| the neverending story…. |
[23 Nov 2009|09:15pm] |
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Originally published at Perches in the Soul. You can comment here or there. The first few months of 1994 had an epicenter: March 31, 1994. I was 9 and on Jan 14 of that year I had undergone bilateral femur, tibia osteomonies (translation: they cut and broke my legs in three places at the hip, knee and ankle and nailed it back together….translation: legal form of human torture in the name of pain relief…).
It snowed a blizzard the night of the 14th the snow drifts were higher than my sister’s head (she was 3). It was so cold that my parents, sisters and a giant Amish family kept been awoken in the night at the Ronaold McDonald House by frequent fire alarms. They would shuffle out in their PJs, coats and hats and wait for the Delaware fire department to arrive and try not to gawk at Amish nightgowns and winter coats.
Meanwhile I was awoken as well…. in the PICU with hives in a body cast. They thought it was my epidural so they took that out in the middle of the night while the blizzard winds whirled outside. The Anesthesia resident got woken up four times before they did it…poor guy. My Grandfather (ever the Top Gun) flew in late that evening somehow to Dover AFB and surprised us all. I have been told it didn’t happen like this but I remember him walking into the ICU room in his US Navy black and gold winter coat (they swear he was in civilian clothes but my morphine drugged mind remembers this) . My grandfather and Dad took the night watches so my grandmother and Mom could sleep and take care of the little girls. (which turned out to be a snow drill with the Amish times three).
My Dad sang Kum-by-ya to me in the wee hours of the morning once the epidural morphine began to fade and six new fractures and numerous nails started to throb…
and that was just the first night of a 14 day hospital stay. and the first night that I counted the days till March 31.
That the day the body cast came off. I counted the days the whole 10 weeks. We drove up there, they took me to the cast room and sawed me out in about an hour. My legs were scaly, hairy and now dotted with fresh scars. I had not sat up in ten weeks. To transport me to x-ray they needed to transfer to the wheelchair from the high cast table. They picked me up gently but gravity failed me…I screamed as I came to an almost sitting position in mid-air. My body seared with pain at a position it knew no more.
Turned out the bones still had not healed. i was not ready for freedom. they hollowed out my cast and made it into a splint which I went home in. I was devastated. March 31 turned out to be a terrible disappointment.
Nov 23, 2009. 10 weeks after total hip replacement (translation: they cut out the top of my thigh bone and jammed a large piece of plastic into the rest of my thigh bone and into my hip socket…translation: more human torture in the name of pain relief). 10 weeks ago I discovered Nov 23 was the end of the dreaded hip precautions. disappointing yet again. I can’t touch my toes…heck I can barely touch my knees. My hips are tight and resistant to the idea that they should now go back to doing what they did 10 weeks ago and more. My therapist doubled my stretching in honor of the occasion. I came home soaked in a tub for an hour and still feel like my hip flexors are made of cement.
you would think i would learn to expect less…to expect no miracles but rather that all freedom especially orthopedic freedom is not free. (if only the surgeons understood this).
yet again disappointing. really these surgeons for all their confidence are more trouble than they are worth at times.
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| the uglies |
[16 Nov 2009|08:36pm] |
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Originally published at Perches in the Soul. You can comment here or there. everyone seems to like listening to my life stories. the little gimpy kid with the disease no one has ever heard of growing up and becoming a doctor has a nice ring to it. the stuff on my resume makes me look smart, sane, mature.
but in reality most of it is a facade. none of it is untrue but putting it all in bullet points on a sheet of paper cuts out all the details. no body likes the details.
the details are ugly. everyone wants to know how my surgery went. but everyone wants me to say it went great. everyone wants to know what being a disable medical student is like but everyone wants me to say its been swell.
I just had a surgery that was basically palliative care. it didn’t cure my disease it kept me from pulling my hair out because I can’t sit still because of the the pain. but the truth is yeah the actual four hours of the surgery went well but physical therapy is a bit of a disaster. i have what appears to be a three to five year old flexion contracture that is not only tough as nails but if it doesn’t get better is going to wear the prosthesis down much faster than usual (which basically knocks off years of walking). No one diagnosed this crucial fact…one has to wonder what role it played in the hip pain the first place. no one wants to hear from the little medical student that her transition from pediatric to adult medicine has been fraught with peril, that the adult orthopods are not only ignorant about her pediatric disease but too arrogant to admit it. I suffer for it not them.
