Lots of things!

So i was going to start off by saying that I'm pretty stressed out these days, but then I realized that being stressed is my norm. I know no other life but balancing a hundred things at once, working hard, and planning for the next step. And really, almost everybody on this earth has stress of their own. So, it's more accurate to say that I'm doing my usual! Which is extremely stressful at times...but more times than not, its just the usual stress that is life. :) 

A list of the things I'm currently working on:

- Setting up a rotation in Bogota, Colombia- I'm getting somewhere now i.e. I have a hospital that is willing to take me! woo hooo!!

- Planning my 4th year rotations- aka deciding where and what i'm going to be doing for the next year of my life (eek!)

- Facing the fact that I'm going to retake one of my board exams (this thought makes me physically ill) to improve my chances of being accepted to a non-Air Force Emergency medicine program...this is worst case if I don't match with the AF...but my life works in worst case scenarios...so I'm planning for anything that could happen :)

- Training for a triathlon on April 11th- Nautica South Beach Tri! This includes weekend rides with team strada, running, swimming, and rock climbing (the climbing is for cross training)

- Studying for Step 2 of boards, Internal medicine shelf exam, Core shelf exam, oh and that USMLE Step 1..again!

- Trying to enjoy life as it comes

-and last but not least...not going insane! :)

So that may not sound like a lot and frankly I know people that do all of this and then some. I'm also super lucky (or maybe unlucky?) that I only have to worry about myself right now. Planning one medical career and life is complicated enough without having to incorporate the life of my family in there too...I can only imagine how tough that must be. So for my peeps that do it all...you totally rock more than you know ;-)

ANyway, despite all of the possible "what if this doesn't happen" or "what if i don't do well on this test or match at that program", I really am just telling myself that I've been here before and it has ALL worked out.  I've been there when nothing I planned for happened and everything I thought was going to happen, never did. No matter how much I scrambled to make it happen, it just wasn't in the cards at the time. Getting stationed in NM to do the opposite of what I was studying, not knowing anybody, and seemingly straying farther away from my medical school dream was the worst...or so I thought at the time. I have deja vu now from that now. I'm not at that point, but I remember it well and am doing the same "scrambling just in case" dance so that I don't even approach that feeling of being stuck again. Even still, if I do end up back there and things pan out totally different than I have been planning...I at least know I covered my bases and that it REALLY WILL BE OK. The worst feeling of helplessness back in NM brought the very best opportunity in my life and got me where I am now. So I'm trying to keep that in mind and not freak out lol. So here's to spending a little less time freaking out and less time making back up plans for my back up plans.  Enjoying the right now!

Thought for the night: Passion!!

So watching the olympics the past couple of days has made me think a lot about passion. I love the olympics because no matter how different the events are...like curling lol...i think its absolutely awesome how passionate all the athletes are about their sport. In my eyes, there's nothing more sad than people who don't have a passion for something. A person with no enthusiasm for anything is boring.  I've known people in my life that don't get excited for anything, don't really care much about anything, and even admit that they aren't really enthusiastic about most things in life...who wants to be around people like that?? I'm not saying people have to be excited about life all the time. But everyone should have something they love right? Something that makes them who they are? Now this shouldn't be a spouse (obviously you love your spouse), or sex (that's obvious), but more like a hobby or a cause, etc. It doesn't have to be something big...be passionate about underwater basket weaving, but that's something!  I hate when people are afraid of doing big things or going all out for fear that they will be judged because they do something "too much".  Who are you to discourage others for doing what they love just because it's not what you love? My favorite dave matthews song says "Some might tell you there's no hope in hand just because they feel hopeless, but you don't have to be a thing like that" and its totally true.

I get frustrated with friends that tell me i need to "calm down" with some of the things I do. "Too much isn't good".....that's what people sometimes tell me. Really!?!?! Since when is enthusiasm not good?  I'm sorry but I'm really not interested in the mundane, over simplified, don't get excited about much kind of life. It's extremely hard for me to understand how people can go through life and not really care and be excited about at least one thing. Maybe they don't allow themselves to or somebody discouraged them. If you're not excited...why even do it? I tend to throw a lot of emotion into just about everything I do, sometimes it's a bad thing, but most of the time it's awesome. Sure you can be disappointed by getting hopes up about something and there's always the chance that you'll fail.  But one of my bosses once told me that if you don't get you're hopes up in the beginning, you've already given up.

So no matter what it is you do...put your heart into it! Even if its something you think nobody likes or is nerdy (i have many of those nerdy passions), or is not popular... be confident, be passionate! Be like the curling people in the olympics who's life goal is to slide a huge silly weight across ice and be the best at clearing said weight's path...they win gold medals for that and its awesome!

Ok that's my thought for the night...off to bed so I can practice my passion tomorrow as I wake very sick people up in the hospital early as hell and ask how they are feeling. lol

Adele - "Right as Rain (Live)"

Love this song right now...

