Regift

I am a little frustrated at myself for feeling annoyed, but just argh.

I don't usually do Christmas gifts, but I know a few of my friends do. So made sure to get them something. And they gave me something. And it was a regift. Opened and mildly used. And seriously? I am vaguely offended. I almost would rather have gotten nothing. I thought about what they might like. And they gave me something they used and didn't like. 

This is why I hate gift exchanges sometimes. Because I have too high hopes. Or maybe too high expectations. Was it too high of an expectation? I just wanted something to say that they thought of me specifically. Maybe that's too much to hope for. This is why I don't expect anything for birthdays. Or holidays. 

Isnt it better to expect nothing and be happily surprised by something, no matter what it is. Rather than be disappointed? 

Can I apply that to everything? Expect nothing from my friendships, and then I won't be disappointed. Expect nothing from people. Do things because it would make me happy, not because I want anything in return. Initiate because I want to. Not because I expect them to return the favor. 

Is that too cynical? It's practical. And keeps me from getting hurt. Or annoyed. Or offended. Or angry. 

In the end, everybody has different priorities. I need to drop my expectations. Do everything for the joy of doing without expecting anything in return. That's what I need to do.

----

I learned something about myself today. That is a good thing.

---

addendum:
I actually have to take a few steps back and realize that I am actually really bad at gifts. It's part of that "emotional labor". [aside: this is an interesting read if you're curious. You'll have to skip through a bit of cringey uber-feminism thoughts, but there are some pertinent ones as well. here]. I shouldn't get frustrated if I am the same way. I will try to be better at these things too.

---

Addendum 2.0
After talking to a friend, I think that I have to revise a lot of this. It is not so much the regift as the perceived lack of thought behind the gift. I don't mind regifts. I don't mind, as long as it's thoughtful. Of course I have to realize that it is all my perception. It may not actually even be true. In the end, it can all be boiled down to this semi: I thought a lot about their gift, and I perceived and believed that they did not think a lot about mine. And I was disappointed.

But I have realized in my last few years that perception is always flawed. And I always try to give people the benefit of doubt. And if there are two options of how I can perceive their thought, then take the better of the two.

Basically.... just gotta get over myself about this stuff lol.

Almost Christmas

1. Christmas
For some weird reason, it really, really does not feel like it's almost Christmas - despite the semi-advent things that I've been doing with friends. I've even wrapped a gift or two. And it still doesn't "feel" like it. I wonder what I'm missing? Or maybe it's because I'm still in San Antonio. And that makes more of a difference because I'm not with family.

2. For Remembrance
One of my favorite nights with the girls in my small group. Hot drinks, lovely, bright twinkly lights on the trees, a night of walking and talking, looking at the stars, good conversation. Minus demon cat biting me :(
Another close favorite was the ridiculous six pots of tea night just because.
Friends are God blessed.
Let me never take them for granted.

3. Presents
I seriously wish my family had more traditions. The main reason is because it's too much of a bother. These days I'm starting to realize that almost everything that is worth something requires effort. Finding presents for people. Visiting someone who is sick. Leaving the comfortable bed to hang out with people. Planning a trip. Hobbies and skills. All of it is time and effort and dedication. And I want to be more diligent about it all.

Of course there are the days where I can't even leave my bed because of laziness.... but it's an ongoing process, okay? ha

4. Late nights
Caught up with an old friend. I was struck by how he was the same, but not the same. Is that weird? I wish I knew how much I've changed since college.
.... and if it was for the better.

The quote that I love: may the space between where I am and where I want to be inspire me. 

5. Love
Everybody wants to be loved.

Volunteering

... is it weird that I don't like volunteering?

I objectively think that it's a good thing and I ought to do it. So I mind over matter things and volunteer. And then think to myself how much I am doing because I ought to. Not because I really want to. But surely that's not how it should be?

I know some people who genuinely like volunteering. And I think they're good people.
Maybe it's that I find interacting with strangers a chore. Sometimes a worthwhile and good thing, but ultimately still energy.

---

I've been having a really hard time finding motivation lately. I just don't want to do anything. If I could lay in bed all day without getting a headache, I probably would.

Sigh.

---

I don't know what I'm looking for these days. Kinda feel like I'm wandering around aimlessly.

Grocery Shopping

Eat fresh food.
Eat frozen food.
Eat emergency pantry food.
Realize there is no food left.
Manage to put off grocery shopping for another few days by eating out and eating extra emergency food.
Go grocery shopping.
Buy fresh food, frozen food, pantry food.
Am hungry after shopping.
Eat snacks and frozen food because too lazy to make fresh food.
.... such is life.

...

This new blogger system sucks. They need to revert back to the old dashboard.

/dislike.


Learning how to crochet. E hooks are a pain, but they look pretty. It's almost more an effort in counting rather than actual mechanics, ha.

Trying to remember what it means to be determined.

Weird

Your heart is a strange little orange to peel.

How.... weird.

Church

Bullet points:

- This church is very focused on outward reaching. I appreciate it.

- Speaking truth is. I don't know how brave it is. It is simply acknowledging what is.

- Am I too critical? Do I see too much fault? Do I have the plank in my eye?

It's the stupid gray areas: is it okay to drink before 21, is it okay to drink until drunk, is it okay to cuss, is it okay to have road rage, is it okay to laugh at crude humor, is it okay to make jokes at someone else's expense.

- This is (not meant in a mean way) a feel-good group. The hard questions are rather glossed over. Why? Because we aren't close enough as a group. Because we don't trust each other enough. Because we are afraid of talking about sins. Because we don't want to change. Take your pick of answers.

Extra thoughts

1. Sleepover
- girls night. felt almost like college all over again.
- random costco run just for macaroons. ridiculous. kinda fun.
- did a craft. i think it turned out well. i miss acrylics. i really, really, really want my acrylic box that's in dallas. i want my brushes. i want all of the art things back at home. (and on that note, i would really like a sewing box, and a scrapbook box, and a crochet box. i also want a glass cutter kit, a tool kit, a few power tools, and a sewing machine. lol. i mean, while i'm still dreaming, i would also like a full size keyboard with a pedal.)
- life stories. i am..... blown away by how different everyone's life is. and the struggles that people have. i think i have fairly mundane life.
- it is an extremely comfortable environment, to be honest. i barely know half these people, and i already know what this kind of vibe is like. i know how the conversations sorta oughta go. i know the progression of the night, i know the type of things we talk about, i know the songs, i know the words. it's like walking on well-worn trails of the past. haven't i already done this at least 4 times? once every single year for ccf, a girl sleep over with questions and sharing and food.

2. Faith
Everything of the sleepover felt familiar.
Except this: faith here is so much stronger because everyone here fights against time to make it to these things. because faith after college is a chosen thing, is a self-motivated thing.

and I feel so in between.

I am spending too much time waffling on important questions and things.

3. game night
- gah. i can't believe this happened the same freaking day. not enough emotional energy. i didn't expect it to go through, but it ended up being at my place, so of course i'll host.
- it was actually good. a small group. a few more life stories. a few games. i dunno. a getting to know you part.

5. decisions
- to choose the path of the straight and narrow requires a steadfast heart

6. picnic
- lovely pavilion. adorable dogs. the most beautiful wicker basket. delicious brie, cranberry chipotle sauce, turkey, apple slices sandwich. salami. brownie brittles. macaroons. chips and salsa. cake and cookies. potato salad. fruit salad. just ugh. so full. so good.
- quietness. the problem of big groups that don't know each other well.  the art of socializing......

midnight thoughts

it's been a long four weeks. and i've had too many thoughts but not enough to process all of it. there is something about taking the time to write down everything i'm thinking.
-and sometimes i wonder if i'm a little on the autism spectrum when i'm trying to reconcile every moment and every emotion and every interaction that i have with people. but that's neither here nor there.-

too many thoughts about fear, chiefs, sicu, rounding, interns and attendings, procedures, the art of feeling useful, music, emotional intimacy, lack of time, feeling "in between", working too much to think, a faith that lasts beyond mere emotion, decisions, inevitability, silver linings, concerns, harmonies, chicken and beer, wine and beer, sand volleyball, long car rides, openness, the strange sensation of walking similar steps as in the past, tears and fears, old relationships, depression, anxiety, new touches, keeping in touch, numb cheeks.

you know. the whole spectrum of emotions.

i am not who i was four years ago.
i feel that so acutely now.
there is so much that changes.

people are transient. people change.
i have changed more than i ever would have expected.
how mutable.

busy

there is something mind-numbing about being busy. it leaves you with no time to do anything but the bare necessities.

work. eat. sleep. try to keep up with friends. cook. do. do. do.

no time to think or worry or consider the future.

