I've been back in the states and back at work for 2 days now. I. Miss. Peru. I set out to find new perspective at this point in my life, meet new people, and truly experience the soul of Cusco and Machu Picchu. I can honestly say I achieved my goal in so may ways.

My absolute most favorite thing about the trip was in fact, not Machu Pichu. I loved seeing what an incredibly spiritual place it is without a doubt. But to be honest, what I loved most about Peru was the rich culture of people that are overwhelmingly proud of their Inka heritage which is electrically still present in their blood and the genuine love for "pacha mama", Mother earth. Maybe it's just that I haven't traveled enough, but I have never met people more in touch with nature.  It didn't take long to understand that people in Cusco and the surrounding sacred valley live and die for the earth. It guides their every move and is the underlying reason in their minds for how their life unfolds. They believe that the wind can take lives as she wants, and they don't question it. It's amazing to me to be able to believe so wholeheartedly that way of life. I wish more people here adopted something like this to believe in. While I know that people there, like everywhere else, long for more money and a "rich" lifestyle, I was moved by the large number of people I did meet that were perfectly happy with their simple lives in the mountains. It was very refreshing for me to see that and a good reminder of the wasteful, materialistic lives we live here in the states.  It was such a humbling experience to share their culture.

Overall, I met some amazing people, pushed my limits physically with the hike, and really engulfed myself in the spirituality that is all around in cusco and macho picchu. I'm home now with a new perspective and goals to return to Peru very soon! :)

Here are some pics:

Initially i thought I could cross Peru off my list. But after this trip, I realized that I added abut 5 more Peru trips to the list! Pictures don't do this magical place justice. Peru: nos vemos pronto!!! <3

Thoughts from the CCU...

So it's pretty much over. The rotation dubbed, "the worse month of intern year"...is behind me!! Yay! Has it lived up to it's hype?? YES...and then some, or a lot. Mostly because we were intentionally understaffed due to the holidays thus making an already confidence destroying  and soul sucking month 10 times worse. I guess they don't want to be the main reason for the exponential rise of depression in more than 4 unlucky interns around christmas. So, I got to be one of the lucky few to experience the CCU during the holidays, how privileged I am. :)

So what makes CCU so bad you ask???

Here is my attempt to describe, with random details, the essence of CCU.

1. Cardiologistss obliviously speak their own language that nobody really understands, unless you too are a cardiologist, and even then its questionable. They presume that interns can speak cardiology the instant they graduate medical school. I mean, of course, how dare I have difficulty following what you're trying teach me right now...I'm clearly slacking since in my long 6 months of training, I don't know the intricate details of a subspecialty of a subspecialty of subspecialty lol. Shame on me.

2. Cardiologists actually believe that non-cardiologists, and possibly the rest of the world, can read their minds and know precisely what they are asking and what they want to be done. Don't forget that they are forever speaking in their aforementioned secret language.

Example:
The question they ask during rounds: "When did the patients chest pain start?"
What they actually mean: "I want you to tell me the results of every cardiac stress test, heart catheterization,  echocardiogram, and cardiac labs were back 5 years. Oh, and what they ate for breakfast on their 15th birthday."

3.  Cardiology is THE MOST evidence based specialty with hundreds, almost thousands of trials with stupid names like, "HOPE, MADE IT, SURVIVE, and BREATHING NOT PROPERLY"...seriously cardiology??? I have a hard enough time remembering the actual medicine much less the trials that proved it and how it was set up.

4. After listening to the various different ways "chest pain" can be described by the hypochondriac, psychotic, insanely old, blind and deaf, the guy who just wants to get out of his nursing home, the blissfully demented lady who probably can't remember she even has a heart, the 24 yr old kid trying to get out of the military, the cocaine addict, and the rare semi normal person that has actual cardiac chest pain, your idea that you actually knew what chest pain was, goes totally out the door. Bottom line: nobody knows what chest pain truly is, not even cardiologists though they pretend to and talk about all the different types using their language. Some days i walked away so confused about whether a person's chest pain was even in their chest. Other days my attending deliberated about the type of pain so much and went through all the possibilities and criteria that I wasn't even sure what a chest was anymore, or a heart for that matter lol. But seriously, after this month, when I hear/see the chief complaint of "chest pain" I have a feeling it's going to make me vomit or punch somebody in the face. Truth.

