Estoy en Jehovahjireh

I read in Genesis 22 this morning. Someone mentioned it to me earlier this year, and in an odd way, I believe I finally am understanding the parallel they were mentioning.

Genesis 22
2. And he said, Take now they son...and offer him there for a burnt offering
3. And Abraham rose up early in the morning... and Isaac his son... and went unto the place of which God had told him.
7. And Isaac spake unto Abraham his father, and said, My father: and he said, Here am I, my son. And he said, Behold the fire and the wood: but where is the lamb for a burnt offering?
8. And Abraham said, My son, God will provide himself a lamb for a burnt offering
10 And Abraham stretched forth his hand, and took the knife to slay his son.
11. And the angel of the Lord called unto him out of heaven, and said, Abraham, Abraham: and he said, Here am I.
13. And Abraham lifted up his eyes, and looked, and behold behind him a ram caught in a thicket by his horns:
14. And Abraham called the name of that place Jehovahjireh

I am in a "Jehovahjireh". A place provided completely and entirely by God.

The Lord has blessed my in uncountable ways, and at times I start to get anxious thinking about it. Even as is, it would take more than this one lifetime I am allotted to pay it back. I struggle with the years that yet lay out before me. I sometimes look at those years as holding me back, and in impatience I turn to Jesus and ask, "why can't I just GO?"  But even asking it, I know full well that it is merely Satan trying to sow his small seeds of discontent.

This moment. This place. I am in Jehovahjireh. And I will go. Or I will stay. As my Lord wills.

Wishes for a Blessed New Year to everyone.
Much Love.

Estoy viva y próspera

I drove in later than usual to work today. I left early expecting the rush hour traffic at the later hour. To my surprise, there was very slim traffic. Thinking about it during my drive, I guess I shouldn't have been surprised. Most have taken the holiday week off of work. I'm thankful to have had a nice weekend. I'm also thankful to have a job to return to, plus... we finally got to operate on the wrist of our dingbat of a patient!! The saga finally comes to a close. :)

On Christmas Eve, I had the opportunity to attend the wedding of a co-worker. 

Adi married Ana!

 Adi, Ana and myself

 Adi waves to me from under the veil while wedding guests throw blessings (rose petals) on the married couple.

 

After the wedding with some of my co-workers. (L to R: me, Min Li, Matt (and girlfriend Lindsey), Erwin (and wife Nadine), Arpit (one of my chiefs from two years ago), and Ash (one of my co-interns)

After the wedding, I drove up to Connecticut for Christmas. I was blessed to be able to spend the weekend with John and Maureen Virkler and their family.

 Silent Night

I had learned just before leaving for the weekend, that the 26th was an OR holiday (Christmas observed). Meaning no cases for us. I wanted to take the opportunity to go into the city, drink a cup of coffee, take a selfie and see the lights. When the Virklers mentioned they had the same thought, they let me tag along!

Amanda V. and little Kenzie, not quite tall enough yet.

I got my cup of coffee at the Christmas Village in Bryant Park.

Grabbed my selfie by the Christmas Tree in Bryant Park as well.

 

 After an adventure through Greenwich Village, with more coffee involved, we found our way to the Spotted Pig.

 And after the Spotted Pig, caught the Subway back to MidTown for the lights!

 Trip complete!

Me, Kenzie and Amanda V

(Little Miss Kenzie was a Rockstar the whole day, we had fun spoiling her!)

  

They had made fun of me for the first selfie, so were willing to help me with a redo at the Rockefeller Center Christmas Tree! (L to R: Kenzie, me, Amanda V., Maureen, John)

 

Thank you NYC! You never disappoint!

Merry Christmas and Happy Holidays!

Much Love.

Estoy relajando antes de las festividades.

"It's Christmas Eve Eve!" ~Eloise (from Eloise at Christmastime)

Last night, I drove into White Plains after getting off work to drop some keys off for a co-worker. On the phone, her voice was so choked with guilt it sounded as if she was about to cry. Her family is visiting for the holiday, and knowing that, her co-workers have gifted her with a three day weekend. She had not asked for it, and knowing how much others will have to work to cover for her, she was having a hard time accepting the gift.

