Uncle Kevin

 Oh Uncle Kevin! God took you home to be with Grandma & Grandpa. I know you missed them. Family was so important to you. As loyal as the rising sun you loved us all, none of us could doubt. These past few years, we could count on your skype call with your update on AZ weather, which of your neighbors had walked by that day and the latest update on your ailments. I say that with utmost fondness and endearment as only you deserve and as it will be mentioned for as long as our memories exist. 

Looking back through family pictures for specific faces, patterns start to rise. In the case of Uncle Kevin, you would see his face in one of three places. 

1) a yearly Christmas picture, taken solo and typically with the Budweiser stein he had received that year. I did not save any of these.

2) a yearly picture at the annual butchering, again taken solo, as he manned the kettles for the cracklins 

For example:

 I did find one with him away from his position at the kettles and in the garage where the butchering was happening. Taken probably 27-30 years ago, he was still making that same face even two weeks ago when I was skyping with him! 

3) family pictures, and I found three of those. For example, the one below. I remember Mom telling Carrie to sit at Uncle Kevin's feet to cover up his flip flops. 

Other than those he randomly would pop up. There is no story for the random ones. But in a way that makes them even better!

This is just an example, but you can often see Uncle Kevin off to the side of a picture, not looking at the camera. 

Maybe we were together to celebrate Mom's birthday. Whatever the occasion, I'm glad we built a snowman, rubber gloves and all!

This was perhaps the biggest surprise find for me as the pictures of Uncle Kevin were so rare. I wonder if I was telling him a story, and he patiently listening. Either way I was very excited to show him my cassette tape!

This was from my last trip home to see Grandma before she died, after which Uncle Kevin moved to AZ. He's such a proud uncle with Peter Bear and Little Lincoln. He was called a gentle giant at his funeral. This photo illustrates that well.

The last time I got to see Uncle Kevin in person was actually in San Fransisco. He flew from AZ to meet us there for a few days. Doesn't look it, but he was secretly very excited to be there!!

Last picture of Uncle Kevin, taken NYE 2020 by his neighbor.

Love you Uncle Kevin!

Estoy enojada con la muerte.

 My efforts to follow through with shaking off the heavy chip on my shoulder, as mentioned in my last post, have not played out as planned. In fact, the entire train they were on completely derailed and is now a crumbled pile of bent and smoldering aluminum, the efforts once on board now vapor rising above the demolished heap. 

I must, start again. Start at the beginning and try again. 

COVID hit our team again, on a personal level this time. 

The two residents that had (for whatever their reasons were) decided not to get the vaccine, both got sick with COVID and were out on quarantine. Unfortunately, one of those residents, had been on the transplant team when he became symptomatic. So out of an abundance of caution to the transplant patients, half of the whole team, even those asymptomatic, were mandated quarantine. The extra work load was felt on the rest of the program.

Then, after a long fight with COVID, one of our trauma PAs lost the battle to COVID. Tony was the PA that I went with to his island of Anguilla last year and participated in their Medical Fair. Tony's death was felt near and wide, nurses, PTs, current and past residents were posting on social media their sadness at his death. Tony made everyone feel appreciated.... because he told you so. "I appreciate you man! I appreciate you!" He'd never hesitate to give you what he had. "Christy you want some coffee? Let me give you some of my coffee. Where's a cup? Let's find a cup! Let me give you some of my coffee!" Rest in Peace Tony!

It gets increasingly difficult to remain positive. To refrain from saying I hate COVID.

Then in the midst of that, and trying to gear up to take my last ever ABSITE. Received the sudden and unexpected news that my uncle had died. 

The events of this past week are, quite frankly, not safe for public space. Perhaps, I'll write them down for myself and post in a delayed fashion. Or perhaps, I won't. If I did... chances are the stories wouldn't be believed anyways. My team was actually a great comfort. Only few times previously had that strong bond you form when fighting shoulder to shoulder in the trenches was felt as strongly as it was this past week.  In short, schedules were able to be moved, and a few of the ABSITE exams, and in the end, I had q2 call, took the ABSITE post call, then flew home for my uncle's small graveside service. The morning after my second call, rounding quick with my team to get them set for the day before I ran over to take my test, emotions were very high. I noticed a look of half-bewilderment and half-terror on the face of our medical student. Trying to take a step back to reassure her, she responded, "oh don't worry, I only understand maybe half of what's going on anyways." Which I interpreted, that her facial expression was merely a reflection of what she had been seeing exhibited by us.

A bit of a train wreck the second half of January was. But as I said, I must start again. Start at the beginning and try again. Goal: to walk out of this residency program chipless. 

Much Love and Prayers.

Estoy estudiando.

 As expected my week of vacation went by too quickly. I have just finished going through my patient list, and was a bit apprehensive of what was going to be waiting for me on my return. I came across more than a handful of events that I would have handled differently, so I am glad I was away. Looking forward to moving on and leaving the events of last week in the past.  It's going to be great!!