Quarter Life Crisis

I think I'm having a quarter life crisis.
What am I doing? Do I want to be doing this? Why is my life like this?

---

-later in the day edits-

Midnight coffee ramblings where I am desperate and tired and sick of trying.

Would I ever survive without my friends and family?
So much gratitude for people to lean on. Distance may separate us, but my affection for you surely transcends that. I hope that I am someone that they can lean on as well when times are hard.

A wise word from my mom, who has always been the sturdiest of all sturdy rocks, who I would want to model my personality, who has so much wisdom:
Everything has an impact, and the people who love you feel the waves you make. Both the good and the bad.

Grateful that they absorb the bad; but I need to work harder so that I can share good waves.

BLAH

feeling TIRED AND SICK OF EVERYTHING.

Introvert Battery

I am like a battery. I only have so much people-charge in me at a given time. And I ran out right after church, which was pretty crappy because then I felt pressured to eat with people anyway. So that was a horrible meal. Delicious, but horrible because I didn't want to talk at all.

And I didn't even have time to finish my book :(

Recharged and hopefully I can make it through the day. 

Groups

Had two fairly distinctive group outings this weekend so far. Both of them sorta kinda first time with the group, except for a friends that invited me into the group. 

First: A small group grill out. It was really fun. Serious CCF vibes in terms of feel of the group. Umm, a lot more type B than type A planning though. :/ (so not efficient). One of the pastors hung out with the group, which I thought was wow pretty indicative of the type of community they're trying to run, I was pretty impressed. The food was great, the company extremely welcoming and open. Good people, genuine conversations. Most of them sorta related to medical stuff, a lot of them had ink - I like that too. The only thing I worry about is that I might try to superimpose my experience from college into this new group. Not everything needs to be done the same. 

Second. Went floating on the river and loved it. It was a lot of pharmd's and a handful of med. I would love it even more if I went with a huge bunch of my good friends. I seriously wish a bunch of people weren't spread out across the country just so we could all float on the river together. 

I know the stereotype is loud, drunk people getting more drunk on the river.

But I swear it's super relaxing and the ultimate chill day. Super peaceful, a lovely balance of cold water and hot sun (getting that vitamin D yeah!), languid conversation, a couple of little rapids for excitement, the hilariousness of trying to stay together. It's great. With or without alcohol. And then if it's a group of close friends? Gah, it'd be a perfect hangout. 

Thoughts: Haha so different. I liked them both.  

extra

Just a random aside on on random thoughts:.

1A. business
- Dependence on business. Even though medicine is fairly necessary just in general, it is still dependent on the patient coming to the doctor for a service. It is still a... business (?).
- a surgeon needs to have enough patients. but anesthesiologists get business from surgeons. if you don't have a good relationship with surgeons, you don't have enough business.
- i suppose it's all assuming that you're private practice, not hospital contract.
- the anesthesiologist was kinda gossiping about her group and the people in it. some of the newer partners haven't established a good base of surgeons to work with yet and desperately needed work - so ended up asking if anyone wanted to sell their calls. like what? and it ranged from 350-750. i'm slightly flabbergasted. i mean, i don't know the exact rates and the pay for call, but they were desperate for business that they had to buy calls.

1B. gossip. there's too much. even in medicine. i don't think it's good to listen and talk too much about the so-and-so new surgeon hired in whatever hospital that said this and that. And even beyond gossip..... there's is definitely a type of work camaraderie that I don't think I understand.... There were a ton of people who talked really openly about their problems in passing. Like hey doc, how's it going? Meh, just paying spousal alimony and child support cuz it's the first of the month, doc. Uhhhh too much.

2. saying goodbye
- still do not know how to say goodbye properly. i just want to walk away. i think it's supposed to be slightly more emotional. but.... it's just another thing that happens in my life. am i really that sad? not really.....
- and how does one stay in casual-business-contact with someone? like... i know we're not friends, but i might want to keep in touch with you casually because we worked together and i think it's a good thing to do, but i don't really have anything to say to you except business.

3. eating
- i gained THREE pounds in the last month. lol. I am seriously amused. After losing about 3-5 lb from studying month, I gained it back. I blame my rotation, which had free food.

4. relationships
- my standards are probably too high....
- and i think i am not an easy person to get to know or to love. who i consider someone who is easy to love: incredibly accepting of flaws and faults, adaptable and flexible to the other person,
- first dates are increasingly annoying. can i just skip to the comfortable-with-you part?

5. FOMO
- i don't often consider myself someone who feels fomo too much. but i want to be in the loop intellectually. i want to know it's going on. i want to be invited (who doesn't?). but even if i'm not, i don't get offended (most of the time - depends on the situation and people).
- but i think.... i understand.

6. compliments
- I honestly DON'T TRUST COMPLIMENTS. An nice attending who says good job, I'm like... shifty eyes, do you actually mean that or are you trying to be nice? I'd rather know the truth. Or have constructive criticism. Save your compliments until I know it's true.
- he complimented me today and I was like.. thanks. HOW TO PROPERLY RESPOND TO COMPLIMENTS?

How small

How small we all are.

Flying however many thousand feet in the air, body safe within a metal contraption, I stare out over the sea of white clouds. Glimpse the acres of land below. Forested areas, desert areas, civilization with a thousand tiny little houses - as small as a play piece in Monopoly. Fly through the trailing vapors of a helpless cloud. Dream of world where you are so, so small.

A thousand tiny houses. Each one with people - with hopes and dreams and struggles and daily fears and tears and joys and happiness.

What does that dictionary of obscure sorrows call it?
Ah, yes.

sonder
n. the realization that each random passerby is living a life as vivid and complex as your own—populated with their own ambitions, friends, routines, worries and inherited craziness—an epic story that continues invisibly around you like an anthill sprawling deep underground, with elaborate passageways to thousands of other lives that you’ll never know existed, in which you might appear only once, as an extra sipping coffee in the background, as a blur of traffic passing on the highway, as a lighted window at dusk.

To their eyes, I am just a passing wink flying overhead.

How small we all are.

equilibrium

I've been thinking on equilibrium recently.

This idea that there is a sort of equilibrium between the you that you show to the world, and the you on the inside who only you know -or a precious few as well-.

There must be a porous membrane between the two, where some of the inside you bleeds through and people see the marks of your heart on the outside you. They call it "wearing your heart on your sleeve". All of your emotions, all of your thoughts, all the fears and doubts and happiness and strange quirks and weird idiosyncrasies that are unique to you, just you, only you.

I am always surprised at the people that have a paper thin barrier, one that might not even exist. The people that willingly talk about their current struggles, reveal slightly embarrassing pasts, are unabashedly forthcoming of their odd habits.

I am not that brave. I am not willing to be that vulnerable.
In theory, I guess.

Fear

The most dangerous thing about loneliness is that you start talking to yourself in the silence. As if your own voice could fill the air and become the chatter from friends, the encouragement from family, the sound of being. But instead, you just hear your own voice and the loneliness in it.

It is like a hug that you give to yourself. It doesn't quite work. 

----

All right," said Susan. "I'm not stupid. You're saying humans need... fantasies to make life bearable."

REALLY? AS IF IT WAS SOME KIND OF PINK PILL? NO. HUMANS NEED FANTASY TO BE HUMAN. TO BE THE PLACE WHERE THE FALLING ANGEL MEETS THE RISING APE.

"Tooth fairies? Hogfathers? Little—"

YES. AS PRACTICE. YOU HAVE TO START OUT LEARNING TO BELIEVE THE LITTLE LIES.

"So we can believe the big ones?"

YES. JUSTICE. MERCY. DUTY. THAT SORT OF THING.

"They're not the same at all!"