I very quickly put an end to her qualms about accepting the three day Christmas weekend. We are, after all, surgery residents and pulling together and covering for each other is what we do. She will have ample opportunity to pay it forward and pay it back. A part of me was saddened to see that residency creates in us an almost inability to accept more than a "golden weekend" (saturday and sunday) once a every couple of months, if we're lucky. But an even greater part of me was really happy to see how our small family of surgery residents takes care of each other.

I, myself, was able to spend Christmas Eve Eve at home as well. I was able to wake up and read/study for 5 straight hours before even getting out of bed!  I've had a Pandora Christmas station playing all day long, and even after putting down my books, was able to maintain the productivity. Cleaned the nooks and crannies!

I found the tin of Jacques Torres Wicked Hot Chocolate mix that my sister had bought long ago during her visit. Perhaps I could go buy some milk and make the Christmas Eve Eve extra special! Opened it. It still looked good. So then decided to shake it in an effort to mix up the separated layers. Two seconds later I had a cloud of chocolate dust settling all over my apartment. Christmas Eve Eve extra extra special!  On a brighter note, it made my apartment, previously smelling like bleach, smelling like chocolate instead. So after cleaning again, I went and got the milk anyways. There was about 1/2 cup of mix left, and figured I'd better use it quick before it had a chance to fly away from me as well. Christmas Eve Eve extra extra extra special! ;)

On a follow-up note from work,
1) The kid with the machete to his wrist injury showed up back in the ED again. So we booked him again. Super excited, as we had a second chance to do his repair surgery. We waited for the day with anticipation. We even called his mom the day before to make sure she was going to make him come. (It was his mom that got him to show up back in the ED again). Aaaaaaand (drum roll....) He didn't show up.
Well, to be completely honest, he showed up 5hours late. My Attending confronted him. He's going to give him a third chance. This kid is lucky. Many Attendings would have signed off on him after the first time. The kid is also a dingbat. Even with repair and months of hand therapy, at this point, full return of function to his hand is highly unlikely.
2) I got to operate on the twins again! Only this time from a plastic surgery perspective. Talk about continuity of care! :) They are growing so big!! It's so fun to watch them grow and develop. They don't go anywhere without their fuzzy pink blanket. I say, it must be a magical blanket. One of the twins can be crying, give her the blanket, and she's instantly calmed down and quiet. It's pretty cute. They're moving up the separation to next month. I'm going to have to find a way to get in that OR, you know, for continuity of care! ;)

Much Love.

Estoy disfrutando aprender cosas nuevas.

Did you know that there are eight layers to the eyelid? I learned that this past week. I learned it in preparation for a surgery in which I dissected through one layer at a time to arrive at a dermoid cyst at the corner of a boy's eye. I'm sure I completed the surgery much slower than necessary, but doing delicate surgery with your Attending watching your every more saying, "Don't mess it up! Don't mess it up!  Don't pop the cyst!" (Of course, not in such politically correct terms ;) Well, I imagine that would slow anyone down.
I've never really liked working so close to the eye before, always felt like a wrong twitch the patient made, or I made and we'd somehow end up with a needle in the eyeball. But I learned that it doesn't have to be like that. If you understand the tissue you are working with, and respect the tissue you are working with, then it will return the favor to you.

I had a really good case lined up for this past Thursday. I had just gotten into bed Wednesday night when the long range plastics pager went off. I groaned to see that it was the ED. I was soooo tired, had close to zero desire to go in to work. But I knew there was no way around it. A kid had cut through all of the extensor tendons of his hand with a machete. Perhaps not an emergency, but at the same time unable to be ignored, and so I got dressed and went in. Cleaned the kid up and put him in a splint which kept his hand in extension and then scheduled him for the following day for tendon repair. Having crossed all the T's and dotted all the I's I headed home again and finally got some sleep excited for a nice case the following day. Unfortunately we start our day to discover our patient had walked out at 2am!!! Nooooooo! We tried calling the patient and his parents but without luck. He has every right to walk out against medical advice, but I just want to know why?! A couple theory's could be that he was coming due for his next fix, or perhaps he already knew another surgeon he preferred. But for whatever reason, I do hope that he gets some sort of help... before he permanently looses function of his hand.