I am getting up at 5 AM, rounding on patients I do not know half the time, writing notes either observing (as in not touching) in the OR or occasionally interacting in clinic till 5PM when I go to PT and get pushed on till I finally get to go home by 6:30 and then repeat. today i repeated plus SWINE FLU.
then I try to prepare for things like my interview on Friday, fall asleep on my computer and then wake up in the middle of the night and worry about the flexion contracture that gives me muscle spasm cramps randomly and frequently that leave me begging for tramdol and has not moved a single degree in the last three weeks.
no one wants to hear that some times I come home and I cry with frustration and pain. no one wants to hear about how some days I absolutely hate my chosen profession not just because it has so few answers for me but because no one have the balls to admit they have no answers. Good gosh people just tell it like it is. do you think I somehow don’t know that it sucks?
no see that doesn’t sound all that inspirational now does it…
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| H1N1-Swine Flu is Overrated |
[15 Nov 2009|11:02am] |
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Originally published at Perches in the Soul. You can comment here or there. 2000 deaths a day nearly all children.
853,000 pediatric deaths a year.
this is not swine flu.
this is a disease that is completely curable. it also doesn’t exist in the developed world.
Malaria.
lets compare shall we…
Swine flu has caused 6250 deaths since April ‘09.
3,900 Americans. **
thats the kicker.
80-90% of the malaria deaths are in Africa.
so the next time you see one of those glossy articles about swine flu or five minutes spots about just how bad swine flu is..think about the value of a life.
Every three days the same number of children die as all the swine flu deaths combined.
Does the life of an American child mean more than the life of an African child?
You know the answer to that question and you also know that CNN is never going to report about in a glossy five minute media spot. Because no one likes to know about dying children
It so much easier to forget they exist.
I too am guilty of this. For the last six months I have taken notes in lectures, carefully masked and gowned and prayed that my little patients would not end up in the ICU.
I took the h1n1 vaccine along with my other classmates three weeks ago.*** We have been chosen, our young age, our knowledge, the investment the state of NC and the federal government has made in us and our daily exposure makes us first in the line at our hospital even over residents and attendings.
Yesterday I was all in a tizzy because I woke up with a fever, body aches, cough, sore throat and my roommate is recovering from swine flu. Student Health was all in a tizzy too as they listened to my history and promptly wrote me a script a 120 dollar script (20 dollars with insurance) for tamiflu. I am faithfully taking the drug.
Its not what I am doing is wrong. I just can’t help but wonder what kind of difference we could make in saving the lives of children if we had the backing that swine flu has.
What if for every dollar we spent on swine flu, we sent a penny to Africa for malaria cures? How many lives would we change? save?
Does a death require less grief if no one knows it happens? Or can we be held accountable for the lives we could save and don’t?
I shudder to think of God’s justice and how much it pales our own man made justice.
Somehow I doubt he is going to buy the whole tree falls in a forest with no one to hear the sound excuse….
**(right NOW swine flu is spreading to the developing world more and more, Ukraine and Mongolia are facing huge numbers with the disease. In Mongolia the WHO fears it could overwhelm their health care system but for the last six months while all the money has been spent, all the decisions have been made its been a developed nation disease…I wonder how many vaccines are being sent to Mongolia???)
***(there is a 2-5wk window period for the vaccine to give you full immunity, my roomie got sick at the end of week 2 so I was not fully immune yet)
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| Desperate housewives…. |
[11 Nov 2009|08:12pm] |
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Originally published at Perches in the Soul. You can comment here or there. Biblical WOMANHOOD????????????????