5. Congestive Heart Failure. Swollen testicles. Disgusting marshmallow people whose skin could potentially look like one of those egg crate mattress covers if you poked them enough. GIve lasix and wait for the urine to flow. More swollen testicles. There are no words to describe how much I hate congestive heart failure after this month. That's all on this incredibly boring and annoying aspect of cardiology.

6. EKG's. Finally starting to get the hang of it. Or so I thought. That little squeak of confidence was destroyed when asked to break down every aspect of a "difficult" EKG (fyi- a stone cold normal EKG at times can be difficult for me lol) in front of the whole team including the eletrophysiologist (best EKG readers in cardiology by the way)
It sort of went like this..

Dr. EKG: Dr. Ramirez, what you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul. 

Me: Okay, a simple "wrong" would've done just fine. 


(one of my FAVE movies ps)...But that's pretty much what happened.




7. Everything in cardiology seems to have like 10 different stages an subtypes and subgroups. For example: CHF stage C NYHA class III-IV grade II diastolic dysfunction.  Do people actually know what that even means??  Really??? You might as well say CHF stage furry class 5 subgroup 6 subtype 13 grade yellow. I mean I learned it and all. But so annoying. I prefer my patient's version of classifying her husbands end stage heart failure, (in VERY heavy korean accent) "He hart no wor so good".  So much easier.

...so as not to sound like the month was all bad, here are some last good things about CCU

8. You can actually burn a line i a certain area of a persons heart with an arrhythmia and it beats better. Thats just pretty cool. Seems counterintuitive, but it works. THose really good EKG readers are geniuses.

9. You get to electrocute people on purpose, with their permission. Also pretty cool. I noticed that I was actually really interested in the electrophysiology aspect of cardiology, more than I expected really. I usually don't like things having to do with electricity, but just the idea of the heart, floating in essential water, can have electricity flowing through it making it pump sort of blows my mind. If the heart can do it, i think we can find a way to make iPhones water resistant so I don't have to replace my phone so often. Seriously, get on it apple.

10. Learning stuff. I didn't think it was going to happen this month. Interns are mostly worker bees. We do as we're told and even if we do have an idea or plan or voice, it's usually ignored. That being said, i never had any ideas of plans on cardiology in the beginning because I had NO IDEA what was going on and what I was even intending to talk about (like the patients chest pain). Not to sound utterly clueless, but cardiology is such a specific specialty, you'd be a food if you thought you actually were good at cardiology prior to intern year or even during intern year. So considering that my initial knowledge of cardiology was close to negative ranges, I feel like I did learn a lot and could possibly be approaching about a 2 or 3 now...on a scale of about 827364872648762387. But seriously, i did learn and even got a few pimp questions right from time to time. And the best part of all, aforementioned genius eletrophysiologist guy that I was pretty much afraid to even look at for fear of my life gave me surprisingly good feedback on my last day. He even told me that he thinks I could be a cardiologist if I wanted to. He crazy. Or maybe he's doing the secret language thing again and that's just code for "you're a dumb silly girl."


So it's over. FINALLY. Can' say I enjoyed it, can't say I hated it. Actually yes I can. I hated it. BUT....i did learn a few things along the way and I'm always grateful for that, it's never time wasted. Looking forward to a more normal life now.

 I'm off to Peru. To find balance and perspective again.

Ready for a break...

It has been a tough holiday to say the least. I hasn't really felt like a holiday even happened to be honest. I'm not complaining really, it's just a different feeling to know that xmas, my favorite time of year because of family time, came and went without event on my part. I could see everyone around me enjoying holidays and it just felt like I wasn't a part of it, what a weird feeling. But, i guess I knew this non-holiday holiday would come eventually. And overall, it sucked a lot, but now its over. It's the new year already and it feels like just another day. 2011 was one of the best years ever, and in some ways, the worst. The good made up for the bad and vice versa I guess. I don't really have big plans for this year in particular. I just want to live as much as I can doing the things that I've dreamed of with people that love me and do all of that without regrets. Doesn't seem that difficult...we'll see.

Anyway, i have 1 week left of CCU and it feels amazing. I can honestly say this has been the most challenging rotation of the year. Challenging in the sense that the work load has been ridiculous. It hasn't all been bad though. The days when i can barely keep my eyes open, those days are bad. The days when, because of the crazy work load, i feel like I can handle complicated patients way better than I could just 2 weeks ago are pretty awesome. Cardiology is actually really fascinating to me and if the schedule wasn't so nuts, I would consider doing it. But i'm perfectly happy being a cards geek ER doctor :) I've learned a lot and for sure still have more to learn all the time. It's been the kind of fun that i'd rather not do again lol.