YOU THINK SO? THEN TAKE THE UNIVERSE AND GRIND IT DOWN TO THE FINEST POWDER AND SIEVE IT THROUGH THE FINEST SIEVE AND THEN SHOW ME ONE ATOM OF JUSTICE, ONE MOLECULE OF MERCY. AND YET—Death waved a hand. AND YET YOU ACT AS IF THERE IS SOME IDEAL ORDER IN THE WORLD, AS IF THERE IS SOME...SOME RIGHTNESS IN THE UNIVERSE BY WHICH IT MAY BE JUDGED.

"Yes, but people have got to believe that, or what's the point—"

MY POINT EXACTLY.

--- Terry Pratchett

Oh Sir Terry Pratchett, you atheist. I can understand where this is coming from, I really do. 
The thoughts of 
God has a plan
Trust that he has something greater in store for you
There is a purpose to all of this
You have meaning
"For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.
-- Jer 29:11
"And we know that in all things God works for the good of those who love him, who have been called according to his purpose."
-- Rom 8:28 
"...but those who hope in the Lord will renew their strength. They will soar on wings like eagles;     they will run and not grow weary, they will walk and not be faint."
-- Isa 40:31

Sometimes they feel so very trite, like platitudes. An encourage-o-gram that an acquaintance might press into your hand. Like graceless, meaningless condolences. A social courtesy. 

But it all comes down to faith. 
Atheists say it is a delusion.

Justice. Mercy. Rightness in the universe by which it may be judged. 
Love, goodness, faith.
None of it is tangible. I cannot hold it in my hands. And there are days that I wonder if it is all a large lie that I am telling to myself. The quiet voice in the night. My own voice that tries to fill the silence.
If all of this is a chasing of the wind. If there is nothing to hold onto. If there is no solid ground beneath my feet, then where can I walk next? 

Quick Thoughts

Quick Life Thoughts (i.e. in which i muse upon several small topics and proceed to have no greater insights than to just document a messy life)

1. Small Group
- glad this is restarting. we'll see how successful it is... i am a little doubtful due to uhh.... personalities..... but still hopeful.
- this stuff -the sharing- is one of the main the reason why I think {religion}{God}{Christianity} is worth it. It is not the right reason for many reasons. And I know that. But right now, it is one of the main ones that is keeping me here. Community.

2. Online Dating/Dating Apps as a girl
- Uh yeah. It is actually weirdly easy to be a girl on a dating app. The limiting factor is me.... And how picky I want to be, I guess.

3. Future anxieties
- They are almost overwhelming. But what can I do but grit my teeth and carry forward? This too shall pass.... hopefully.
- Talking in small group - where everyone was voicing almost the same worries... it's so ridiculous that we all feel such similar emotions, and yet feel so alone in them at the same time.

4. Guitar
- It's coming along. I think I have a lot of trouble with songs I don't know by heart. And off-beat rhythm. I want to try to figure out a way to get better at improv, certain chords, transitioning, and learning songs without just chord strumming. It's really, really fun though. I don't know why this stuff is so fun as an adult, compared to as a kid when I had violin lessons. I almost wish I had the time (and money) for guitar lessons. I seriously regret/squandered all my kid lessons growing up. I could have done so much more for them.

5. Counting blessings
- Every day. Every day.

6. OR
- I like the OR. I do. We'll see how much I like it in the future though :/

Small Talk

Small Talk and Business.

An ENT doc came and talked with my attending at lunch. A thirty minute spiel on her qualifications, availability, and kinda why he should send her patients pre-op in specific situations, etc etc.
It was selling herself as a business. It was a commercial. It was a business connection. It was a way to get her face out there and to say hey I'm a new doc in town, use me as a resource.
I would hate doing it.

Gah. I hate it. I don't want to be an adult.
There are specific things that make someone more successful at business. You do not necessarily have to do such things, but they definitely improve business connections, increase face time, make better introductions.

Availability.
Affability.
Ability.

In that order.
Good grief. May I never have to seriously deal with business.
I could do it. I mean, I know can do it. The art of selling yourself.
If there is a purpose behind meetings and hand shaking and smiling, sure I can do it. Talk to charm a person. Talk to impress. Talk for a specific reason. Talk and laugh and smile with your eyes so it looks like you are genuine, remember about the other person's family and children so it makes you seem friendlier.
Doesn't mean I like doing it. I hate the game of trying to pretend you both are friends.

My attending called me a little quiet.
I told him my quietness was because I did not see the point in saying anything except what was necessary. Not because I was shy.
He said, yes, I can see that.

Referrals and relationships between doctors... it's such a... mildly shady business. Kinda like drug reps. It's mildly shady, with potential for real corruption if someone truly does not have solid morals. And even for someone who does.... choosing the non-ethical path is sometimes extremely tempting (whether for money, for less hassle, for a variety of reasons).

Medicine is not medicine. It's a business in America.

Thoughts

1. Weight
- My new attending says he expects me to gain 4-5 lbs in my four weeks with him due to free food. I am... skeptical. I mean, I love free food. But I've realized that I am a stress-weight-loser. I think I lost 10 lbs since med school started :/ (this is not a thing to brag about. it's actually pretty bad. i shouldn't be losing this weight.) I need to gain about 5-10 lbs back. Especially muscle strength. It's kinda unhealthy and I don't know why I am not hungry when I'm stressed. Ugh. What's going to happen in residency if I'm more stressed? I don't have another 5-10 lbs to lose...

2. Holding on
- There are so many blessings I need to always count. I need to hold onto truth, onto grace, onto love. These things shall pass.
...right?

3. Size
- Problems always look so big when you are in the middle of them. But with a perspective change, you can see them for how small they really are in the grand scheme of things.

4. Face your fears.
- Confront them. I am afraid of so many things. I really am.
I am afraid of being too stupid for residency.
I am afraid of not matching.
I am afraid of not being good enough.
I am afraid of not being a good doctor and hurting patients.
I am afraid that I am setting myself up for failure.
I am afraid of being alone.
I am afraid of choosing the wrong specialty.
I am afraid for my faith.
I am afraid of losing myself.
I am afraid I will dislike my future career.
I am afraid of being an adult.
I am afraid to look.

I am scared of too many things.
Does everyone have these fears?
Logically I know the answer is yes. But then why does it feel like I am alone in these thoughts?
To see people move forward with such confidence... I am really envious.

Can I remember what it means to put faith in God?

Convince

On bad days I just try to convince myself that
lighting a candle
wrapping myself a soft blanket
making myself a cup of hot tea
will make me feel like i am not going to die.

Lucky

Gahhhh I am so lucky.
Or blessed.

Gahhh I can't really believe it.
I really, really treasure my friendships.
All of my friends have given me far more than I have ever thought possible.
I feel like I have received far more than I have ever given.

I am stressed and tired and burned out and halfway on the verge of tears anytime I think of the future. But gah, my friends are amazing.  

counting my blessings.

dregs

what does it mean to be happy?

words

being upset doesn't help.

Aaron and Mimi's wedding notes

1. Almost decided not to go due to timing, but reconsidered since I think this one of the few times where I will see a lot of these people again due to everyone leaving Houston soon. (That's a whole different post right there on cities that you love but maybe not anymore because the people you loved there are not there.) and yknow, to celebrate their wedding. Lol they are a cute couple! Aaron's deadpan quips over a caring heart, Mimi's friendly, bubbly nature over her steadfast heart. God will bless this couple.

2. You don't realize how confined (?) you are until you leave on a trip by yourself. No, that's not quite what I mean. Maybe:  You don't realize how liberating a car is until you have used it to leave. Or I don't know. Maybe: Wanderlust. The strange sensation that you could pick up your bag and just leave without a word to anyone. To end up in South America on a whim, or a three day car trip to no where. Just because. 

Just because. 

When was the last time I asked myself: could I leave this? 

3. And then a lot of things happened. Of which, were too frustrating to really write about until I am in better time/place. 

hard questions

i've been asked a lot of hard questions recently. And I don't have good answers for any of them.
I wish life was more black and white.
I wish life had a instruction manual.
I wish life had markers like trails do, to tell you that you are on the right track, that you have made it to the next bench mark.

I am tired, even if I sleep at 9 pm. I am burned out, running on the last drops of oil. I am sick of everything. I want to complain about everything, even though I don't have much to complain about.

Laugh with the rest of your energy. Smile because it is necessary.
Keep going because there is no other option.