Correct me if I am wrong but could someone please tell me about a woman in the bible who looked like an American, fundamentalist housewife sterotype? I can think of perhaps of two Mary the mother of Jesus and Martha. Mary had a child out of wed lock in a culture that would stone her for it. (um ok so maybe not like an American house wife) Jesus came to visit Martha’s family and he praised her sister Mary for not cooking dinner but sitting and talking theology with Jesus and scolded Mary for doing housework rather than learning…(not exactly a role model…)
The women that bible speaks most highly of look NOTHING like American housewives: Tamar fought domestic violence, Sarah became the mother of an entire nation/people group, Deborah was a judge and a warrior, Esther was a shrewd politician and a queen, Ruth was a caregiver and the sole breadwinner (no pun intended) for an elderly relative (she also went and lay in a man’s bed who she was in love with to tell him her feelings for him..), Rahab was a prostitute who descendant was Jesus, Elizabeth proved the impossible, Mary gave birth to a child outside of marriage in a culture that would stone her for it, Joanna and Susanna ministered to Jesus, Mary (sister of Martha) listened and discussed theology with Jesus, Mary Magdalene was a prostitute whose enduring story teaches us about grace and who also was among the only followers who were fearless enough to go to Christ’s tomb after his death, Aquila made tents and may have been one of the first missionaries, Lydia was a wealthy, successful businesswoman who was the first European known to accept Christ she along with Phoebe were leaders in the early church….
Come to think of it maybe Paige Patterson is on to something. The women today have indeed lost sense of biblical womanhood. Could you imagine what the world would be like if every woman who follows Christ actually lived like these women did? (OR a if a few good men did too?)
Could you imagine a woman would shrewdly crush the head of a foreign general (either figuratively or literally, diplomatically)? Or could you imagine a woman so strong and wise that a general refuses to go to battle without her? Could you imagine if there was a woman like Esther who would go before the governments of nations where genocides, other hate crimes or gross human rights violations are happening and convince them to stop? Could you imagine if women would support their elderly, widowed family members like Ruth rather than sending them to nursing homes or griping about them? Could you imagine if women of the world fought back against violence toward women and children like Tamar? Could you imagine if the women of the world embraced the children born unplanned or unwanted? Could you imagine if women in nations where there is no freedom of religion quietly yet openly worshiped and ministered like the women at the tomb? Could you imagine if women stepped up as leaders yes pastors, ministers, teachers in places where there is no faith or where faith has died?
How different would our churches be?
How different would our families be?
How different would our world be?
…if every woman got up from the mud of our world that exploits women and their bodies and brushed off the dirt of centuries of fear and ignorance hidden in church tradition but lacking biblical substance and embraced her calling…whatever that calling may be from motherhood (yes even the stay at home kind…love ya MOM!) to ministry to beyond.
how desperate our world is for biblical womanhood….how desperate…
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| Circles… |
[07 Nov 2009|10:20am] |
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Originally published at Perches in the Soul. You can comment here or there. I spent a good portion of this week figuratively and literally lying prostate on a table having my someone pull my body into various positions until with my teeth gritted and tears stinging my eyes I said “I surrender” My orthopod last week said my x-rays were perfect, my PT progress was not. He lifted the precautions for PT which means we can attack the flexion contracture with full force.
And so we did and because scheduling PT is like scheduling meetings with Obama I had three days in a row. While it was exciting and somewhat luxurious to lay on my belly… by the third night I was downing tramadol at 1 in the morning because the muscle spasms were bad enough to wake me from sleep. I have been down this road before…my connective tissue just gives up and hopes I won’t notice. Then I spend months fighting it back into submission. Only to have it eventually give up again and we go back through this whole cycle of me laying prostate on a table for several months….
Then there was the scheduling mishap that landed me on a surgery rotation. And here I was waking up at 5 AM from my muscle spasms disrupted sleep cursing myself for letting Student Services sign me up for Peds ENT. Three hours later I was either in the OR a place that makes me feel cold, nauseous and bored or in ENT clinic having my attending yell at me in front of patients to hold my otoscope like I held my pencil…I explained I was HOLDING IT LIKE I HOLD MY PENCIL…it never occurs to him maybe I don’t hold my pencil like everyone else….and I have daily flashbacks to writing my name in Kindergarten over and over again. My teacher standing over me saying THAT IS NOT HOW YOU HOLD YOUR PENCIL. I remember looking at her and wanting desperately to please her but knowing fully well that I could not hold my pencil the way and form the letters. Why couldn’t she just understand that this way was working for me….