Now that CCU is almost over...it's time for PERU!!!! I still can't believe that this whole thing is even happening lol. We literally came up with the idea totally not thinking it would be possible on such short notice...but here we are, 1 week away from flying to Lima. I'm so happy that it was able to be done, maybe some higher power had something to do with it because I've really needed it. After the tough holiday, tough relationship ending, tough work schedule, i need to go to a spiritual place and find perspective again. It's so easy to lose that while working all the time in an unhealthy schedule, seeing people at their worst all the time, and being around what seems like a constant stream of negativity from other overworked doctors around you. It's funny how we go to places far away from what we know to really find ourselves, there's definitely something to be said about that.

7 Days!!! :)

One of my favorite people sent me this quote today...so very true. 

“Destiny is a curious thing. It doesn’t always take us where we want to go, and many times ends up taking us to an unexpected place where we feel confused, lost, with no idea where to go next. These are complicated and painful moments that make us suffer and question who we are, along with what we want the most in our lives. But if we really make the effort to see these challenges as opportunities to find ourselves, we will understand that it was exactly what we needed to discover and strengthen our role on this planet.”
                                        [rickymartin]

peace

Source: Uploaded by user via Sherry on Pinterest

I needed this today.

Very exhausted.

More later....

What an amazing day!!!!

If my life was written as a book, (a ridiculous, crazy, emotional, weird, etc, book) Dec 14th 2011, this day, would no doubt be a very important page.

Today I found out that I will finally start my training in the field of emergency medicine at San Antonio Military Medical Center. It still sort of has not sunk in that this will actually happen in about 6 months. Although at the end of the day, I'm here, right now, exactly where I want to be, there have been times where I felt like I would never see this day.

Sure, it possibly sounds dramatic. But aside from the underlying blessings of my own health as well as the overall health of my family,  I've had days where I felt the opposite of blessed. Such days include the day when the Air Force revoked my medical school scholarship because I didn't actually get into a medical school in 2006 and proceeded to station me at Holloman, AFB in buttcrack, New Mexico to do fix airplanes. Also going down in the books as an equally "my life is ruined" day was the day when, after telling them I wanted to continue to pursue medicine, my own squadron commander and Air Force Headquarters ("The Man") told me, in not so many words, that now that I was a aircraft maintenance officer, going to medical school was not part of my life plan anymore and that I should proceed to accept the facts as a proud military officer.  Both of these epic days sprouted many other epic days that just made me really feel like my dreams were dwindling away with every day that passed.

It's pretty crazy to think back to those days and truly understand how I was able to look past all of the negative feelings of despair and not allow myself to be discouraged by the obstacles that, at the time, were everywhere I turned. I don't think I'll ever really know how I did that. I guess it's just one of those things that you don't really think about, you just do it. I remember like yesterday wishing and praying to God that if he would just help me get to this day, I'd never ask him for anything else. I remember so vividly the feelings that time was passing around me, taking my dreams of being an ER doctor with it.

That being said, it's still so surreal to me that I'm even typing this post right now. I've been fighting against everything and anything to get to this day that now that I'm here, I have a hard time actually believing it. I'm not implying that I've grown up living the life of hard knocks or anything silly like that. Simply that nothing in my life has ever come easy. I feel like i've spent my life struggling and fighting against to get here, to this day.  On the days like I talked about before (opposite of blessed days), there was nothing more that I wanted than to be finished fighting for "this life". But now that I look back, I feel like days when I felt like God or whoever had forgotten about me, were the days when I actually gained the most. It sounds all touchy-feely, I know. But no matter how many terrible days I have now, or how many times I think about how "tough" this life is right now, I look back at those days, remember how opposite of blessed I felt, and immediately realize that those were the some of the most influential days of my whole life. And without them, this amazing day, would not be nearly as meaningful.

So I love today. I love that I finally feel that some of my hardwork has paid off. But what I loved the most, was the feeling I got when I read my email telling me I was selected for Emergency medicine at SAMMC. I LITERALLY felt like the moment I read those words, the 200lbs, ever-powerful backpack of doubt and fear that I had been carrying around for a loooooooong time (even in my sleep, not just since last year) just disintegrated into thin air.