Adele - "Right as Rain (Live)": "Adele performs 'Right as Rain' Live and Unplugged"

Planning for Colombia :)

I've been trying to plan out my 4th year the past couple of days and it is STRESSFULL! There are so many rotations I want to do and not enough time to do them all. The other thing that is causing me stress is planning my rotation in Colombia. I'm pretty sure I want to do a pediatric rotation. Everytime I go to Colombia to visit I always get so heartbroken by the children wandering down the street, in traffic, selling gum to make some money.  I always end up buying their whole supply as soon as I see them and end up giving them extra money to go buy themselves ice cream lol, those kids LOVE ice cream.  Since I was a kid I can remember giving them my whole stash of pesos that my parents gave me...they always got mad when they found out i gave it to the kids on the first day lol.

 But when I go back for my rotation I really hope I can finally do something more for them.  Setting up the whole things is somewhat of a production, since it is sort of difficult to call Bogota and get in touch with somebody, not to mention the right person who can actually help me. BUT, i know it'll be TOTALLY worth it. It has been 5 years since I went to the Dominican Republic on the medical mission. That trip was a complete life changing experience for me and now drives my dreams of doing third world medicine.  It put everything in life back in perspective.

Here are some pics of Bogota, Colombia!

Top of Montserrate looking down on Bogota! It's beautiful there. 

University of Los Andes- The school/hospital I'll be working with; also my cousin's medical school!

My aunt Teresa and a little guy we met while hiking in the mountains living with his family. We dropped off food and clothes for them. He was born in that house and has never been seen by a doctor...ever!  He's the reason I want to go back!

My favorite kind of patient...

Dr. R: "So i see you had some chest pain last night?"

Mr. L, 70 y/o marathon runner: "yea i thought i was maybe having a heart attack, but i'm fine now, i think I just ran too hard."

Dr. R: "It doesn't look like a heart attack, but we have to get one more set of results back, but you can go home later today."

Mr. L: "Today huh?"

Dr. R: "Yup, any more questions for right now?"

Mr. L: "Can I run tonight, I have a track workout planned."


I never get tired of these patients! This guy was pacing the halls in his robe and Saucony running shoes just itching to be cleared, and I loved it! I love it when people are actually involved in controlling their health and staying active. He looked like he was maybe 60 and could def run circles around me. I ended up going back and re-iterating how important it was for his future races that he rest for the next week. But I know how he feels!

Maybe I can be like that one day! Afterall, it was a pack of a few 70 yr old men that got me through my first marathon. They kept me going the whole way with dirty jokes and all! I love old runners :)

"I regret my regrets..."

I just started on internal medicine 2 days ago and already I love it. Doing the medicine and thinking
through/learning the pathophysiology of everything is really cool but it would eventually get boring 
without the occasional patient that brings you back to reality. I def don't know even nearly all there is to
know at this point...but I know enough to get into a dangerous "routine" as some docs call it. It's really
easy in medicine, once you do it for long enough to reflux orders, tests, and treatments...to become
somewhat detached. Sometimes on a rotation that is really fast paced (like this internal medicine one right now) I catch myself getting bogged down with the routine. Most of the time I can realize it and take a 
step back and remind myself that the little things matter just as much to people as the big things.  


We had a patient today who, in short, asked us if we could give her a "shot" so she didn't wake up. She
later told us that she wanted to go home and drink all the beer in her house to just end everything. While I def can't understand what she is going through, I couldn't help but think how ironic it was that she was so sad and hopeless about her condition, but the only thing she wanted to do was the one thing that 
seemed to primarily lead to her current state.  She went back and forth between crying and joking, but it was clear that was how she dealt with knowing she was at the beginning of the downward spiral that is Hep C, cirrhosis, end stage renal disease, lung cancer, and many more health problems. She definitely
snapped me back to reality and made me think about the choices we make.


My most memorable patient so far, a guy in his late 50's, dying from pretty much failure of every system in his body because of drug/alcohol use in his past once told me, "I regret my regrets". You'd think he was miserable, crochity old man who just was better of dead...right?? Wrong, this guy was the happiest,
most peaceful, and one of the most inspiring people I've met. Not because of his past, but 
because of his outlook on the choices he made in life. At first I wasn't really understanding what he 
meant by regretting his regrets. I've always been torn. Am I of perspective that we learn from everything in life, good or bad, so its best not to have regrets...learn the lesson and move on? Or that its ok to regret
things, as long as I regret the right things. But after knowing him
for a short while and having him tell me all the time that life was about choices, the good ones AND the bad ones (and he def made a lot of terrible ones lol), I realized he was the ultimate testament to having no regrets. Riddled with disease, he loved every minute of his life, even at the end. He had choices, he made certain ones that ended a certain way, but he was happy with that. I don't know that I'll ever be able to honestly say that i have no regrets, is that even possible??? But he definitely taught me that life is about
choices, standing by our mistakes, owning up to them, and not letting them bring you down.


So today I was definitely brought back to reality to say the least. It's not everyday that I have a patient 
politely ask to die. Are we making the choices today that we're going to be able to accept
tomorrow?? Maybe we'll never know until we're there. So for now, I'll just try to only regret my 
regrets...