like time passes too quickly. I'm starting to feel like I'm running out of time, and there's still so much work to do. So I don't often allow myself to look beyond tomorrow.  Once in awhile a week or so, but only for special reasons (like trying to figure out when I'll next be able to go to church!).

I feel like I am incredibly rich in relationships. I think of the friends God has blessed me with over the years and I swell with pride. I think of those that have come into my life from all over this wonderful world even for a short time and I'm so thankful for each one.

 

I feel like this world, although it continues to Amaze me, has ceased to Surprise me. The horrors. The disgusting. The evil. The miraculous. The beautiful. and the good. It's amazing how they all exist and thrive among humanity all individually and yet sometimes all together.

 

I feel like one day it will all make perfect sense. When I see Jesus. And until that time as long as he's with me, then that's sense enough for me.  

 I feel like I'm tired. 

 

But join me yet in dancing to my birthday song!

Much Love.

(all photos taken today. October 16, 2015)

Estoy disfrutando este día de otoño.

 I let myself sleep until I woke up on my own. My covers weren't even wrinkled when I finally stirred from beneath to make myself some coffee. Looking in the mirror I could see the left side of my face was smashed. Even my eyelid was indented from lying in one place for so long. Coffee made, I grabbed the cup and took it back to bed with me. I propped myself up half under the covers and slowly enjoyed my coffee while reading in bed. It's the best part of a day off. Waking up without an alarm and then reading in bed with coffee.

I went for a run today. Hadn't done so in over a month, and within a quarter mile could feel the muscles of my legs switching form aerobic metabolism into anaerobic metabolism. But I kept going; it was my day off and therefore could pace myself as slow as needed. Ground was still wet from the rain yesterday so was going to bypass the park, but at the last second turned into the trail anyways.  It was worth it. The October sun. The clear air. The colored leaves starting to dot the trail and intermingle with the green of the trees. Even the mud was just the right amount!

I went on some errands to keep myself outside.  The majority I didn't necessarily need to actually complete, but I was just looking for excuses to stay outside as long as possible. I thought about buying a pumpkin, but realistically knew that it would stay sitting by my door probably until covered by snow and I'd forget it was there. Revealed anew in the spring after the snow melts away I'd finally dispose of it my head hung in shame at how poorly I take care of my decorations. So to save myself the inevitable shame I passed the pumpkins resisting the urge.

It's hard to explain the renewal one feels from having a day like today. A moment to sleep. A moment to relax and just be thankful. Thankful for today if nothing else.

I pray God has blessed your Fall day as beautifully as he blessed mine.

Much Love.

Estoy llevando dos localizadores.

I have often run into the general assumption that the use of pagers, or beepers, is antiquated, out-of-date and no longer used. Unfortunately they are still very much used in the hospital setting. We, general surgery residents, at WMC each carries his/her own beeper. There are then trauma beepers for those designated as trauma responders for the shift. And then there is one more.

There is the 0298.

Designated as the consult/critical value pager, it ends up being the catch-all of surgery pager. The 0298 is it's own rotation. A single resident is assigned this pager for the month rotation. And that's all they do, carry the 0298. No OR time for the duration of the rotation, as you have to be able to respond to pages as immediately as possible. I held the 0298 for the 1st time October 1. The consult resident for the month was post-call that day, so couldn't stay and therefore on my first day back on Vascular I was also honorary consult resident. I got a couple of comments about how I was "growing up" carrying it for my first time. As if its some sort of right-of-passage for a junior resident. In a way, it does carry a huge responsibility. Whoever carries the 0298 is in constant contact with the rest of the hospital. While everyone else is in the OR, he/she is out and talking with other services, answering questions, and putting out fires (not in a literal sense). It also carries with it the general understanding that whichever resident is carrying it will be able to discern between emergent and non-emergent and respond appropriately.

It is the month during which a resident carries the 0298 that is notorious for turning a gentle, kind and smiling soul into something close to resembling The Hulk! I won't go into details as to how and why, but it has a lot to do with 1) politics and 2) the general culture existing among all levels of staff/faculty at WMC that says 'well...that's not my job!'

I survived the day with only some difficulty, most of which was from the fact that I was trying to be both a vascular resident as well as the consult resident. Finished my last note before the clock struck 9pm and clicked save with a happy yessssssssssss (which rhymes with successsssssssssss) making the med student studying next to me laugh.

Much Love.

Estoy orando.

I had a plan this morning.  Why did I have a plan?  I really can't remember why I had thought that would be a good idea. Cannot honestly provide a reason for making a plan for my day other than momentary lapse in judgement.  As I'm sure you've assumed, the day turned out nothing like the aforementioned "plan." The fact that I'm writing on 10/1/15 is the perfect ending to such a day, as I had wanted to be writing on 9/30/15.

It just wasn't a good day... I mean it was a fine day. I was in the OR all day. But my chief was post-call and my intern (Adi) had to cover my other case as I was in an emergency case and therefore our team had no one on the floor. And it was our last day on service. So both Adi and I get out of the OR late, and back on the floor again even later and try to wade through the mess that had accumulated throughout the day in our absence. Takes extra time to get the service tee'd up to be handed off to the incoming team.  And then even extra time to receive sign out of our new service.  Both Adi and I are going to Vascular for the month of October. We had a quick Vascular team meeting in the trauma bay before finally heading home for the night. Hearing from our new chief and her expectations for the month. I was "punished" three times already and the month technically hasn't even started yet.

Much Love,