----

We had to do something called "Priorities" in class. You write down, physically, on pieces of paper - six of your greatest priorities. Family, friends, career, God, hobbies, whatever. Then. Physically tear up two of them.
And then do it again.
And then tear up another one until only one is left.
It's a little disconcerting to actually go through that.
What is sacrificed first?
What is left?

---

pour water on this body
because i am cracked and dry
i am yearning

---

Just a little more, please.
It is possible. It is doable.

Considerations

I killed a cockroach today. Yuck.

--

Balance.
Is it worth it if you experience happiness and sadness in equal measures?

--

God.
I saw a patient who has such a rare brain disease, and the physicians caused iatrogenic pan hypo pit. He was a high functioning pilot with a pregnant wife and three children. He now can't recognize his 6 mo daughter because it's been that long since he's been in the hospital.
Their room is decorated with crosses and Bible verses and photos of his children.
She told us, sometimes he responds. I asked him, do you love me. And he nodded. And then I asked, do you love the Lord?
And he said, yes, and it's important to the Lord that I love him.

Faith. Where do people find such faith?
Is faith found? Is it cultivated. Or is it borne from something else.

There once were seeds that were thrown.
Some fell along the path, and the birds came and ate it up. 5 Some fell on rocky places, where it did not have much soil. It sprang up quickly, because the soil was shallow. 6 But when the sun came up, the plants were scorched, and they withered because they had no root. 7 Other seed fell among thorns, which grew up and choked the plants. 8 Still other seed fell on good soil, where it produced a crop—a hundred, sixty or thirty times what was sown. 9

Or is faith all about the environment, and nothing to do with the seed? Are the seeds not all from the same stock? Where upon is the difference?
And then, if so, then who chooses the environment? Is it our decision or is it not within our control.

--

Fear of the future.

--

Guard your heart.
Guard your heart.

An exchange

Here is the proposal. Would you want to go?

A quick intake of breath. It depends. Can I hear a little more about it?

In what instances would you say yes, and when would you say no?

A pause. Well, that's a good question.
A consideration. I suppose the answer would most likely be a yes, but I would still like to know more information before I commit to anything.

That's fair, I suppose.

Thought

What is the difference between
I think
I feel
?

Productivity

You know what would be amazing? If it were possible to have enough mental capacity to:
- go for a run.... WHILE
- listening to my Spanish podcast/learning thing.... WHILE
- doing practice questions.

Why can't I do them all at the same time? That would be so freaking productive. Sometimes I can x2 of those at once. But usually both of them suffer from half attention.

midnight dreaming

it is all tenseness and that strange unfurling feeling that tingles and burns at the palms of your hands. it's measured breaths, each one eight seconds apart, as if to say look, see here, my body is still under my control.
except you cannot control the quick thumps of your heart.
but who would hear that unless their ear were pressed to your chest?

be worn
like a frayed shoe whose sole has worn away

be empty
like a jam jar, traces left on the sides, but never enough to make something from it

be quiet
like a midnight hour that never sleeps

it would have been better to just turn the lamp off, close the book, turn over and fall into gray dreams.
it would have been better to dream of a midnight that sleeps.

minor human condition contemplation

The idea that what you see as important is not valued by other people.

Everyone has different priorities. And when you make a point and say, look at this, shouldn't you care about it? And they look and listen and then shrug. Or even worse, comment and say, that? It's such a minor issue. Why are you so emotional about it?

It's the ultimate invalidation.

Oh, so you're offended by that?

And ooh doesn't that raise a person's hackles to hear all of that strong emotion and arguments and exceedingly vital points be boiled down to just a mere "offended"?! 

So looking at things logically and boiling things down to just the major points can be invalidating. How funny, that we care so much to not offend people these days. If it is true... then it is true.

Except it doesn't always work that way. There is always an emotional component. But can the other person realize that their priorities is not always a major factor in other people's lives. Would that be a personal offence? Or a very abstract, logical disagreement? 

How funny. That people can be such different creatures, despite some very consistent truths. 

Once upon a time, I thought that everyone just wanted to be known, to be loved. 

And I think that is still true. But now, I am thinking more about how someone wants to be known, how they would want to be loved.

---

I remember someone saying stuff about hypothetical situations and thinking, seriously? you would waste brain space on that?
I'm sure someone thinks these musings above are similarly useless. Ha, how fun.

Reminder. Dissemination.

This is probably the weirdest quirk of mine because nobody I know does this. Or maybe people do. And nobody talks about it.

I reminded myself who I am again today.
It's an exercise of understanding myself. Or naval-gazing, if you want to half-joke, half-insult. Sometimes I do it for other people just to see if I could condense what I know of someone into a few paragraphs.

I don't want who I am to bleed out into the corners of the world, like watercolors bleed into its surroundings.

I've heard it done in a simplified version like this:
Write down "I am _____" x10 on a paper. Now fill it in.
You will realize that the first few, you give generic answers.
I am a daughter.
I am a student.
I am religious.
I am a lawyer.
I am whatever.

But when you run out of those social identities. You start putting in what you think of yourself.

I am an introvert.
I am good at reading quickly.
I am sometimes a mean person because I thought I was being clever.

Whatever.

Regardless. These days. I have been forgetting who I am as a side effect of trying to be adaptable. So today I reminded myself of the things that I cannot compromise. Of the things that would break me. Of the things I want to change and the things I hope.

In the end. I know who I am.
And what can anyone say that I do not already know of myself?

A first

I got legit yelled at by a patient today. And of course it was on my nursing shift. Holy, nurses have it so much rougher. they don't get enough respect from the patient.

-edit-

So yeah. Weirdest nursing shift ever. First time yelled at by a patient and first time where an old lady tells me she wants me to marry her nephew.

Yeah.

Nursing is tough. Mucho respect.

holy moly new obsession

holy freaking moly goodness
i am obsessed with Peter Gergely right now
he's freaking insaaaane

Movie

I have watched THE WORST movie in the world. It is so bad, it gave me headaches. 

Ugh we literally walked out halfway through the movie. Never have I ever seen a movie so bad. 

Hindsight logic

This is the most difficult thing about logic: to realize that your "logic" is not actually based on the facts of the matter, not actually based on "truth", but to recognize that you already know in your heart what you want the answer to be - and then look for the logic that supports that.

If that is true, then what could possibly change your mind?

No. You would first have to change your heart.

It is the most illogical thing in the world.
And yet, that is how it is.

---

sidenote about EM.
Ugh. I met someone in here who was incredibly rude-not-rude. It's the kinda physician who isn't actually rude, and yet he doesn't say any of the pleasantries to make someone feel comfortable. I've realized that I'm actually a lot "softer" than I thought I was.

---

introvert meter
It has been a really long time since I've so distinctly felt this, but today I was like.. holy freaking goodness, I cannot be around people for one more minute. I cannot talk to anyone otherwise I will be horribly rude and mean.
Good gosh.

s/p IM test

This has been the best weekend I've had in a long time. It was filled with the perfect amount of people and action and fun and self-relaxing-time. Not a real post, just a sort of documentation post for myself.

Finished the test and then made gumbo (which turned out fantastic). I am getting pretty good at making the roux. Finished the gumbo at J's house, adding the okra and shrimp. And then played a bit of Clue and Taboo with the asian crew. It was pretty fun, talked a bit of the IM test with Alice. Drank sips of some odd novelty Buddha beer, an amaretto with lime and coke, pretended to play Clue with Janet but totally gave up and just randomly guessed because we didn't care enough. Taboo was fun; I'm too competitive and I don't relax enough with games lol, but whatever. I wish I stayed longer, but no biggie.

And then sorta transitioned to the potluck with the IM folks at Paul's place. This is the few times that I have been the only girl in a group gathering. I'm hardly the girl that hangs with only boys by myself. I have more girlfriends than guys. It was just interesting I suppose. Half were married but didn't bring their wives. And I guess paul isn't that good friends with any other girls?? I'm not really sure. And Namjong didn't join us. But whatever. They were chill. It was too much medicine and not enough people. Honestly. If I was there or not, would it have made a difference? I think the mark of a comfortable gathering for me is if I know people. Still I guess it was interesting. It was all talk of medicine and poop jokes and stuff. There were quite a few moments where I was like.. wow, this is such a guy conversation. I wonder if it would've been different if I weren't there. Lots of urology innuendos and such.