Much Love.

Estoy extrañando a mis sobrinos.

We made it happen! I turned in all my favors and secured a three day weekend without call! I bought a ticket and spent every single second with my family in Illinois celebrating Christmas and the fact that we were all together! The weather in Chicago delayed my flight home bringing me into NYC after the trains had already stopped. But, it is NYC afterall and an uber is never no more than 5 minutes away, so I got home eventually leaving just enough time for a quick nap before prepping for my 07:30 presentation this morning. I was so tired that I think I left out about half of what I had wanted to say, but then again I don't really remember. All I know is that it was so totally worth it!

Every single picture makes me gush about my nephews and I want to show you and have you agree with me that I have the cutest nephews ever. But I know there is a line, even if I can't see it, a line exists between acceptable and excessive amount of bragging about my nephews. Therefore, I will reign it in, and apologize if unsuccessful in my attempt.

 Peter Bear and Little Lincoln

Miles Austin keeping tabs on everyone!

Cute little sparkly red nose reindeer face painting at the neighborhood Christmas party!

 Little Lincoln makes an absolutely adorable elf with his spectacles falling down his nose!

Fireman Peter out to rescue the good guys!

 

 

Police officer Lincoln out to catch the bad guys!

Who ever said a police officer can't have swag?

Amazing how little boys automatically know how to be a super hero!

 It's a bird...  It's a plane...

...It's a little boy all ready for his Sunday School Christmas program!

(Heart squeeze)

 Merry Christmas 2016

Much Love.

Estoy practicando cirugía plástica.

Plastic and Reconstructive Surgery.
I wasn't but one hour into my first day of the rotation December 1st, and had come to the conclusion that I can not be a Plastic Surgeon.
Not that I had ever really seriously considered it, but at the same time could not deny that I liked the reconstructive stuff, the creativity required to make something look pretty again.
But alas, without going into detail, I shall not be a Plastic surgeon.
That being said... this month is proving to be absolutely amazing! I am loving the surgeries. Seeing the surgeries. Discussing the surgeries. Doing the surgeries. All of the above.

At Westchester, Plastics alternates taking hand consults with orthopedics. And then it alternates taking facial trauma consults with ENT surgery and OMFS (oxillo maxillofacial surgery). This past weekend it so happened that Plastics was taking both Hand and Face call simultaneously. And it so happened that I was first call for Plastics Friday, Saturday and Sunday.

Now, my basic understanding of both hand and face consists of simple anatomy and physiology that I learned back in med school. Which translates into... I know nothing. I am doing my best to learn fast. The weekend was intense. Two of the three nights I didn't get home until 3am. and even home I'm still on call. No chance of a nights rest because the pager goes off multiple times. Gave me a little bit of appreciation for being a resident, and that when I go home, I can be all there.

I am having so much fun though. I got to reduce my first broken nose. A guy got his finger caught in a wood chopper, and I got to piece it back together. A man had the palm of his hand completely in full-thickness avulsion, and I got to put it back on. A girl's face was attacked by a pit bull, and I got to make it looking like a face once again. And then a whole slew of smaller things in between.

Thankfully, they don't leave me on Plastics first call by myself. I have a fellow back up if I need it. Most of the time I could just text my plan for their approval or their advice.

There's so many things I want to see yet before the month is past. Certain special plastics closure would be so helpful to have in my bag of tricks, and then of course things like reducing broken noses or dislocated fingers as well!  We'll see how it goes!

Much Love.

Estoy agradecida.

I was blessed to be able to be with friends and family for Thanksgiving this year. It was the type of thanksgiving where everyone was invited and then brought their turkeys along with. It makes for a home brimming with life... and turkey. But no one minded, and we just got to eat that much more turkey!