Overall, what an amazing day. I'm definitely going to bookmark this day and come back to it multiple times just so I know it actually happened.

Source: lifeslittlepresents.blogspot.com via Sasha on Pinterest

distractor post

It's match week!!!

I'm working furiously on Peru adventure planning to keep my mind off the match. I've narrowed down my flights, buying them this week!!! Hopefully booking an adventure tour that involves hiking the Inca trail..also this week! You would think all of these things would distract me from the match. (wrong) I have self diagnosed ADD so it's VERY easy for me to jump back and forth from thought to thought.

So very excited about this trip.

Other things to distract me this week: my cousin time I'm getting, the ever present ambulatory care, working out?, online xmas shopping, etc.

Ahh it's match week!!

ok, i'm done now, even this post can't distract me :(

Random thoughts...

•  As you can tell (or maybe not), I'm in the process of redesigning the blog! Actually, i'm not redesigning it, my cousin, the Xio part of XioKat is doing it for me :) Visit her blog and website, buy they're stuff, its awesome! I'm hoping redesigning= more posting, we'll see!

• Thanksgiving break was great. I got some much needed rest and time to see family. Sad that I'll be here for xmas, working, overnight, on my birthday, in the CCU, hell on earth. Wish me luck and prayers that I stay sane :)

• I don't even want to mention the upcoming (6 days) Air Force residency match that will determine my fate for the next few years. Lots of worst case scenarios going on in my head. I don't think its normal to be simultaneously looking for places to live in San Antonio, TX AND Okinawa...such is life. Bring it on AF!

• To celebrate and rebalance myself after this ridiculous match business, I'm planning on crossing an item off my bucket list very soon!!! Just sent in my leave paperwork to take an amazing trip with a very great friend to Cusco, Peru and hike the Andean mountains of the Urubamba valley up to the incredible Machu Picchu!! I can't even get over that I'm typing this because this has been a dream of mine, literally, FOREVER. Let's hope the AF comes through and I can overcome the mounds of computer training and jump through the obligatory hoops the silly AF requires me to do. Again, bring it on AF, your antics are  NOT getting in the way of this.  *side note: this trip will result in me having to do 4 months of wards straight upon my return, yes, i said 4, yes that's going to be insane. Who are we kidding though, it's Machu Picchu, it's worth it! And when do we ever get to travel like this? I'm doing it. :)

• I bought those silly five finger shoes. So far they're awesome but incredibly different and will take some getting used to. I ran today in them, maybe more than I should've. Feet are hurting now. I think if I can adapt my plantar fascia will like me again. Updates coming. 

• My cousin, from Colombia, is visiting me tomorrow for a little over a week! Very excited. She's a future doctor and awesome. 

• Currently on an outpatient internal medicine clinic rotation. It's quite boring/annoying. I don't care about pulmonary function tests...or diabetes follow ups. I DO care about short days and weekends off. So no complaining here. :)

...that's enough random thoughts for now. 

Oh hey there Machu Picchu....

Sometimes I wish...

...that I was perfectly content with being a housewife and that I didn't care about the whole saving lives thing. I say this almost weekly, but really, who am I kidding?? With my domestic skills, I would make the world's most terrible housewife and my family would prob pay be to go back to work. It seems like it would make this life easier some days though. Until I realize cleaning and laundry stresses me out more than a crazy ER full of dying people. Maybe in another life.

...I was more girly. I've NEVER been an actual girly girl, as most of my friends have often told me. I've always been known as the tomboy of my family and I've actually gotten much better, thanks to my cousins :) I own actual high heels and dresses, several actually. This is an improvement from just a few years ago. I'm pretty content with my girlyness, or lack thereof. But sometimes, and by sometimes i mean once in a blue moon, I get the urge to wear dresses and high heels but then I quickly remember the trauma i have experienced from wearing high heels and my high heel PTSD comes back. Oh well, I'll stick with my flats out of respect for my feet, they do a lot for me as it is. :)

...I wasn't so stubborn. (this is not likely ever going to happen) Being stubborn isn't always a bad thing. It is part of the reason I've accomplished most things in my life. But sort of like the housewife thing, being less stubborn and more able to accept things I can't change would again, make this life A LOT easier lol. I guess it comes with the territory of being my mothers daughter. I never give up on anything. I often struggle with understanding that giving up isn't synonymous with walking away. Sometimes we just have to let things be and realize that, in my mom's own words, "cant save the world everyday." Let it be. Maybe a new tattoo idea?? ;)