 The twins are so rowdy and big! They picked a tomato for me to eat. Ate bulgolgi, pasta, salad, ate tons of delicious chocolate chip cookies. I liked it a lot. I got bit by a million mosquitoes though lol. Maybe I have diabetes, my blood is too sweet. It really didn't help that I wore tshirt/shorts and all the guys had long pants sigh.

Their house was so interesting. It was like another world. Flies were super annoying and everywhere. But they had such a vibrant backyard, kids playing, tomatoes growing, a neighborhood, the sun and bright blue sky in the back. All of it, it just seemed like such a domestic place compared to my apartment. But I like my apartment and my roommates and the quietness and my own room. I just wanted to comment on the difference between stages of life, I guess.

The Saturday: Woke up mildly early at 8:30 without an alarm because my body is a little silly and likes routines. It was a lovely waking up though, where awareness slowly creeps in and the sensation of lying in bed becomes reality and then you are awake, but it's okay if you don't open your eyes quite yet. Just lie there for a while, listen to the birds chirping outside, luxuriate in the sensation of stretching limbs in bed, and then when you feel like you've been lying for long enough, then that's when you open your eyes. So I woke up and ate breakfast. Kind of a meandering wake up and mosey on over to the kitchen feel. Yawning as I open the fridge, delighted that I went shopping yesterday and have fruit galore. That I have the choice of breakfast and can take my sweet time because I don't have anywhere to be. Sunbeams from the patio window, a quiet Saturday morning. I decide on Cheerios and strawberries. The strawberries are so sweet and my tea is soothing and I just spend time reading a book.

And then Fiesta. Went with the roommates, slathered on sunscreen, checked out a music festival that didn't have anything yet, so we walked to market square, tobin center, locks and dams, gorgeous jasmine and hibiscus flowers. turkey leg, sitting on the county steps, the river walk, such green and blooming flowers! especially with the yellow sunglasses, music festival, art museum with copper lines, running down the river walk with my phone and ID in hand and flipflops, funnel cake with chocolate/strawberries funnel cake.

I had a great time, I really did. It was all gorgeous blue sky, the smell of festival with fried foods, giant bowls of margaritas, sausage on a stick, snow cones, kettle corn, meat, the live music with the deep bass, the hot sun on my face and hair, the sunglasses sitting on my head, the sweat on my neck, the fair atmosphere, friends that laugh and joke, the crush of a festival crowd etc etc. It was lovely. It was everything I would hope for a day out.

Then we swam for a bit, which I absolutely adored because I haven't swam since so long. A brilliant sun and the cool water, slick on my skin.  A hard cider in a gatorade bottle. floating on my back, treading water, laughing with kiera, lying on the lounge chair with phil as the sun bakes my skin and the music plays. it's all sunshine and a spring that is on the verge of summer and relaxing and fun.

Then an absolutely gorgeous shower that cleans off sweat and sunscreen and chlorine, puzzles and nibbles. Shrimp, bacon wrapped scallops, and guac with chips. I read most of my Red Rising. Watched a bit of an action movie, music, crosswords, friends, and just general stay inside relaxation,

Sometimes I love life. I really do.

objective beauty

the moon in the dusk sky
the flutter of birds wings over head
the white flowers crushed like stars on the asphalt
the unexpected bloom of flowering trees
the feel of a breath expanding lungs after a run
the sound of lapping waves


keep your heart close
and your dreams wide.

MishMash

a mishmash of thoughts.

1. interlacing
- it is always extraordinary to me to realize that we step in and out of each other's lives so easily. i will probably never see my attending again. i spent a good four weeks with him. learned about his likes and dislikes, his dogs and his family, his motivations and his opinions on medicine, his half thoughts on politics. i feel like i know this person by now. and then i left his office after i thanked him for a good four weeks, and
that's it.

isn't it just so weird how easy it is to walk out of people's lives if you don't put any effort into it?

2. alcohol
- i definitely know what kind of drunk i am now. and also my warning signs before anything happens.

3. over noodles
- why does rice take so much longer to cook than noodles? i made a typical homestyle dish with eggs&tomatoes, a side of slightly pickled cucumbers, sliced chicken - supposed to go over rice. but i was too hungry to wait. sooo... over noodles.

4. contacts
- in love with my new contacts. i am no longer as blind as i was once.

5. burnout
- i think i really have hit the point of burnout. i feel like i'm steadily beatdown by studying and work and i really want a full week of doing nothing. but.... there's no time.
ugh.
it never ends.
and yet, i take breaks - but it is never enough to fully recover. what is wrong with me.

6. jasmine
- flowers on the bedstand. it is olfactory heaven.

breathe

deep breaths.
anxiety in the veins
calm in the arteries
let each breath draw into the lungs
and the fear flow like poison out
with each exhale

A whatever post

Whatever

whatever whatever whatever whatever whatever;
whatever whatever whatever-whatever

Whatever whatever whatever whatever whatever whatever whatever whatever whatever whatever. Whatever what what ever what ever whatever whatever whatever whatever whatever whatever whatever whatever whatever whatever whatever whatever whatever whatever whatever.

whatever whatever
whatever
whateverwhatever whatever whatever whatever

whatever whateverwhatever whatever whatever.

WHATEVER.

Thankful

I've been really upset and stressed recently, on account of future stuff.

So it is in this time that I am so, so grateful for friends and family.
I cannot fathom what kind of emotional nutcase I would be without people.
As much as I pretend that I can handle it all on my own and fake my way through crap, I can't.

That is all.

My family is amazing.
My friends are God-given.

And I am thankful.

Reflection writing

Six word stories. 55 word stories.
Forced bit of "reflection" in my IM rotation.
Some examples of good six word stories: "For sale: Baby shows, never worn."

Regardless, my short medical stories below. 

---

Doctor’s cynical heart. See you soon.

Long days; Fine, give him norco.

---

Fifteen hours in, eyes are tired.

The pager goes off, the nurse says he is complaining.

Heroin user for years, in and out of rehab, leaves AMA.

No, don’t give him anything else.

Beep, beep. The pager again.

Give me something. I’m in pain!

Orders and notes and nineteen other patients.

Fine, give him norco.

Duty

i believe in duty. i believe in responsibility.

that if my friends for some reason became a nonfunctioning alcoholic, i would tell them. because even if they hate me, that is the duty of a friend.

and vice versa, of course.
if i ever, for who knows that reason, ended up drinking a beer every morning before work or something crazy.
i would hope that my friends would sit me down and shove that fact in my face.

maybe a bit more diplomatically, but still.

to say, i strongly do not condone that. and i will be here to help if at any point you want to stop too. i can't change your life for you. but here some reasons that i am concerned for you. hear me out. and if you don't want to do anything, that is your right. but i have the right as your friend to bring it up periodically without you getting mad. and you have the right to tell me you're not doing anything about it every time i bring it up, and i won't get offended.

and i think a person who would not say the hard things to their friends is not really a friend at all. because that means you don't actually care. and the only thing worth in that friendship is sharing "good moments".

---

i think this carries over for religious things as well.

---

A duty to CARE.

This is where I firmly believe that Christianity has the right of it all: that we have a duty to one another. To care for each other.
The pessimistic me thinks that without that duty, I would not care about anybody at all.
And sometimes I think that nobody in the world cares about anyone but themselves - and potentially their nuclear family.

I think I know what is going on. I am actually offended. Wow. I don't get offended that easily, but I think a sliver of my current emotion is "offended". Because I hold this belief that if we are friends, you would want to know me. And if not, then we are not friends. And then I mentally downgrade whoever as an acquaintance. As if, you don't want to know me? Fine, I don't need to know you either. The least common denominator.

And that's.... that?

---


Do I expect too much in waiting for people to ask about who I am?
am i supposed to lay it out bare to everyone without prompting? is that what most people do????

Transient

Remember that all things will come to pass.

The good, the bad, the sad.

The tired, the worn, the weary
the joyous, the laughter, the smiles.

What is everlasting, what is there to hold onto.
This is faith,
a part of it, at least.

But emotions? Those are all transient. A fraction of a smile, a half-penny of a grimace.
So remember this then:
The delight you feel now, relish in the feeling because it is here and now.
The sorrow you feel now, remember that it will fade away with time.

In this way. Live for the moment. Live for the future.

She wipes away tears.

She wipes away tears.