So here I am in my last 6 mons of a doctorate program and am being yelled at for how I hold my pencil. Oddly not much as changed in 20 years.
or the last 8…
On Thursday night and Friday morning I put on makeup, I styled my hair, I wore designer clothes….and went to my first peds interview here at home. I walked into my faculty interview and before I had barely sat my little spazzing butt in the chair Dr M looked me straight in the eye and said ” Amy, I am not going to interview you, I know you well and you will have no problem staying here, you fit in well here and we want you to stay. Now surely they are pros and cons for you staying in town but just so you know if you rank us high, you will match here. Now what other schools are you applying to?” I sat there in my smart suit a little stunned, I had prepared answers to all the usual questions. I had not expected to be courted, to be wanted badly enough to not even be interviewed. My chief resident interview strated similarly after we looked at cute pictures of his baby girl..”Amy, everyone knows you and likes you, we want you stay here so I am going to give you the 5 min speal about why you should.” And the 5 min speal was not some standard thing it was obvious that it had been well prepared with regards to me…these people know me well, they have had 8 years to study me. And part of my wall melted a bit I walked out slightly intoxicated by the idea that it would be so very easy not to break the cycle and just stay here….
and here we are back to where I melted four years ago sitting in a Ruby Tuesday where my dad handed me a check of early inheritance. And I dissolved into tears and called the med school admissions office the next morning to declare my intent.
so here I am laying prostate on a table with my teeth gritted and my eyes stinging wanting so badly to just say…STOP I have had enough but not wanting to appear…weak.
It is so easy to just keep going, to just circle around and around and around…
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| The safe house…. |
[28 Oct 2009|10:02pm] |
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Originally published at Perches in the Soul. You can comment here or there. Today I went to the peds surgery conference. Because yes I admit I wanted FREE LUNCH.
Well there is no such thing as a free lunch at least not when you are me.
The lecture was crowded. All the peds surgeons were there, all the residents more than half the peds residents and all the peds medical students and the entire Peds ED staff. It was so crowded there were people on the floor…
The topic was led by a Sr surgery resident and was on Peds tramua. It was well done. I was sitting there eating my potato salad and turkey sandwhich when all of the sudden JKP my peds surgery attending (FROM LAST APRIL FOR CRYING OUT LOUD) stops the resident looks around the room and say A. L. (my name), what are the five Ps of compartment syndrome. THere are like 50 people (no lie) in the room including surely some of JKP’s current residents and students for him to torture. I had a big bite of my free lunch in my mouth and half mouth half cough “Me??” like an idiot. “Yes you!” he says with his big grin, “you can phone a friend if you want.” “Um how many Ps are there again?.. ” I am racking my brain I know all about compartment syndrome but I don’t know if I can describe with only P words. I know the symptoms the treatment, the causes.
“UM umm.. pain, pulseless, pallor…” Coldness, coldness I think but I can think of a P word for coldness. “Um someone can get the other two. ” I mumble. Here I am a fourth year and am being pimped by an attending in front 50 people and I get it wrong…how humiliating. Of course an eager third year gets the last two…”polikothermia (coldness) and parasthesia” some kid who probably knows endless acronyms and couldn’t actually talk to a real human being or even treat compartment syndrome… but as I began to think about it more I took the compliment.
As I left and wandered back to Peds Cards Clinic I realized something scary…
JKP likes me which may seem terribly contradictory because I really was a terrible surgery student not because I couldn’t suture quickly to save my life but because I lacked confidence. But the reason he likes me is because I wrote an essay about my last day as his student( http://wakeelf.livejournal.com/2008/09/23 ) . And because I spent time with little girl who was very, very terrified one Friday pre-operatively after I left the service (long story). He found out about this after a Mom told him on a follow up appt three months later. He e-mailed me a thank you note.