...I had a longer attention span. My presumptive ADD sort of conflicts with my need to learn things for myself. I genuinely have to look up everything I'm taught, despite where/who I hear things from. Not in a distrusting way at all, I just always feel better reading things for myself straight from the source (i promise i'm not crazy controlling freak). I believe we should trust, but verify. That being said, I really have to work on my attention span. I go to read an article or a chapter to verify what I was just taught for example, and I can't make it through the 3rd page before thinking about what my next meal is going to be,   how far I'm going to run that day, or some other random non-important thought. I need to get a grip on this attention span thing...intern year is not the time to get distracted by every car that drives by lol. I feel like that dog from Up...sqquiirrll!!!!

ok I'm done now. There's many more things I could add to this list. Sadly, that last one is the limiting factor. Off to sleep.

This might actually be my wedding attire, one day, except red instead of purple... :) :)

Source: ninephotography.squarespace.com via Bix on Pinterest

I get to Starbucks before it opens :(

Not to be insensitive at all, but today I kept seeing facebook posts and even hearing people say "never forget".  And shamefully, I'll admit, I had no idea it was Sept 11th until I got home from work! :-/ Fail on my part as an active duty  military officer. In my defense, I didn't actually forget, I just never knew what day it was, seriously. Crazy what waking up before 4am daily,12 days straight without a day off, and extreme fatigue can do to you.  I live not by the actual date, but by how many days my patients have been in the ICU, I've been getting to starbucks before they open lately, and my attending has already told me to eat more for breakfast because my growling stomach during rounds is distracting... it's quite sad. lol

ANyway, MICU has been going well so far otherwise. One thing that I mentioned in my last post that has continued to be a theme of the month is death. Not because my we as a MICU team are bad doctors, but because it seem that this month we have been the terminal cancer service. In the past 2.5 weeks, i think only a 1 or 2 days have gone by where we didn't discharge a patient to heaven. Most were expected, a couple were not, and those were the rough ones, but not the roughest. THe roughest for me to get over are the ones that don't actual die. They stay "alive" but they're not actually living.  I don't dwell or let it really get to me to the point where I can't do my job, but I do have to admit that I am sensitive to this aspect of medicine, always have been. It's a good thing right? I feel like we live in a doctor culture, especially in the military, where we frown upon sensitivity. We are people, not robots no matter how tough we pretend to be. I bet even the big tough surgeons who puff their chests out all day long pretending to be big and bad get a little sad from time to time. lol  That being said about the daily death we have had this month, I have to say that there's a fine line between trying everything you can to preserve somebody's quality of life and keeping their heart beating until family can find the strength to say goodbye. I hope I don't have to ever make that decision for somebody I love. Either way, all I know is med school does a terrible job of introducing us what to do when you get the call "Mr/Mrs. X is just passed, come now, the family is very upset"....yikes!!!

Anyway, that's depressing. In happier news, next month I will have a life again! :) Things I'm planning on doing:

- Step 3 studying...only because I HAVE to
- Celebrating the fact that this crazy schedule that Tim and I have had due to studying for tests is over!
-Thursday night group rides with king william cycling group!
- uncover hidden treasures in san antonio/austin
- find places to hike/rock climb
- have groceries in my apt on a regular basis
- take lots of pictures...of everything
- cook...a lot
- stay awake past 9:30pm

On a side note: Since my mom recently welcomed a beautiful Chinese exchange student named Maggie, I decided that I'm going to visit her, my new sister, in China and I'm making this (climbing in China) happen soon...no matter what it takes!!  ;)

Source: onsight.com.au via Sasha on Pinterest

Welcome to the MICU....

I've been in the MICU for 1 week now and it's been great. By great, I mean that I'm learning a ton and I love the work. THe last 3 days, 3 patients died...rough. I pronounced my first death, did chest compressions twice already, and had to give some pretty tough advice about withdrawing care. Everyone has said that MICU is the busiest rotation and that I'll never have time to workout. So far, i've had the opposite experience. Everyday that I come home from being surrounded by death and dying, i feel compelled to run and exercise. Maybe that's just my way of feeling alive and shaking off the emotional weight of the day, but it's become necessary. (my love handles are also benefiting from this lol). Anyway, MICU is rough but amazing to say the least.