 Ezra Elizabeth turned One on Thanksgiving Day. She is full of kisses, tasty "mmmm's" and smiles. She loves doggies and kitties, but only at safe distances. There's no one she is not willing to love... eyebrows and all! :) Made Thanksgiving that much sweeter to get to love on this little sweet pea a little.

Pie for Thanksgiving.

I got to be with the Viens for Thanksgiving this year. I was looking forward to it. Since Bekah moved out over a year ago I have not stayed there as much as I did when first moving out East. It kind of gave me a feeling of "Home for the Holidays" to get to return after many months. It was also really fun to leave work Wednesday night and tell everyone "Happy Thanksgiving" as I skipped out the door. When you have no change in your work schedule it seems an almost futile sentiment, but with plans for the holiday you can really sense and share the excitement.

So for the next three years at least, I'm sure to be working on Thanksgiving. That being said, I did my best to eat enough turkey this year to last.
Blessings everyone,
Much Love.

Estoy siendo refinada con fuego.

Wood firing of the Kiln at Muddy Brook Potters! November 19, 2016.
Daniel 3: 9-29 

  They spake and said to the king Nebuchadnezzar, O king, live for ever.
¹⁰ Thou, O king, hast made a decree, that every man that shall hear the sound of the cornet, flute, harp, sackbut, psaltery, and dulcimer, and all kinds of musick, shall fall down and worship the golden image:
¹¹ And whoso falleth not down and worshippeth, that he should be cast into the midst of a burning fiery furnace.

 ¹² There are certain Jews whom thou hast set over the affairs of the province of Babylon, Shadrach, Meshach, and Abednego; these men, O king, have not regarded thee: they serve not thy gods, nor worship the golden image which thou hast set up.

 ¹³ Then Nebuchadnezzar in his rage and fury commanded to bring Shadrach, Meshach, and Abednego. Then they brought these men before the king.
¹⁴ Nebuchadnezzar spake and said unto them, Is it true, O Shadrach, Meshach, and Abednego, do not ye serve my gods, nor worship the golden image which I have set up?
¹⁵ Now if ye be ready that at what time ye hear the sound of the cornet, flute, harp, sackbut, psaltery, and dulcimer, and all kinds of musick, ye fall down and worship the image which I have made; well: but if ye worship not, ye shall be cast the same hour into the midst of a burning fiery furnace; and who is that God that shall deliver you out of my hands?

¹⁶ Shadrach, Meshach, and Abednego, answered and said to the king, O Nebuchadnezzar, we are not careful to answer thee in this matter.
¹⁷ If it be so, our God whom we serve is able to deliver us from the burning fiery furnace, and he will deliver us out of thine hand, O king.
¹⁸ But if not, be it known unto thee, O king, that we will not serve thy gods, nor worship the golden image which thou hast set up.

¹⁹ Then was Nebuchadnezzar full of fury, and the form of his visage was changed against Shadrach, Meshach, and Abednego: therefore he spake, and commanded that they should heat the furnace one seven times more than it was wont to be heated.
²⁰ And he commanded the most mighty men that were in his army to bind Shadrach, Meshach, and Abednego, and to cast them into the burning fiery furnace.
²¹ Then these men were bound in their coats, their hosen, and their hats, and their other garments, and were cast into the midst of the burning fiery furnace.

 ²² Therefore because the king's commandment was urgent, and the furnace exceeding hot, the flames of the fire slew those men that took up Shadrach, Meshach, and Abednego.

 ²³ And these three men, Shadrach, Meshach, and Abednego, fell down bound into the midst of the burning fiery furnace.

 ²⁴ Then Nebuchadnezzar the king was astonished, and rose up in haste, and spake, and said unto his counsellors, Did not we cast three men bound into the midst of the fire? They answered and said unto the king, True, O king.

 ²⁵ He answered and said, Lo, I see four men loose, walking in the midst of the fire, and they have no hurt; and the form of the fourth is like the Son of God.