It's tough, this conversation. The radiologist called us this morning and said, there's a mass in the colon. 9 inches from the rectum. Potentially cancer. But we don't know yet. Pathology will tell us soon. We said thanks, hung up, and then went to go tell the daughter.

The facts are easy. This is what it is. This is what we know. These are your options. The delivery is harder. What do you want to do? And when she turns to her father, who is watching and listening to us with that same smile, and asks him what he wants to do. Do you understand?
He responds in half formed thoughts. I feel fine right now, I think. There is something in me? I feel alright right now, alright alright, cancer is bad.
She turns to us and says, well, that's your answer.

And my resident pauses for a second and tells the daughter as gently as possible, the way he is right now, you will have to make the decision.

And she moves her hands helplessly and tries to find the words. And she tells us this.
She has been taking care of this gentle old man. Except she works two jobs and is gone for most of the day. And most of the night. And her sisters can't won't help. But she told us to put him as DNR/DNI -i am ready to go the sky-, and her sisters called her on the phone to seriously question her intentions of that order. Do not resuscitate. Do not intubate. But she looks at us helplessly. I can't take care of him myself, she says incredibly quietly, speaking down into her hands.
And then she tears up and cries. And the whole time, her father is sitting besides her smiling a little.

She wipes away tears
And he touches her hand.

And we are all quiet for a moment.

----

Heartstrings

I don't consider myself easily moved. But this certainly brushes against the strings of my heart, and sorrow is the chord that comes from it. 

A really gentle Hispanic old man, concern for colon cancer, and also dementia. He is emaciated and literally skin and bones, naked but for a diaper. An overgrown baby, except with age spots on his hand, broken teeth, and years of life behind his eyes. But he grins a large welcoming smile every morning and laughs and tells you he feels well. And today, when we asked if he had any pain, he says no, no, except for my heart. 

Chest pain, we ask. Shortness of breath? Does it radiate anywhere? 

No, nothing like that. My heart hurts. I am ready to go. 

Go? 

I am ready to go to the sky. 

Ah, I look at him and I can tell that his flesh does not reflect his soul anymore. It is like the body confines him. 

The physical body is not who you are. 

Saturday Morning

God, cleanse my heart.
Rejuvenate my soul.
Let me remember what it means to try. To care. To love and yearn. To reach.

I'm fumbling in the dark, I'm struggling with my own fears, I'm trying so hard with so little.

Burdens on the shoulder, burdens of the heart and soul. Would you take them from me if I asked?
Is there rest to be found?

I am weary.

Tell me it is all worth it in the end. Let me remember that the struggle is for something.

It is Saturday morning and the air is cold and crisp, the steam from my tea is warm and fogs my glasses, and my heart is still.

God, I am listening now.

Long call

On call till nine.

I am starving. Like. Ravenous. Like, I want to eat a whole pizza. I am salivating at the thought of instant ramen at home. Or Indian food. Oh my gosh I am going to go buy Indian food on the way home. 

Ughhh dying.

-edit-
got out an hour early.
went asap to my fav indian restaurant. the extra 15 minutes before getting home is worth it.
so good. hunger is truly the best spice.
the savory-ness, the spices, the salt, the rice, ah my gosh!
 I am in almost in rhapsody at how delicious this is!

Little things in life <3

Waiting

As a Med student I'm usually trying to stay out of people's way. So having people wait for me to do my exam and talk to the patient is freaking weird. 

tired

i seriously just closed my eyes to blink and then fell asleep for 20 minutes.

i need another weekend off please.

Wisteria

Oh my gosh.

The wisteria trees have bloomed all around my school and I am in love. If you have never walked by a wisteria tree in bloom, you need to rectify that in your life someday. Gorgeous hanging purple blossoms all over the tree, and the intoxicating sweet scent of florals that you can smell from so many steps away. It really makes me unconsciously smile, even if I'm walking into the hospital at 5 AM.

It is a childhood scent.
The kind that dives straight into memories and half remembered dreams.
It's the memory of riding a purple bicycle around the neighborhood block, hating the feel of the helmet but trying to make my mom happy, enjoying getting baked by the Texas sun and riding fast enough to make a breeze against my skin.
And then stopping at the house that had the beautiful purple flower tree. Inhaling great big breaths to smell it all. Trying to pick a blossom, but a little too scared of the bees. Finally darting in and grabbing a forlorn petal as my prize that I stored in my treasure closet for years until it faded.

Wisteria.

Anxiety

If there's one certain thing that can make me anxious, it's forcing me to be late for things. (e.g. I have to wait for someone before we go to x event).

My old tank mate saw me pacing and checking my phone every few seconds, he laughed and said, oh yeah that's one of your pet peeves, isn't it?

Yeah, it really is.

I think I got this from my mom...

equivocal

sometimes i think i will never fall in love.

---

to preface that statement, I got coffee/studied with a friend today. And we got to talking about parents and relationships and such. Who played what role, who took care of the kids and house, who made the decisions, who was the last voice in the decisions, who loved the other person more.

What a trick question - do you think you love your significant other more than he/she loves you?

Do you believe in this statement: Whoever loves the least controls the relationship.

What an ugly, cynical saying.

But the extremely pragmatic side of me thinks that it is very close to truth.
Loving too much makes you vulnerable.

And I always try to make myself invulnerable. It is an ingrained habit of mine by now.
If you hold yourself too closely, will you ever fall in love?

Assortment

A couple of random thoughts that are floating around:

1. Trauma

During trauma call, around 5:30 AM, I'm 30 minutes away from getting the hell out of the hospital and into my bed after a 26 hour day - I have to go to do a consult in the ED. No prob, I got this. Simple HPI, some ROS, a little bit of the physical exam, grab some history, I can do this. Go to the room, and the poor guy (who has a swelling red arm for the past week, probably going to be called cellulitis) wants to talk. Every single question I ask has a 5 minute answer with an associated story or two. And if I try to move on, he tries to go back to the story.

....
I am utterly, graciously, tired. I... honestly don't really care. I just want these darned answers (specific, short and sweet) so I can go back and write them into the chart within 30 minutes. It is not in my job description to be a quasi-psychologist as well. Or a friend. To listen and be interested in his life outside of his disease. To actively listen to woes and sorrows and family issues and his love life or lack thereof.
Everything I said in that above paragraph is "true".
But I feel/felt so bad. What patient wants to be treated like a disease rather than a person? And how callous is it to ignore a person so desperate for human interaction? That this man would even attempt to go into his life story with a passing medical student.

Truth does not always mean right.

But I was so tired.
I don't like this side of medicine.
In surgery, where residents are worked over grueling hours, you can really see how people act without their frontal brain filters. If they are easily angered, if they have patience or not, if they snap or deflect blame, if they go a little sleep-drunk, more talkative or not - it's all apparent.
When I am tired, I really don't want to be nice. I know that it is not in my nature to be kind or nice or gentle or whatever fruit of the spirits. Those are my "second thoughts" (thank you, Terry Pratchett). And it makes me worried that if you strip away my filters and my moment where I can think and process and make my decisions to be kind or gentle, then I'm just going to be a horrible person by instinct when I don't have the time to think. And who wants that?

I don't ever want to blame my environment for my own actions. I don't ever want to say, I was rude because I was working 26 hours and I was tired. That is true. But it is also just an excuse. There is always room for improvement.

But I don't think I was rude or even technically "mean". But I certainly wasn't nice. Ugh, I hate these types of scenarios. Should I have gone the extra mile and talked to him longer? Spent an extra 10 or 15 minutes listening about his sick father who cooks great food and the events that lead up to his right pinky toe amputation? It's just 15 minutes. Would it have helped? Would it have made him feel better? A chance to connect to patient that I will literally never see again, most likely. What is cynical and what is realistic?

I don't know why this scenario bothers me so much. Most people probably just go do the consult and leave and forget about it.
No, I do know why. It's because I think I know the "right", "good" answer, and I took the easier, maybe "wrong" path. Not entirely, but for the most part.



2. Weekend
I realize that I have greatly changed since college after a college friend came to visit this weekend. People are not static.

And I really, really love balmy days with a hint of sun and a soft breeze. Perfect weather to walk through a farmer's market and enjoy live music. Some couples were dancing triple-two. If I find a boy, I hope he dances.


3. Socializing
 The OR is the weirdest place. You really get to know people through small talk here. I don't like small talk.