Tomorrow will be 1 yr since Tim and I went on our first date. Crazy. Crazy that he has continued to ask me on dates for a year. Crazy that he has continued to put up with me during this year of unknowns and moving and changing of plans. I'm pretty lucky in my opinion ;)

Thing's that I'm not used to yet...

1. This patient history:  22 yr old male with bilateral lower extremity below the knee amputations, right hand amputation, and blast injury to testicles and penis. (this kid is not a rarity sadly)

2. Being called doctor by above patient and him thanking ME for my service....are you serious??!!! I have done nothing compared to the sacrifice and decisions these kids make everyday. 

3. Realizing that I'm not a med student anymore and my signature actually means something now (mainly, I have a licensee to kill)

4. Waking up at 4am daily...and wanting to go to bed at 7pm

5. Being far away from Tim and seeing him once every 2 months :(

6. Knowing that my holidays will be spent in the hospital this year

7. Feeling like all I do is work and sleep

Source: None via Sasha on Pinterest

My path from A to B is quite similar to this. Doing my absolute best to enjoy this round about path that seems to be the theme of my life. :)

It's 7:22pm. Bedtime.

Deja Vu, I hate you.

So before I start this post, I want to note that I just read my previous post and i really don't even remember writing it! Totally serious. It was a good post, and I'm glad I wrote what I wrote, but I honestly don't recall writing it. This post on the other hand, I wouldn't mind forgetting...


Today was my day off. What did I do today?? Here's a list of the progression:
1. Got a hair cut
2. Spent way too long re-writing my CV while drinking Starbucks and people watching [ps-why does it feel like always have to re-do my CV but I never feel like I actually have done something awesome enough to make it better???]
3. Watched my new tv obsession, "I Shouldn't be Alive" on Animal Planet and got lost in my thoughts about how I would most likely die in each of the situations presented in the episode.
4. (Feeling guilty about watching tv): rode my bike to Mad Hatter's Coffee and started writing my new personal statement for this cycle of emergency medicine applications
5. Had a moment of horrible deja vu and despair about the fact that this whoooole drawn out process that is the military match AND civilian match is happening again :*(
6. (frustrated with my negativity) rode bike to eat away my stress with sushi and somebody who really inspires me [you know who you are]

I usually think deja vu is pretty cool, eerie, but still cool. I HATED the feeling I got today when it seemed like all my stress of the match, not knowing (again) what on earth I will be doing or where I will even be doing it, totally came rushing back. I've been telling myself for the past year now that everything happens for a reason and this is where I'm SUPPOSED to be right now. But i guess I just can't help but let the weight of everything, including the powerless feeling this process gives me, overwhelm me right now.  I know the right thing is to just relax and have faith that I'm doing everything, literally EVERYTHING, in my power to set myself up for matching in San Antonio this year. And I know the right thing to say is that, whatever happens will happen and things will work out for the best. I know that I can't plan everything (nor do I want to). And I know that I can't have back up plan B through Z when it comes to trying to end up in the same location with Tim.

It's almost painfully obvious that this is yet another lesson in faith and trust that it's all part of a plan. But I don't feel like any lessons today.  We're all entitled to have our days right? THe days when we feel like we're losing our grip on things we thought we had strong control over.  The days when we can resist what we know is truth only to be followed by a day of regrouping. I think today was my day to resist...and I successfully did that. Maybe tomorrow (i hope!!) is the day to regroup and move forward. .

PS-
I (not so?) ironically stumbled on this pin today...

Source: lilluna.com via Sasha on Pinterest

I love my job

It's 11:21pm, I'm home blogging instead of working on a case report that is due soon, and I love it. It's my day off today and honestly it hasn't really felt like a day off. Nights have been going relatively well. It is crazy busy and I feel like I'm running around like a pager carrying chicken that just had its head chopped that's trying to find it's way around a hospital. After the first night of getting lost, asking nurses how to do pretty much everything, and figuring a small amount of things on my own, I feel like I have the hang of things. By the hang of things, I mean that I know where  to find my patients in the hospital and can stumble my way through the calls I get from nurses. I haven't had anything too crazy happen just yet but last night was a close one. I came within a couple hours of having to pronounce somebody dead :(  I was pretty sure she was going to die last night but she (or somebody else) kept her with her family for a bit longer. I talked to her family and prepared them for the end that was very much in sight. It was really tough. As a medical student I've seen very sick people before, but never on my own. I was never the ONLY person that was in the room with a family and their dying loved one. I kept her comfortable and just let things play out. I'm not sure if she made it through the day today,  I guess I'll find out tomorrow.  It just made me really think about how fragile we all are. Here one day, and gone the next.