²⁶ Then Nebuchadnezzar came near to the mouth of the burning fiery furnace, and spake, and said, Shadrach, Meshach, and Abednego, ye servants of the most high God, come forth, and come hither. Then Shadrach, Meshach, and Abednego, came forth of the midst of the fire.
²⁷ And the princes, governors, and captains, and the king's counsellors, being gathered together, saw these men, upon whose bodies the fire had no power, nor was an hair of their head singed, neither were their coats changed, nor the smell of fire had passed on them.

²⁸ Then Nebuchadnezzar spake, and said, Blessed be the God of Shadrach, Meshach, and Abednego, who hath sent his angel, and delivered his servants that trusted in him, and have changed the king's word, and yielded their bodies, that they might not serve nor worship any god, except their own God.
²⁹ Therefore I make a decree, That every people, nation, and language, which speak any thing amiss against the God of Shadrach, Meshach, and Abednego, shall be cut in pieces, and their houses shall be made a dunghill: because there is no other God that can deliver after this sort.

Much Love.

Estoy separando emociones.

After weeks of agonizing waiting...

I turned the corner with my Attending, our patient's father sees us from the door way and joyfully greats us with, "She's pooping!" We don't say anything at first, almost too scared to believe it to be true! But he keeps repeating it, louder each time, completely oblivious to the other inhabitants of the unit. Mom joins in, laughing more than actually saying anything. She keeps going back and forth between the bathroom door and the room door to make sure we keep coming. Our patient, inside the bathroom, exclaiming to her mom to close the door, she's not done yet!  And little brother, not sure what's going on, but aware enough to realize whatever it is, is very. Very. Exciting! We get to the door and Dad hugs me... he squeezes me so hard. His little girl is pooping! And I couldn't help it. My eyes got wet all on their own. Welled right up! My patient pooped and I cried.

A few days later, she got to go home, and that night I had a nightmare. I dreamt that she came back to the hospital. I dreamt that she was admitted under General Pediatrics and a large collection in her abdomen was drained by Interventional Radiology. The worst part of my nightmare, was that we hadn't known she was there. Not until the next day at work, a pediatric resident, stops me in the hallway to ask about her history. My eyes still get big and my heart rate goes up just thinking about it. First: our patient having to come back. And Second: her not coming back to us.

You wake up from a nightmare like that and immediately start praying, "Please, let that just be a nightmare." "Please, let her be okay."

Much Love.

Estoy leyendo.

One of our Pediatric Surgery Attendings at the hospital is the Clinton's neighbor. I've been assisting him in the OR the past couple of days. It's interesting to hear someone talk about our recent election from the viewpoint of a neighbor. You don't sound more normal than to be called someone's neighbor. When you think of arguably the most powerful position on this Earth, you don't typically think of that position as being held by someone's neighbor.

A couple of recent photos:

 We had our first W.O.W. event of the year. Not everyone was able to make it as presentations were being prepared and traumas came in just at the change of shift, etc. But those who could attended, and we missed those who couldn't.

 I missed the couch on our first attempt at a group photo.

 

 Women Of Westchester (some of them)

 

 My Mom and Dad flew out to visit me last month. They spent a couple of days hanging out and spoiling me. They bought me candy. Made use of the hotel hot tub (see below). And played trivial pursuit until I would fall asleep mid-question. I let my team at the hospital know, and they were real cool with covering at the end of the day to let me leave at 6pm so I'd have as much time as possible to spend with them. It was just two days, but it was pretty cool of them to come see me! Love you Mom & Dad.

Much Love.

Estoy tratando ayudar.

I was on call this past Saturday. It's always a rough time, sometimes worse than others. It didn't help this time that one of my co-interns called his chief at 04:30 am in hysterics. He was about to break, no longer trusted himself with the care of any patient, grabbed his bag and left. It left the rest of us to scramble to cover all of his patients. It's all about prioritizing, and just never stopping.

The weekend passed. Those who needed it took a moment to breathe. I know that I left the hospital Saturday night, wanting to go home and sleep, but drove to CT instead. I just really needed to be with my people on Sunday.  And we all came back today for another day, another week.

