Estoy ganando mi posición.

Last Saturday was two weekends in a row I took 24 hour call on Saturday. The first one was rough, this one, the on call team for the day... we made records.

It started at 7am with a ruptured Abdominal Aortic Aneurysm which took my chief to the OR emergently leaving all 25 patients on my list to me.

Thankfully, for the next three hours my senior took care of all incoming on call work knowing that I had a lot to handle rounding with each Attending, getting plans in place and discharges taken care of.  But three hours was all she could afford. By 10am our first three traumas were rolling through the trauma bay doors, and she could no longer keep it from me. From then on we attacked the constant onslaught together.

It never stopped, and we just kept going with it. It wasn't until Sunday...when the torch had finally been passed off, and looking retrospectively across the settling dust that I realized what we had just survived. Over a 24 hour period we had gotten 15 traumas and 20+ consults on top. (To put in perspective, by 6 traumas and 8-9 consults its considered a busy call). We had patient's die... too many die. Did my first open cardiac massage. Put a man's leg back together after he'd drunkenly managed to self-eject himself from his vehicle, half mangling his calf in the process.  More than one opportunity to put in emergent lines and chest tubes.

I am so thankful for the team I was with that day. They were good examples for me.  Great examples of how to prioritize and organize. And remaining positive was so easy with them. Business aside, we were where we wanted to be, doing what we wanted to be doing. 

After one particular messy trauma, our trauma attending turned to my senior and commented, "Are you surgeon?! You look like butcher!!" as she had blood stained the entire front of her scrubs.
Or during cardiac massage my hands started cramping so I passed off to my senior to take over and in return got a sarcastic quip from my attending poking fun about being a girl and needing a break.

I don't know how many more similar calls I'm bound to have over the next five years, but I hope I'm with an equally hard-working, dedicated and amazing team as I had this past call.

Much Love.

Estoy agradecida con corazon llenado.

It's finally official. I matched into a categorical general surgery position at Westchester. It's honestly a little hard to believe. It only took me four extra years to get to this point.


To be able to stand for the General Surgery oral boards, or sit for the General Surgery written boards it is first a requirement to have completed 5 years of a General surgery residency. Thus far I have been blessed to receive one year preliminary contracts. What categorical means is that I finally get to sign a full five year contract. When asked, "how much longer?" I can finally say, "five years of residency."

It felt longer at the time, but four years...
Four years during which God kept me going one step at a time, unsure of tomorrow, let alone beyond. Four years of applying and reapplying. Four years of rejection. Four years to build on the lessons God had started in Guadalajara. Four years to understand even deeper that I have absolutely zero control. Four years to love my Jesus even more.

I remember going for a run a few years ago. There were flurries in the air, really too cold for human lungs. But I needed to run. I pushed myself until my chest started to hurt, a dull substernal pain, and then I pushed myself harder. It's wasn't until the pain started radiating up my neck into the left side of my jaw and left shoulder, that sense broke through my thoughts and I realized I was giving myself a heart attack. I had been willing to suffer pain, because I had caused it. During a time when I really wasn't sure where I was going to land there was something in my life that I had control of, and this pain, this feeling that I was controlling, was making everything else take a back burner. I started walking. 

Or at a time when I knew I had finally run out. Wasn't sure how I was going to pay my next bill.  I was well aware that without the generosity of family and friends I would have already been homeless, jobless, penniless, and drowning in debt. Contemplating everything to prevent myself from having to ask to borrow more, out of pride. Maybe even living out of my car.  When God took the car from me, scolding me for even considering it. Once again, reminding me that I have no control, He let me know that "You don't even have a car Christy." Trust was all He asked, and I threw up my arms in defeat. It was all I could do.

It is all I can do.

It was even just a few months ago when I was 99.999% sure that I was not going to be offered anything beyond this final prelim year. That surgery was not where God was ultimately going to lead me on this path. Would it break my heart? Maybe I thought so, but I was willing to give it up for where ever I could be useful. Anesthesia? Psychiatry? Only God knew. And in the meantime, unknown to me, God was working in the hearts of my co-residents and Attendings granting me grace in their eyes. It is because, and only because, they advocated on my behalf that I was considered for a categorical position. 

There is no doubt in my mind that I am here today, of nothing that I have done on my own. It always was God who has brought me through. May I never forget, even for a moment. May it always be.

Romans 11:33-36
³³ O the depth of the riches both of the wisdom and knowledge of God! how unsearchable are his judgments, and his ways past finding out!
³⁴ For who hath known the mind of the Lord? or who hath been his counsellor?
³⁵ Or who hath first given to him, and it shall be recompensed unto him again?
³⁶ For of him, and through him, and to him, are all things: to whom be glory for ever. Amen.

Much Love.

Estoy tratando guiar.

After my first week, as stand-in chief, the real chief returned. I was feeling thankful after that week. For one, because I had survived. For two, no one had died, coded, deteriorated, or been a rapid response. For three, the sub-intern on our team had been surprised when he had found out I was just a second year, stating he'd thought I was at least a 4th year. I interpreted this to signify that I had hopefully done something right. (One of the first lessons I learned in Mexico: How to look like I know what I'm doing... especially when I have no clue.)