For those of you outside of the profession if you get pimped (asked a question) in a room full of 50 other people by an attending currently not your own one of two things is true. 9/10 (in places not cut-throat) that attending thinks you are awesome (he might think this see above) or really smart (not true). For that attending to be in another specialty far, far from yours of interest means he really, really likes you if he actually knows your name. Or occasionally an attending will do it TRULY because he/she doesn’t like a student but its rare. So yes we humiliate people we like, as a weird medical compliment.. and you wonder why doctors are so messed up…
Here is the thing at my current academic home of 8 years. Everyone knows my name. Not just JKP. But all the Deans, the head of my dept, the program directors. I am never that kid they had on the service three years ago. Its not because I am so great, its because I have been here forever and I am only the med studednt ever to go all four years here with a disability. Generally I am well liked, well supported and safe. So safe, no one doubts rather I should be here, no one thinks twice about a doctor in a wheelchair or amplified stephscope in the peds cards clinic.
I have been scheduling interviews and dreaming of moving on. In my heart I know this is right. But today I realized its going to hurt. More than I realize. Because the outside is not safe. Everyone does not know my name. Everyone does not respect me or my existence. Out there there is no JKP or Dr. O or Dr. J to fight on my behalf or even cheer me on.
Outside I am still a questionable admission….outside I am chronically ill, pre-existing condition, idealist, non-conformist who came into medicine knowing who she was and had little interest in fitting into some medicine mold.
Am I ready for that? Am I ready to leave this safe harbor I have sailed in for 8 years?
Read the rest of this entry »
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| Why my life will never be reality TV worthy… |
[22 Oct 2009|07:58am] |
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Originally published at Perches in the Soul. You can comment here or there. I have had a relapse of the more severe anemia. My concentration at work is lagging and I am tired all the time. Its way worse than the hip issues. Sometimes though all this makes me laugh. Maybe I laugh so I won’t cry.
Yesterday I came home during my roommate’s bible study. It was 9:30 time for my little anemic self to get ready for bed. Getting dressed and undressed on hip precautions (no bending past 90 degrees) takes twice as long and is mind-numbingly frustrating at times. I went to remove my socks with my good foot and in the process I pulled the scab off a bug bite. I am on Asprin to prevent blood clots post-surgery so I bleed from small cuts like I have stepped on nails. So here I am sitting there with blood running down my ankle. My house is full of strangers who block my way between my room and the bathroom. I am wearing only underwear on the bottom and a loose shirt on the top. I can’t put my PJ pants on because I don’t want blood all over them and all over my legs. I can’t wipe the ankle clean because I can’t reach it on hip precautions. Finally I grab a blanket pool cover up thing from St Croix, wrap it around my waist, hop over to my flip flops (so not easy on a new hip) so I don’t drag blood all the way to the bathroom. Then I try to run fast (as if I can run at all ever much less right now) through the hallway in hopes no will notice me running in a tropical pool cover up and night shirt with blood gushing from my ankle. They did and they sort of stared at me as if I had lost my mind.
I turn the bath water on and stand there with my sponge with the long handle (compliments of Mt Sinai Orthopedics) and wipe away the blood and clean the tiny, tiny, tiny sore on my ankle. All that drama for a mm break in the skin. I walk back to my room, pull on my pants and laugh as I got into bed. Then before I could read two pages I fell into the deep, desperate sleep of anemia.
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| so long and thanks for all the fish… |
[12 Oct 2009|03:46pm] |
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Originally published at Perches in the Soul. You can comment here or there. 8 years of academic work.
7 days a week. 24 hours a day for most of that eight years (minus college summers)…
Speaking of summer..4 summers of medical volunteer work in the developing world
10-12 academic honor societies and two or three service ones. And one for professionalism and humanism in medicine.
88 page honor thesis.
45 different papers reviewed for a medical publication…that I first authored…
7 medical mission trips.
countless hours. countless cups of chai tea. countless effort.
and do you know how my esteemed alma mater of 8 years summarized my work in my Deans’ letter (hugely important document that is sent to all residency programs)
She excels in academics all the while overcoming challenging physical limitations.