In case you missed it... I've got more than a small chip on my shoulder when it comes to the inner workings of my current service. I really should work on shaking it off a bit more as it's become so heavy over the years I'm starting to walk with a noticeable limp.  

One day at a time!!

Pictures from this past week:

Visited my friends Sirish and Kristina Mulpur and their son Noah. Pardon the overload of cute Noah pictures!!

 

Great Falls National Park along the Potomac River

Trying to get a picture of the three of us at the Great Falls was easier said than done, and really rather humorous as Noah and I both struggled to keep our eyes open looking into the sun. In the end, we had a plethora of pictures, most of them hilarious, one of the acceptable, but all of them wonderful!

I spent the remainder of the week studying up in CT. There's just something comforting having a loyal study buddy keeping you company! Thank you Finn!

Much Love and Prayers!

 

 

 

Estoy celebrando.

 I have vacation scheduled for this coming week. Six months ago when I penciled in my vacation weeks, there was a plan for each and every one. Of course, it is now here and that plan was just a nice idea. Never even came close to reality. So I was looking at the week ahead and pondering if I should just go ahead and go into the hospital. Monday is already planned to be a crazy day, extra pair of hands would be appreciated. 

So I removed myself from the temptation. Far from the temptation. Will go and visit a friend in another state. Figure if I'm in another state I can't come into the hospital.

Unfortunately I wasn't thinking about any vacation when I made the schedule, so had scheduled myself to round this weekend. No one to blame but myself for that one. Whoops! And I have multiple M&M presentations that I am responsible for this coming Wednesday. Technically I could hand them over to someone else to present for me, but one of them is my lady that most recently lit a candle in Heaven, and I want to do her justice. And if I'm logged in to present her... then I very well can't get out of the others. Good thing about virtual conferences. Can log in from anywhere. 

But that also means I've been working on my presentations all weekend. Safe to say "vacation" hasn't quite started yet. But I'm looking forward to not waking up at 4:17am tomorrow. That'll be a great start!

I am also expecting a very specific email tomorrow. I officially signed my contract for next year on Friday. I will be working as a General Surgeon in Lafayette, IN for one year starting August 2021. Then, Lord willing, a Global Surgery Fellowship at Creighton in Omaha, NE. Having signed the contract, I am expecting a mountain of paperwork for licensing and credentialing. Yay!, not really. I'm not excited at all. But pretending to be so as to lessen the pain of getting through paperwork. 

Much Love and Prayers.

Estoy cuidando pacientes crónicos.

 Acute Care Surgery. The service for which I am currently acting chief resident. What exactly does that mean. Surgery for acute pathology, perhaps. So what is "acute" in the world of medicine. A dictionary will be happy to provide you with a vague definition such as; (of a disease or its symptoms) of short duration but typically severe. But you only feel wiser in reading that definition, when in reality you still probably couldn't explain something that is acute. 

I'll share with you my cut off. Think of two weeks. I'm sure I picked that up somewhere back medical school. But needless to say, if duration is shorter than two weeks, you'd be safe in considering something to be acute. Longer than two weeks, and now you are looking at chronic pathology. 

So Acute Care Surgery. Surgery for pathology of duration less than two weeks. Easy examples: appendicitis, cholecysitis, perforated ulcers, perforated diverticulitis, necrotizing soft tissue infections, volvulus, obstruction, incarcerated hernia.... basically if you are in the ED and need a general surgeon, chances are you'll be seen by an acute care surgeon. 

So now looking at my service, I go through my patients appreciating their "length of stay". 34 days. 54 days. 20 days. 39 days. 15 days. 60 days. 124 days. 25 days. 85 days. 161 days. 26 days. 23 days.  Just to list a few. The irony of my service's name is not lost on me. There is nothing "acute" about my collection of chronic patients. 

One of my chronic patients, does an amazing job of remaining positive despite difficulty. He should write a book, give a TED talk, or something. We all could use some of his optimism. Every morning we approach his room and he's already woken, sat himself up and is looking at the door in anticipation. We came by 15 minutes late the other day, and he called us out on it. "You're late!", he said. I had no idea he was counting on our early morning rounds so much. Then the other day on my afternoon rounds he changed the conversation on me. He asked me about his pathology, and relating it to the pathology he had originally presented with. And I saw realization spreading in his eyes as clear as day. He had finally, for the first time, realized what his situation was since before he came to the hospital. Chronic.... stinks. It traps its human with pain and convalescence. Holds them hostage, preventing from living their life as desired. One could easily understand how they can slip into the role of victim to their chronicity. But even after mulling over our conversation and his realization, my patient was up and looking towards the door when we walked in the next day. 

Much Love and prayers.