But overall its going well, I can't complain. I'm learning a lot and I think I'm actually getting to closer to the day when I actually FEEL like a real doctor. One thing I have noticed that I hadn't really thought about was the amount of young, drastically injured people coming to the hospital for rehab. I see them as i'm walking into work everyday. On a daily basis I see no less than 5 kids wheeling themselves and their newly amputated stump around the hospital. WHen I see them all I can think about is everything that landed them here. The process from being wounded in theatre to being able to wheel or crutch around a hospital on your lunch break form rehab. I  can't even begin to imagine the battles they fight everyday.  So it does make me sad to see so many young people like that. But it does make me re-evaluate things when I get frustrated and feel overworked or tired. I'm incredibly lucky and I can't forget that.

I think it's pretty amazing that I get to experience all of these things for a living and even better, get paid for it. The hours are long and it's a lot of sacrifice. But in no other career would I be able to actually make an impact on people and truly give back as much as I do. It's a special gift to be able to be here and good or bad, I wouldn't change it.

Night shift= no sweat...literally

I'm starting my 2 weeks of night shift tomorrow! Contrary to what my colleagues have expressed, I am very excited to start! This out of proportion happiness is probably due to the fact that I'm just so anxious to start being a doctor already, a real doctor. Not that 2 weeks on nights makes me a "real" doctor by any stretch of the imagination.  I just really want to get out of this holding pattern I've been in during these past 2 weeks of "research" block. (I mean really, how can I do research when I haven't even seen my first patient of my medical career???)

 So I know nights is going to kick my butt in more ways than one but I'm actually very ready to start learning the real things that doctors do. I'm ready (I say that now) for the 3am call about a patient who is having chest pain and needs help. I'm ready to frantically run my little intern feet down the hall to a code and immediately realize that every ounce of medical knowledge I thought I had suddenly disappeared and I have absolutely no business being part of a code, much less running one! I feel like I'm ready for all of these things! Oh and just for the record, ready does not mean prepared. I'm fully aware of how unprepared I am to manage the needs of every and any medicine patient in the hospital at night. But I do think that it's more important to be ready than prepared in certain situations. For things like crazy night shifts and running codes that not only take you out of your comfort zone, but destroy any last memory you even had of feelings of comfort, there is no amount of time that could prepare you adequately. I have this feeling, and I've been told, that it's just one of those things that you have to go through to fully understand. I guess it's like the whole "you had to be there" jokes. Except I highly doubt I'll be laughing, maybe, who knows.

The things that I'm putting in the "bright side" category about night shift:
       -no waiting at the BAMC gate for 3x the amount of time it took you to actually drive there
       -no extra people (i.e. interns, visitors, random people that just get in the way) around to worry about
       -the lack of extra people will decrease the number of people that see me screw up!
       -The cooler temperatures during which I will be leaving. No sweating on the walk to the car, yes!!
       -The "learning experiences" I will get...*nervous laugh*

...and that's all I can think of right now. This list surely decrease starting tomorrow as I'm sure I will only see fewer bright sides (literally) after my first night shift.

Off to continue my quest to stay awake as long as I can and sleep all day tomorrow. (so far I'm failing miserably!)

I hate Blues...

Today was Monday...It's "Air Force Blues" day where we're required to wear the dreaded uncomfortable blue uniform.  I felt a little on the blue side today for a few reasons.  I guess I was just following the blues day theme.

I start night float on Friday. I'm pretty excited to finally start working and get out of this holding pattern/psuedo research block i've been in. I'm also pretty scared that I'm going to be so overwhelmed and not know what i'm doing. I'm not going to be alone, but even with help there, i hate feeling like/being an utterly clueless doctor. It's going to be busy, no sleep, and crazy.  Wish my patients luck!

Short post today (see paragraph 1). I'm off to visit a friend and eat some yummy Filipino food. That surely will mark the end of Air Force Blues day. (i hope)

Source: None via Marybeth on Pinterest

The chase has...continued!!!

Weekend with Tim!