In between taking care of my kids I go over to the main hospital and check-in with my co-intern. Get through some pending paperwork for a patient's discharge, whatever he needs. And really just to make sure his head is still attached and he's aware of his feet still under him. It's going to be one day at a time for a little while here.

Watching someone go through these struggles, really renews my caution at encouraging any student towards surgery. It's not fun to watch someone panicking and question their entire life's choices and ability to even continue on. And especially this year, because we did loose an intern last year, I don't want it to become a trend.

Much Love.

Estoy despertando cada mañana como nuevo.

Two individuals. Two surgeries. Two teams. One place. One time. 

My chief assisted one Attending, while standing across the table looking in the opposite direction yet with the exact same view, I stood assisting another Attending. We started the surgery off. We were just the beginning of a day long surgery to separate a pair of twins conjoined at the hip. My Attending and I worked on Blue Baby while at the exact same time my chief worked on Pink Baby. Probably the second time laparoscopic surgery was completed simultaneously on a pair of conjoined twins in the history of the world. The babies took it like a champ... or champs! ;) 

At one point of the surgery my Attending looks up from Blue baby and mentions. "You know... we went through residency, through fellowship, and as an Attending had to work to get here. What did you guys do? You just woke up this morning." 

His point being, that we are two incredibly blessed residents to be in the right rotation at the right time to have an opportunity like this simply handed to us, but there's actually a lot to be said for that. 

There's a lot to be said for simply waking up in the morning. Because once you wake up, you can then choose to get up, and then, to move forward. And who knows what the new day holds for you? If we don't get up in the morning, we'll never find out.

Isaiah 43:19 Behold, I will do a new thing; now it shall spring forth; shall he not know it? I will even make a way in the wilderness, and rivers in the desert. 

My heart is so full right now! There are times when I get to my car at night and take off for home and finally release which ever emotion I've been tamponading all day. Most often it's a cheer, a shot of joy at something new I got to do, or a beautiful surgery I got to witness. Today, "a cheer" didn't come close to covering it. 

Can't wait to wake up tomorrow morning!

Much Love.

Estoy jugando con niños.

Halloween randomly found me making my way home the roundabout way. The dark of night and winding my way through Sleepy Hollow.  The town does well to live up to the story bestowed on it by its name.

Started Pediatric Surgery today. My first time to ever rotate through this service. I have just spent the past four months over in the main hospital with the majority of my time on the surgical floor. I am so welcoming the break and the chance to do something different for a short while. Looking forward to learning something new!

Started off the day pulling a tooth out of a kid's lung. (His younger brother had kicked him in the mouth.) Finished with an appendicitis. Taking care of consults, traumas and the floors in between the two. All-in-all not bad for my first day on Peds.

Tomorrow is a scheduled separation of conjoined twins. Good month to be on Peds Surgery!

Much Love.

No estoy segura.

Acute arterial thromboembolism can cause acute arterial occlusion and in such situations is considered a vascular surgery emergency. The longer the dependent limb or area is without blood supply the higher risk of permanent loss of function. Best case scenario, to the OR emergently with vascular surgery with removal of fresh clot and restoration of blood flow to the dependent area. No harm done. Unfortunately an acute arterial occlusion can present with sudden neurological deficit. For example, sudden loss of sensation and movement of a leg or arm. Followed by frequent misdiagnosis and delayed trip to the OR.

This unfortunately happens too often. Just recently, the Reverend came in and was diagnosed with a stroke, was actually treated for a stroke. It was over 12 hours later, when the pain in his leg continued to persist that a different diagnosis was considered, vascular surgery was called and he was taken emergently to the OR.

The following day, one leg saved, attention turned to the Reverend's other leg. Also compromised, it was in need of emergent intervention. Yet one by one, to my increasing frustration, my Attendings were convinced it was okay.
The Reverend: "It always looks like that." "It turns blue like that when I get out of the shower." "No it doesn't hurt at all."
I'd hate to say that a Reverend would lie... but none of that was true!! The only thing I ultimately could not argue with was... "I don't want anything more done. I don't want surgery."