But then Hanna returned, and any idea that I might have done an okay job was dissipated. No one said I had done a bad job, or even handled anything poorly. It was just in watching her example of leading, compared to what I had been able to pull together.

She had asked me how I had done. I don't even remember what I had said, but she had immediately dismissed my response.  She had known full well what she had asked of me, and then what had subsequently been asked of me on top of that. It is perhaps the primary way a surgery resident learns. Thrown in, draw on your resources, build on your skills, figure it out, and move on.

She's been gone off and on quite a few times since then, either post-call or to take a trip or a test. It's much easier to step in for short periods, especially when I'm not half distracted by the needs of a second service. Plus, I'm getting some really good OR time, the cases usually snatched up by senior residents!

Today was supposed to be my day off as I'm scheduled for a 24 again this weekend. But a Pancreaticoduodenectomy was scheduled so Hanna gave me permission to come in anyways and double-scrub with her on the case. By the time morning conference finished and I was able to run to the OR the case had been aborted. So disappointing. Like major bummer. But then, since I was unexpectedly free another one of my chiefs gave me her gastrectomy case.

Much Love.

Estoy vestido bien.

My work jacket. Well worn after 18+ months. Fabric now thin and zipper broken. It helped keep me warm. It is now time to retire this trusty jacket.

New jackets were ordered for our program.  One of our Attendings/Assisstant program directors has paid for them out-of-pocket. I was gone when choices were submitted and so I had been put in for one of the gray/pink jackets instead of the black/blue ones. Made me cringe when I heard that. But they arrived today so I tried it on.  and you know, I think I can handle this!

Much Love.

Estoy lista.

Am thankful I was able to attend the wedding of Stuart Kilgus from Toledo and Sarah Lanz from Rockville today. My cousin Kristin Anderson was there. She and Nate had flown out from Illinois for the weekend. The sunshine, the fellowship and the respite could not have come at any more needed time. Last week had stretched me. By Friday night, my "fight-or-flight" instinct was pounding through my veins, and I had to admit to myself... I was on the verge of "loosing it."

But I've been able to calm down a little, and I'm ready to go back in again now.

And the donut did last the whole week!! When I was finally able to leave the hospital on Saturday, I stopped by the auto shop and finally got that taken care of. If feels so good to be able to drive again. It didn't help my stress level last week to have to putt-putt home after work and worry the whole way that something worse was about to happen.

He always provides.

"Are not two sparrows sold for a farthing? and one of them shall not fall on the ground without your Father.  But the very hairs of your head are all numbered.  Fear ye not therefore, ye are of more value than many sparrows."  - Matthew 10:29-31

Much Love.

Estoy llevando una pesa grande.

Sometimes much is asked of you. Sometimes it catches you unawares. 

When it happens, it is not for you to fail. It is for you to rise to the occasion.

It is March, and with a new month comes a new rotation. This month I am on the team that covers Bariatric surgery, Hepatobiliary Surgery and Transplant surgery with some general surgery thrown in here and there. It is, as a whole, a random collection, a sort of catch-all of a team. I knew it was going to be a rough week. My chief is gone, she's away for a week. She left the day we all switched. She sent an email before welcoming us all and delineating expectations.  In her last line she included the following concerning her time away, "During this time Christy will be in charge of running the service as a whole, and I will be available by telephone."

She included that line more for the other two members on our team than for me. She had spoken to me in person before hand.

So March 1st was geared up to be an awful day. I was to take charge of a brand new service with 35+ patients. I couldn't do official rounds in the morning because of a required meeting I had to go to off campus for the medical school. So I had to get in extra early to do lightening rounds and run the list with my intern to get him focused. (I've never worked with this intern, but I have not heard a single good thing about him from anyone who has.) And by the time I got back from that meeting there was a Liver and Kidney Transplant, patient in the room and waiting for me to jump into some scrubs and get going. But right before scrubbing I was getting paged about my patient's from last month, and seeing that they needed attention had to take a time out to fill in some gaps/paperwork. And last but not least, the fourth member on our team is a 4th year resident rotating with us to do transplant surgery from a program in Brooklyn. I basically wasn't around to welcome him, get him situated, etc. By the time I left the hospital late that night...I was just so thankful none of my patient's had died.

March 2nd...had myself all psyched up to be much better this day. Rounds not so rushed. Spend time with the med students. Make sure the rotator is comfortable. Get after the intern when appropriate and most potentially affective.  But before long I get a text... the consult resident is out sick, you have to carry the 0298 today. And then not long after that I get another text. This one from another chief who is gone (same place as my chief). As her resident is out sick (the one supposed to be carrying the 0298)... can I see her patients for them and write their daily notes.
"Sure, no problem." I respond immediately to both.  And I ment it, but within a short amount of time the weight of responsibility on my shoulders had suddenly become very... very... heavy.
There were three residents gone, and I found myself covering for all three of them. Two of them chiefs with their appointed services. And therefore, as a second year, I find myself not only acting chief for two different services, but carrying the consult pager as well.

I'm doing my best to fulfill what has been asked of me. Everyday is a new adventure. It takes me a long time to get everything done so the days have been extra long. The chiefs are coming back next Tuesday. I think I'm going to hug them, I'll be so happy to see them again. I just pray it comes before my knees give out, buckled from the weight of walking like this.

Much Love.