Coworker talks. In a team lunch of 6 people, chief resident, one second year, two interns, two med students. Half of us are not-white. Guess which half carries the small talk at the table?
I really need to learn the art of small talk. The kind that goes on extensively for weeks.


4. Personality
I've decided that I'm probably sociopathic. Or on the Asperger's scale.
Maybe.
I really admire [am really jealous of] people who can navigate social situations innately.


5.  Faith
Oh tenuous faith.
I wish that answers were so much clearer.
I feel like a child who asks why? why? why?
And maybe I am the child who asks why, but doesn't wait for the answer.
Can you reconcile for me social issues and Christianity?
Is it true, is it right, is it good?
I want to feel the nail wounds with my own fingers, I want to see with my own eyes, I want to hear with my own ears.
I want to know the why behind all of the reasoning.


6. Finger problems
... I realized just how long/skinny my fingers are. Attending looked at my gloves and said they were too big. But I've tried one size down multiple times and the finger length is way too short - even though the width is marginally better. One size does not fit all. Heck, multiple sizes do not fit all.

Whoops

I accidentally insulted a fellow. Whoops. 

In trauma call, he's trying to get a central line in and just cannot get it. It's getting increasingly traumatic and the poor patient is getting poked so many freaking times. I'm just like.... Maybe call an attending?? Can we stop sticking this patient as she's basically moaning in pain as you keep shifting her fractured pelvis?? 

And he's the fellow. 

Well. Never let it be said I don't say what's on my mind? 

Ugh. The problems of medicine hierarchy. 

... Office talk

Hopefully I will never engage in this. But I have a sinking feeling that it's going to be the norm and I will be uncomfortable many more times.  

My residents just pulled up a list of all the faculty and went through each one going...

I don't care for him

She makes really bad decisions. 

He's nice. Just slow. 

I cannot stand her. 

Ahhh!! Can we just talk about food and pets and hobbies and stuff? 

Food

Was going to write something about thoughts and emotions or whatnot. But I just looked through Facebook and I am really really really jealous and envious and omg :(

All the Chinese New Years food pictures. I REALLY WANT ASIAN FOOD. 

Xiao long tang bao. 

Sticky rice. Oil rice. 

Tofu. Doh gan. 

Asian soups. 

Noodles. 

Ughhhh salivating. 

I think I need to go buy some fake Asian just to tide me over. 

indecison

the worst place to be in.

i waffle between "omg, i do love this; this is what i ought to be doing!"
and also "no. I can't do this. It sucks."

I like a lot of surgery. I like the OR. I like stitching. I like trauma. I like doing procedures.

I hate the hours. I hate the standing (my feet hurt right now ugh). I kinda sorta don't like the people.

ughhhh

Tiredddd

I'm not going to make it. 

Trauma shift tonight and it's only 3 pm and I'm already tired. I'm so screwed. 

I mean. I have been up since 4 am. But I still have another 15 hrs to go. 

So screwed. I'm already yawning every few minutes. 

--

Edit: okay. 5 pm. And technically done with clinic but can't go home bc my residents took me here :/ OMG SAD. Soooooo gotta wait for them to finish their notes and then... I dunno. Do I go to trauma or do I go home for 10 min to grab a bite and change? Ahhhhhhh. I have 13 h left in the day. 

--

Edit2. Holy wow. Midnight now. 12 am. On the dot. Just went into a major trauma OR case and they wanted to know my name since I was pretty helpful. !!!! Got to hold a beating heart in my hand and pump it/cardiac massage. So awake! And dehydrated. 6 more hours to go. 

--

Edit 3. 1:45. Not going to make. I'm really tired and it is dead silent in the trauma pit. Except for the resident singing along to uptown funk. Trying to study. But obviously you know how that's going I I'm writing this. Thinking about tomorrow and I think I want some chicken sagwaala. Also need to go grocery shopping. Mrkkkkk. My scrubs are bloody. Ugh. And I'm not hungry but I want to eat. What to do. 4h and 15 min left. Not going to make it :(

Edit 4. Almost there!!!! 15 minutes left. Patients actually came in. So had just enough work to stay awake. Still need a shower. Still want Indian food. Had quite a bit of fun today. Maybe. I dunno. Tired. Will decide if today was fun after I sleep. Which is... Not yet. 

Edit 5. Holy crap I am so mad. Get home just to discover that all the freaking hot water is used up. And all that's left is this tepid shower water crap! ARGHHHH. And I was really looking forward to a long shower. Freaking hell. I am going to bed now. I hate all you people who wake up early to shower and take all the hot water. Ugh. Angry.  

Edit 7. Slept all day. Went grocery shopping. Slept some more. Didn't get Indian food, but bought a box of diy butter chicken at the grocery store. In conclusion. I had a good trauma call :) life is pretty good. 

Beautiful things

To close out this day, I had the unfortunate pleasure of having one of those conversations where I could not say anything right with a acquainta-friend. It was essentially... one unfortunate comment after the other, followed by did-i-really-just-say-that questions. I can only look back at that conversation and laugh and cringe at the same time. It's one of those conversations that make me think I should never try to talk to anyone ever again because holy crap, I am so awkward I might even be on the Asperger scale or something and gracious it'd be better if I just shut my mouth and not interacted with anybody.

REGARDLESS, to mitigate thinking too much, went for a run (and it was a good run, yes).

But when coming back home, it was the crisp air on my warm cheeks, night time where the street lights glow over the asphalt, and I am so acutely aware of the movements of my limbs as I walk after running for so long. I closed my eyes and was reminded of the midnight walks on the Inner Loop where it just felt like the world was empty and so large, so vast, and the quietness was inherent in the bones. And I look up and there is the night sky. It is beautiful. You might have no idea how beautiful it is tonight. But the little winks of light just hang in the dark gray sky and it is so bright. It's just breathtaking. I couldn't help myself but lie down on one of those recliners besides the pool and look up and up at the sky. The sound of lapping waves at the pool, the wind brushing the leaves, the lights ghosting the underside of each leaf, and how lovely the darkness of the sky, studded with stars - just sprinkled across the sky as if someone had scattered them by the fistful and they just landed there. The coldness at my cheeks, shiver, numbness at my bare legs, my hands tucked into my jacket, and as I stare at the endless blanket of night sky, there is Gungor whispering into my ear, You make beautiful things.

And if you strip away words and indecision and arguments about theology and apologetics and social issues and inconsistencies...
You make beautiful things.

Isn't that truth?

Surgery and Crap

Fourth art line. Second try, with a few hiccups.

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Told the anesthesiologist that I was thinking about general surgery and he gave a whole spiel about how it's really hard to be a female surgeon. He goes on and talks about a lot of surgeons's wives who are also physicians - and invariably they are internal medicine, family, peds, etc etc (i.e. not surgery). And then also a female surgeon who loved her job, fell in love, married another surgeon, and now she's a mom now. Not practicing. And the husband dude is still a surgeon. And then he says, all that training down that drain - to be a mom.

And then he says, "You know [insert other senior partner, who is a female surgeon]? She has dogs. No kids. You'd like to think you can have it all, [family and career], but..." he shrugs. "Make your choice on what you can live with."

How utterly annoying.

I get really annoyed because there's no way he'd say any of that to a male student. And it freaking pisses me off because it's not like he has had to struggle with any of that. And it seriously makes me angry because it's basically saying, what - because you have two X chromosomes and can carry a baby, you probably shouldn't go into these specific specialties - unless you just want to have dogs and no family. And it's so frustrating because it's not like he is actively trying to be rude; he was honestly trying to give advice as he sees it. But that's what his words boil down to, right?

I hear it. I do. And my response is a bit of a screw you, thanks. Because at the heart of it, maybe it's naive and crap, but that I really think I can have it all. But realistically, I know something would probably have to give. There is only so much time and energy.

It is not often that I think this, but times like these I can't help but think that it would be so much easier to be a guy.

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Stuff

Got to help amputate a knee. Very cool. Lot easier than expected. And attending let me dos lot more than I expected. Cut most of the muscle and the bone (power saw!). And the muscle flap was much easily created than expected. The wonders of modern medicine. 

Also an extremely sad case because the lady thought prayer would heal her foot, to the point where she didn't come in and get it treated u till it became gangrenous. Just ugh. 