I was one of the lucky ones to have start residency on a non-inpatient rotation. Not only is my first couple of weeks non-inpatient...it's actually a non-patient rotation...RESEARCH! :-D  At first, I was bummed out that the huge build-up to internship felt a bit anti-climactic. My first real day of being a doctor didn't even require me to come into work! However, I am NOT complaining at all. It was a blessing that I was able to have the weekend off because my Tim was able to visit me! He arrived Friday night and we had a great weekend. I showed him around downtown San Antonio and King William. We spent most of the weekend on bikes making plans to live here in our own cute King William house. It was nice and I'm excited to see what the future holds <3. We rode around town, did Crossfit with some fellow interns (which totally kicked out butts!!) in their home crossfit gym (CROSSFIT EMESIS) they made, cooked ourselves a fantastic dinner, and just relaxed. It was a weekend that we both needed to put things in perspective again.

Now that the weekend is over I'm looking forward to really getting a study/workout regimen started. I have lots to do in these next 5 months and a lot is at stake. Residency, Boards, EM applications, fitness goals will for sure keep me busy and hopefully make the time without Tim go by fast! 

Pics from the weekend...

Our vehicles!

                                           Post-thai dessert: Tres leches cupcake and cheesecake

Dinner my Teem made for me!

Pioneer building in King William

Admiring homes in King William historic District

Dancing at a beer garden on First Friday <3

Source: 1.bp.blogspot.com via Sasha on Pinterest

Sometimes we fall off...In my case, it happens a lot...just have to remember to check the breaks and keep the wheels turning <3

Home is where my bike is...

I'm approaching my final week of residency orientation! It has been somewhat of a long 2 weeks full of paperwork, endless power points, safety briefings, and trying to re-adjust to being back in the Air Force. In-processing, the military word for checking in and starting at a new duty station, has pretty much been a painful experience for me. Mostly because something got lost in translation (i.e. my SSN-which is kind of a big deal) and made virtually every form I was supposed to have, every system that I had to have set turn out incorrect. Long story short, I had to do everything at least twice to fix the error in my SSN.  BUT...it's ok, it all worked out and I got a 2 week lesson in patience :)

In other news, I'm getting settled! I LOOOOOOOOOOVE my apt..well...with the exception of the elephant wearing high heels that lives above me. It has gotten better over the past week. However, the first week I was certain the upstairs neighbor was practicing her runway walk promptly at 3am daily!!! Aside from that, the apt/loft is amazing. It's the nicest place I've ever lived in and it makes me feel like a real adult...scary. Not only is the place awesome, the location is great. King William is a very unique historic district with a great soul. There are several galleries, independently owned shops and restaurants and just a general alternative. It's not your run of the mill suburbia and that's what I love about it! Probably the best thing I like about this location is that I can (and do) ride my bike pretty much anywhere. Downtown is a 5 min ride, King William is 1 block over from where I live. In phoenix, i really only rode my bike with groups and when I was specifically training for races. I forgot how much I loved just riding my bike places, no real training goal in mind. For example, i rode my bike to get my hair cut last week after a very very long day of orientation. It felt so nice, other than the little fall I had, to ride a bit and "unwind" after work! Overall, in just a few short weeks, San Antonio has brought me back to my bike and makes me feel at home. I'd say that's a good sign! 

So now that I have one week until I start and am more or less settled, life is better :) The interns and residents have been really nice and helpful so far. I know it's going to be a tough year in so many ways, but I can honestly say I'm excited and grateful. 1 year ago I was in San Antonio ironically. During that time I can remember feeling like I belonged here and praying that I would match here. Well..I did! (sort of...more on this later)This year, I'm here, and praying that I STAY here. I guess we'll find out soon enough. I mean, who would be more perfect for SAUSHEC (pronounced: SAW-SHEK), than Sasha! (prounounced SAW-SHA) I mean really...can it be more obvious that this is where I'm supposed to be!? ;) 

Here are some pics from the past couple of weeks!

The outside/inside of my complex: South End Lofts 

Waiting for a red light in Downtown :) (I'm an eternal tourist)

Houston St. and St. Mary's- sitting at a starbucks 

"Beauty...it rubs against one's tongue

it hangs there hurting one. insisting on its own existence

finally it gets so one cannot stand the pain

then one must have beauty extracted..." 

- this was something i saw on a ride home recently...it's pretty interesting, still trying to figure it out

My trainer!! (and makeshift riser lol) I love it! Now I just need a new bike for riding around town :) 

 Messy and a work in progress...but it's a start

<3