Estoy corriendo.

Given that I covered call last Sunday and going straight into call this Saturday, under ACGME rules I am allotted a 24 hr period off. Happened to be today. Upon waking this AM, I grabbed my phone to 1) check the time and then 2) check the weather. Wasn't supposed to rain until 2pm. Good, I thought. Plenty of time to work inside a while and get out for a run before it rains. When I finally stepped out of my building, unwinding my trusty old mp3 player, I immediately felt the small pings of raindrops. Sure enough, I'd had one deadline for the day, and I'd missed it. I'm trying to be better about getting out when I have the opportunity so I took the run anyways. Glad I did, as the rain stayed light and kept me cool. I pretty much studied the rest of the day. Made food and a co-resident came and studied with me when she got off work. We try to learn by taking the disease process, or symptom or sequelea all the way down to the pathophysiology. By understanding the why, making the result much more clear. We keep hitting road blocks though. All the cellular pathways and mechanisms we crammed into our brains back in med school seem to be half-erased leaving just lines, boxes and inert shapes which lend to recognition, but without reason. Might as well just have brains filled with legos; could actually build something with that. We eventually get around our road blocks and keep plodding on. I'd had other goals for the day as well, but just like my rain deadline, I've gone too late. Will have to save them for the next time.

Much Love.

Estoy respirando.

While I carry the consult pager this month, I also have my primary patients to take care of on the Thoracic Surgery service. One such patient kind of reminds us all of a flower child. I'm almost tempted to say that he can actually pull off his mullet, the one and only capable, but then... let's not get carried away.  He's always cracking jokes, so he gets along well with everyone. Even in pain he's making jokes. Due to all the past surgery on his belly, he had come to us (Thoracic surgery) as a last option. What would typically be done through the belly, we instead opened the side of the chest and got access that way. His lungs are just taking their time remembering how to be lungs again, instead of shriveled sponges. We've put chest tubes in. Taken them out. And then put them back in again. His pain doesn't help either. I dosed his narcotics so high, it would have been enough to completely halt my respiratory drive, but turns out...wasn't even enough for him. It's the first time I've ever seen someone's arterial blood gas actually improve by increasing narcotics.

And then on the consult side of things, we got another breast cancer gone far too long and literally eating away at the poor lady's chest. It's horrifying. Professional on the outside, screaming on the inside I continued with the interview. How did you go to work everyday? "I just put gauze on it, I thought it would go away." On exam I ask her if she's having pain. While squeezing her eyes tight and holding her breath, she tries to be brave,"no, that's not bad."
Honey, that's not bravery... that's denial.

Much Love.

Estoy enseñando.

As consult resident for the surgical service, I get called on average 3-10 consults daily. But of course, there's always the exception. Today was one of those exceptions, not only did I not get any consults, but the 0298 didn't even go off after 12:00. I ignored it, and kept busy, so as to not jinx the situation. For the second you acknowledge the state of calm, the pager will go off with minimum three consults in a row. Literally, the second. From my perspective, it's always a welcome break from the typical hurried hecticness. Unfortunately, I currently have three students assigned to my team. One sub-intern, and two 3rd years just starting their clinical year (brand new babies!). And with days like today they don't get to see all the amazingness that surgery can be.  We spent time going over past consults. An esophagus, completely structured shut after being burned with oven cleaner. Do we take it out and pull up the stomach? Can we even use the stomach? Should we interpose colon in its place, and does that mean the voice box has to go too?  A breast cancer beyond control, infected and eating away at the patient's chest. More discussion on patient denial there, than actual treatment of breast cancer itself.  That's one good thing about medicine, there's no end to topics for study, and we've kept busy despite no consults today. The students haven't complained yet.

Much Love.

Estoy recuperando.

Back to the crazy 24 hr calls in the ED on summer weekends. By morning, you're probably walking around with you head tilted to one side. Simply because, you're just too exhausted to get it all the way up straight. No sooner than you finally make it home the next day and you've crashed on the nearest flat place that can hold your body habitus.  Which then in turn, leads to a considerable amount of confusion when something wakes you mid-afternoon and you have no idea where you are nor what just happened!!

The human body never ceases to amaze me. The other day I saw someone walking down the hall, scratching her head and talking on her phone. You could tell she was part of a family, and as they were all solemn-faced standing outside of the MICU (and it had been the third time that day I'd seen them), one could only conclude they were there to say good-bye to a loved one. And I as struck with amazement. They were saying good-bye to someone, yet no thought to themselves. Someone they loved had stopped breathing, heart stopped beating and eyes stopped seeing. Yet she was talking on her phone, with no thought to her next breath. Beholding her family, with no thought to when she would see them last. And heart hurting, with what belief about eternity?

Our Creator in His divinity has made it pretty easy for us. Our bodies pretty much take care of themselves. Breaks down and builds up; heals itself where needed and when allowed. Then just like our relationship with the Creator itself, we can go mess it up pretty bad sometimes.  Seemingly, to the point of irrevocability sometimes.  But the awesomeness of God's creation can not be limited to science, and without our understanding it survives and healing is provided. The body could never hope to be the same again, nor should it be. It now holds a beautiful story instead. Healing and hope. Same for a relationship with our Creator, once broken and repaired against all odds, carries a story of glory unlike any other.

Much Love.

Estoy celebrando.

Happy 4th of July! Literally ran out of the hospital yesterday, just in time to jump into a carpool with some of my co-residents. We were off to see some fireworks. We sat packed in like sardines facing towards Kensico Dam and watched with wonder as the flashes of light dazzled us, and the deafening sound reverberated within our chests.

 Danny, me, Monica, Min Li

Luke 12:48  "...For unto whomsoever much is given, of him shall be much required: and to whom men have commited much, of him they will ask the more."

For the most part, my life in residency is fairly constant. Nothing new really to report. I did, however, recently move. Have an apartment on the hospital campus now. Weird to be so close to work, but invaluable to not have to worry about driving in snow during the winter. Definite blessing.
Furthermore, I'm back to being a 2nd year again. It's hard to watch as the seniors struggle with teaching all the brand new interns. It's tough, knowing you could do the work three times quicker and correctly, to stop yourself... and leave the work undone waiting for the intern. They have to learn how to manage, correctly and efficiently. How to prioritize and make their own check-lists. We don't remember it... but we were all there at one point.
I'm still trying to figure out what kind of chief I want to be some day. I have no doubt, I'll never actually succeed in deciding, but instead will just have to walk the walk one day. Praying for God's guidance with each step.

Much Love.