---

Third art line! This time done with the patient awake. Got on the second try :) 

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Make me think. 

Trauma call

Third trauma shift. Much busier than the other two.
There were a lot of "firsts".

First time..
seeing a CPR code.
seeing a doctor call time of death
doing an ABG
washing a degloved hand (4th and 5th finger crushed. i could feel the bits of bone)
hearing first-hand inter-department drama (in which ortho and surgery gets mad each other and the chiefs call each other out and voices are raised in the workroom)
cleaning someone's wound while their parents are watching (omg no. never again please)
suturing someone's face
suturing someone's face when they're awake
(thank goodness for Ativan and local anesthetic) 
- 8 simple interrupted stitches with 5-0 vycril; instrument tie.

second time getting an arterial line.

--

I have so much respect for specific med students who actively try to help each other out and split up tasks evenly. Trauma shift is kinda weird in that there are students who have trauma as their surgery rotation. But the other students (like me!) just have trauma call - so I'm put into gen surg and only have a shift in trauma about once a week. So I can see how the trauma call students can be seen as intruding on the trauma rotation students' space. But man, there is just such a difference in attitudes that I've seen.

There's a super cool dude who was incredibly generous the entire night: gave up his OR time because someone hadn't seen anything but urology stuff (this boggles the mind a bit because cool dude also rarely gets to go into the OR); offered minor procedural tasks to other students; incredibly helpful without being condescending. So much respect.

And then contrasting... quite a bit of disdain for the one(s) who always end up hogging procedures and/or trying to push "boring" tasks on other people. Maybe I just value fairness too much.

Practice

I put in an arterial line by myself today!!!!!!!!  I put in a central line too!!! YES. Today is such a win. 

And I got to more in a laparoscopy than usual because I was with a fellow. Put in a trochar, cut the cystic duct, insert the contrast, close. 

And I got to see some IR today too! Which was way cool. 

Got to close a for a hernia, and did it rather well, if I do say so myself. 

I still suck at interrupted subcuticuar stitches. (Even though I'm moderately okay at running subcuticuar). Need more practice. 

Win of the day.

I ran for 50 minutes without stopping today. 

Because I could. And can. So I did. 

This is mind boggling to me. 

It really is mind over matter. 

And it really is a matter of working up to it. 

My goal is inversions though. 

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I always said that I wasn't a marathon runner, but a sprinter. But truth be told, I was more like a lazy walker that occasionally moved a bit faster to pretend like I was a sprinter. I'm still not a marathon runner. But I kinda see how it works now. At a certain point, your muscles just realize, well that's just how it's gonna be, and they keep on going. And I think I could literally close my eyes and my arms and legs will keep on moving. 

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Anyways. 

I'm tired. And I need to study. 

Food. Then shower. Then books. Then bed. 

Maybe I'll sneak in a cookie or two as well. 

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ALSO. Today I got freaking QUIZZED on what movies I've seen in my childhood (like... None at all because I'm a book girl, not a movie girl, and my dad always hogged the tv for basketball so I never watched tv shows and I don't like watching movies by myself and fine I guess I might have had socially deprived childhood). But NO I did not see Clueless (or even know about that movie), or Dumb and Dumber, or Forest Gump, or Scary Movie, or [insert a million other movies and tv shows]. No I don't know those actors or actresses. No I didn't really watch The Price is Right or Jeopardy or know who the hosts are/were. NO, okay?? And asking me about other ones is not going to change that!!!

And their reactions were just pure disbelief.

They literally said this, verbatim. 

 "I'm surprised you're so normal"

"It's like she's never seen a tv."

WELL. Excuse me! 

Ask me a book question instead. 

(I know. I'm a nerd). 

I want to read a book for fun now. 

Un Lun Dun. 

Ring true

Do you think that things in life just happen?
Do you think that everything falls into your lap?

"Passive people have the life that happens to them.
Outspoken people have the life they build and fight for."

Only semi-true. Of course there are qualifiers and other extraneous factors that muddle the waters a bit. But there is some truth in there.

Be bold. Be bold. Be bold.

---

At the essence of it, even though I am still figuring it all out, I know myself.
None of this changes the core of me.  

Tired

How much are you supposed to love your job? Job Career. Career Job. ??

Talking to a surgery attending... he talks about going above and beyond. Scrubbing into as many cases as possible and staying until way late into the night voluntarily. Picking up cases that aren't his. Being eager.

I am interested. But I don't know if I am eager. Is that enough?
I like everything I've seen so far. But to be a good doctor/surgeon/physician/health care worker, do you need to immerse yourself in it?

If my "official work time" is over, sometimes I just want to go home and lay on the couch and not scrub into another gallbladder. Or if I'm sitting in the control room watching intermittent radiographs of a AAA, bored as hell because I literally can't do anything... and it's already 6 pm and they're probably going to take another 2-3 hours... and they say you can leave if you want....(even though it's a case you probably won't see for a really long time, and it's the first one done in this hospital with this type of endograft, and you don't want to miss this! etc etc)
Do I still need to stay to impress them???

If I leave... Is that laziness or just common sense?

How much of this is supposed to consume your life?

Or am I just lazy/tired/a bad student?

ughhhhhh

----

and the flip side argument.
I am here to learn. I am actually paying to learn.
Why wouldn't I want to take advantage of everything I see right now?
Shouldn't I be excited to go into all of these things?
Think of all the hoops a pre-med student would have to jump just to observe these things, much less first assist or close.
And wouldn't you rather learn your mistakes now than later?

ughhhhhhh

positivity

everything is a benefit, a plus, a bonus.
nothing is "expected".
nothing is taken for granted.

Ugh

An attending was talking about his imminent hunting trip this weekend so we got to talking about guns and such. Told him I shot at a range once, but couldn't tell him what gun or what bullets. 

He goes, typical girl. 

... Very irritating. 

Food for thought.

"If all your prayers were answered, would it change the world or just yours?"

BREAKDOWN

1. EVERYONE HAS PROBLEMS.
- nobody knows the behind the scenes of another person's life. struggles are inevitable. people have different problems.
- your difficulties are not necessarily easier not more difficult than anyone else's.
- their difficulties do not invalidate yours. If their happiness does not invalidate your happiness, why should their difficulties? Struggles are not a competition. 

2. EXPECTATIONS
- work hard, expect little.
- plan for the worst, hope for the best.
- realize that my own expectations for myself are practically delusional. be hopeful, but realistic. 
- don't be too hard on yourself when things don't go to plan.

3. BE INTERESTED
- to be interesting, one must first be interested [currently, i am realizing how boring i am. clearly i must rectify this.]
- i need to lose my self-consciousness, my fear of the unknown, my desire to not look stupid, my inability to go try new things by myself.
- be bold.

4. DELAYED GRATIFICATION
- two cookies if you wait 15 minutes
- I CAN DO THIS.

The mantra to repeat:
I CAN DO THIS.
THIS IS DOABLE.
EVERYTHING I AM DOING IS WORTH DOING.
THIS IS INTERESTING. I WANT TO PUT MY TIME HERE.
IT WILL BE WORTH IT.

have i convinced myself yet?

Surgery Notes

Quick jot down before studying:

- Got to scrub into a vascular surgery today (pop to LE fistula). Super intricate, (6-0 vycril!) And the attending was pretty darn amazing. I would want to be like him however many years from now. Slight sarcastic, but jokey, good humor, not mean, enjoys what he does, confident in his ability, willing to help out other attendings and medical students.

- when talking about applying, be absolutely certain. There's a 40% drop out rate in surgery, even with 80h limits. You will be "molded" .

- the worst decision is no decision. people die from indecision (i whole-heartedly agree).

- good clinical judgment is the most important thing. even for surgeons

- Know how you function under pressure.

Life of the Beloved

I decided to skip church today. Out of tiredness and laziness and also a touch of faithlessness. But I sighed and decided it is ridiculous to skip something that is meant to counteract those things. (Give you rest, call to action, deepen your faith, etcetera).

So I picked up Life of the Beloved by Henri Nouwen that was conveniently sitting on my bookshelf, given by a beloved friend a year or so ago.

And its very foundation states that we are beloved, we are chosen by God and that he will give you rest. All the moments where you think that you are not good enough, He is there to say you are my beloved.

I think that these are not my answers or my questions.

God, soften this hardened heart.