By the time the Reverend finally did admit that he was having severe pain from the other leg, it was already hurting his heart as well. Which was then hurting his kidneys, and so on and so forth. My Attendings, finally acknowledging the patient needed surgery for the other leg, and... it was too high risk to do anything. Too late.

Did we miss that small window of time immediately after the first surgery, when we could have saved the other leg? With this leg now hurting the heart, at this point should we just take the leg? Life over limb? Or had the initial lost 12 hours doomed us either way?

Ultimately, the only thing that remained in control was the Reverend himself, "I don't want anything more done."
Which can stop the rest of us from action, but can't stop the What if's and why's. I wish I knew those answers.

Much Love.

Estoy pidiendo ayuda.

It's been a week longer than usual. The American College of Surgeons annual meeting was this week and multiple chiefs had decided to attend this year leaving the rest of us scratching our heads each morning trying to figure out case coverage.

The late nights, it is what it is. At sign out the other day I was attempting to sign out to the night intern and all I can remember now is the laughing. We weren't laughing about anything. Just the fact that I was exhausted, and I was hungry, and so I just had to laugh. And God bless her, she just laughed with me. I think I eventually made it through my list...at least I hope I did.

My sister stopped by the hospital!!! She had been vacationing up in Maine. Stopped by the week prior on her way North and now once again while heading back West. Unfortunately due to the busy schedule, we had approximately 15 minutes this time, and even then I was ignoring the fact that my attending was waiting on me to go round. But it was enough time to swallow a sandwich and take a picture. Plus it was just really cool to have my sister stop by all the way out here! It's a first!

Much Love.

Estoy comiendo cupcakes.

I can no longer say I'm 30, but rather I am now "in my 30s" The difference between those two is much more noticeable than I was expecting. At least I can be "in my 30s" for the next 9years though. Maybe I can spend those 9 years catching up in maturity to what 30s stereotypically signifies. But... something in me highly doubts it. Forever young!

That being said, if I am honest with myself, I am a little bit sad to move on from 30. Thirty treated me well. If I look back a year ago at where I was on this day, future still shrouded in the all-too-familiar uncertainty, I have so much to be thankful for. I could spend the rest of my life saying Thank You and not be able to make a dent in acknowledging what Jesus has done for me. I get to be a surgeon some day. I give this path, and my life back to Him in thanks.

Thank you Lord, for granting me yet another year of life. Your blessings and care given so richly. All my Love, Christy

And now since it's that day again. Join me in dancing to my birthday song!! :)


Much Love.

Estoy uno de un millon.

Mid-life crisis. I am going to take the idea and correlate it to a mid-residency crisis. I figure in a 5 year residency I'm technically in the 3rd year, theoretically the middle. No one has ever really mentioned a mid-residency crisis before, but I'm pretty sure it's a thing. Whether medicine, psychiatry, radiology, etc. etc. etc. There is a point when the resident has to transition from a "feed me" learning to a trial-and-error learning, based on their own decisions and actions.

Unfortunately, there is no outline to follow. No step-wise algorithm to guide ones steps.  It can be quite stressful for an individual to navigate. To take the examples they have seen thus far and really for the first time start to implement them. 

Am I having a rough patch? Perhaps. But really, who doesn't from time to time. It's only normal to feel like you need a break, a respite, some R&R. Even Jesus walked away from it all when he needed to. Only difficulty with that in this particular case, is I can't exactly take that break. Frustration, stress just stays pent-up and borders on anger at it's inability to be released.

We push on nonetheless. When we hear the medicine resident slam down the phone in its cradle across the trauma bay, heads pop up at the sudden sound, but settle right back down again. We've all been there. Or when the chief yells that someone has touched their coat, everyone carefully tip-toes until safe to resume normal speed again. They weren't really mad about their coat. 

We'll make it through. As so many have done before and many many more will do for years after us as well. I'm just a small one of a million, all the same, no different from my fellow co-residents. Neurosurgery, Pediatrics, Oncology alike approach that mid-residency crisis when faced with staying true to themselves yet realizing what it means to be a Neurosurgeon, a Pediatrician and an Oncologist when in the trenches and on the front lines.

Much Love.

Estoy enseñando.

As I am able to progress through residency, claim more experiences under the belt, my role as teacher has become a little less daunting. 

Over the past three or four years I've become a firm believer that the role of the student is to surpass the teacher.  The role of the teacher, to help their student(s) achieve just that. If it does not play out accordingly, shame on the student. And, shame on the teacher. 

I have it easy as a teacher in the fact that, for the most part, medical students want to be there. That being said, I respond in teaching to what the student brings. If they are willing to invest in the service of surgery, I will reciprocate with investment in them. And I will do so with as little propaganda as possible. For the most part, students are incredibly sensitive and vulnerable. They listen to everything, and take everything to heart. I soon realized that if a student is interested in pursuing another area of medicine there is only a minute amount of time to impact him or her before they go off into their desired area and forget all about surgery.  Only a minute amount of time to encourage them to be the best doctor EVER. 

I broke my own rule the other day. My rule about no propaganda. I do not want to tell any student to go into surgery. I believe they have to make their own decision. Because that day will come when they are exhausted, cranky and facing a 24 hour call and they will have to fall back on their initial decision. But the other day, a student approached me about her future. She is an excellent student, still not sure what she wants to do, and therefore interested in everything. Or that's what she says, but her every action screams surgery. I can see it, her fellow classmates can see it, and honestly, she knows it just won't admit it. She came to me almost as if she needed me to say it. And for the first time I told a student to choose surgery. Yes, keep an open mind, I told her. Yes, feel free to apply to any and all specialities you desire. But make sure that surgery is one of them. And she nodded. I hadn't told her anything she didn't know.

Much Love.

eu sou grato

I learned three phrases in Portuguese this past weekend.
hello = oi
yes = sim
no thank you = não obrigada
  
Can't say I actually used them all that much. There's only so far into a conversation you can go with not much more then hello.  Unless that conversation is with a baby... I found it quite humorous to hear a Brazilian say hello to a baby, "oioioioioioioi!" 

Wagner is one of my co-residents. He was actually a 1st year prelim with me two years ago, and now he's back at the hospital as a 2nd year prelim. He invited me to join him and his wife at his sister's house in Pennsylvania for a Brazilian BBQ just like they do back home. To be honest, I was still in bed when he called Saturday to let me know they were about ready to leave, and seriously considered staying there. But the idea of a really unique experience won out in the end and I was soon out the door.

 The BBQ started at 3pm. The first meat to go on were the short ribs. Above picture, spearing the short ribs. They were the first to go on, and then the last to come off, passing the evening slow cooking on the higher racks above the coals.

A cooler full of meat already lined up and ready for the BBQ.

 

So Much Meat. As one would finish it would come off the BBQ, be sliced and passed around on a plate. There were toothpicks available, but half the time just pick a piece up with your fingers and lick them clean afterwards. 

Meat wasn't the only thing served. There was also rice and feijoada (Brazilian black beans). But it was mainly the meat.

 

Chicken heart

They loved them and would gulp down two or three at a time. I was so lucky to grab one with the aorta still attached.  obrigada, mas não obrigada.

 

Each meat was cut right off from the skewer. This was the spicy sausage. The Mexican in me was so under impressed with their version of "spicy"

 

 This gentleman owns a Brazilian restaurant there in PA. He blessed us by cooking all of our meat for us; half of the night with his son hanging on his neck. :) They were from an area of Brazil with German ancestors, you can tell in the blonde hair of the next generation. :)

 This gentleman in pink is apparently super famous in Brazil. Everyone kept making sure I was aware of how famous he was. He was explained to me as kind of like Shania Twain famous. He used to sing Brazilian country music with his brother (Gian & Giovani), but they have since split up and he's currently touring in the states and joined forces with the gentleman on the right, Doug Sanders. Doug is a friend of the family, hence why they were there Saturday with their band. 

 

Pretty sure I was the only one there that night who did not stand up for a picture with Gian, but I could still appreciate the music. :)

Much Love.