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| ….all grown up. |
[06 Oct 2009|10:16pm] |
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Originally published at Perches in the Soul. You can comment here or there. Its been a while. I should probably write about my surgery and I will some time. It went well, recovering in Roanoke was fantastic. Now I am back in Wisnton and life is very well difficult.
DO you remember what you wanted to be when you were five? eight? fourteen? twenty? I do. Teacher, writer, doctor, missionary (/doctor). In academic international medicine I will get to be all four. In six months I will have achieved the three out of the four and the fourth halfway on a shorterm basis. I”m a lucky (blessed) young woman. Its not that I found my niche in the world, although I did. Its not that i have some high and mighty calling or endless ambition. Nope that is not why I am lucky.
This weekend I am helping lead a retreat for young adults with disabilities and chronic illnesses. I just got the schedule. The theme of the weekend is WHEN I GROW UP. We are asked as staff and campers to bring a COSTUME of what we want to be when we grow up for a special banquet. There is only one other disabled staff person who I have ever met working at this camp. She is very nice, smart and pretty. She lives in her parents’ basement and volunteers at the hospital where I learn medicine. So its the two of us plus 40-60 other 20 somethings/late teenagers with disabilities in a room dressed as our greatest ambition. I am sure most everyone will bring something or make it at camp. I am sure nearly everyone will dress up for the big banquet. I just have one question…one thing that makes me put my face in my hands and feel very alone and yet very lucky. I won’t be wearing costume and honestly I might be the only one.
Today I went to my first physical therapist appt in Winston. It was a nightmare. They were unprepared, lost my transfer paperwork from Virginia, had not processed my insurance correctly. But what really got me was they did not understand how I could possibly have a full time job and be recovering from a hip replacement at 25. They didn’t understand that I have to be in clinic at certain times. It was odd to them I was not on medicaid and had complicated out of state insurance (because the blessed school’s policy will not cover birth defects). They looked at me like I had seven heads when I told them no I can’t be there at 10 in the morning or 1 in the afternoon I have a job. and yes a disability.
You know for the last three weeks I lived like I am supposed to live according to my society. …in my parents’ basement. I didn’t cook a single meal, my Mom did my laundry, my Mom picked up stuff I dropped so I would not have to struggle to not break hip precautions, my Mom or my friends drove me around for the first two weeks. This is how most of my friends live (NOT ALL). Oddly enough we never had a single problem with my insurance, I got therapy for proper amt of time each week and everyone talked about how freaking inspirational I was. Funny how well everyone plays around when you play the part they expect you to play.
Being the only one in a room full of disabled people ….its awkward. I didn’t wake up one day and decide I am going to be the one disabled kid who moves out of their parents’ basement. I just grew up, went away to college, chose the career of my choice and lived my life. I’m not a freak, I’m not a pioneer, I’m not anything particularly amazing. I am just a 25 yo almost doctor who happened to be born missing a few nucleotides. My parents aren’t superheros, my doctors aren’t brilliant, we all just missed the memo about the whole disability checks, medicaid basement thing.
My life is difficult but it only compounded by a society that just can’t get over the fact that I became who i wanted to be when I grew up. And not despite of my disability or because of my disability. But because that’s what I wanted and that’s what I worked for.
Today I heard the sound of a heart that was born backwards (transposition of the great vessels) but corrected almost normal state by human hands. Doctors’ hands. Today I finally began to master heart murmurs and laughed with a little kindergarter and teased a young man with Downs’ Syndrome about his girl friend. And I loved it.
so on Sunday I will put on my scrubs and my stethoscope and my white coat and my hospital ID badge with my name and date of graduation there in small block letters. And no I don’t know what corny, inspirational thing I will tell these young adults this weekend other than this: I am so happy being a pediatrician, I don’t think I could ever do anything else. And our social norms suck…ignore them.
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| Traditions…..memories….nostagia |
[07 Sep 2009|05:43pm] |
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Originally published at Perches in the Soul. You can comment here or there. My family loves traditions. Making our family Christmas gifts, singing off key on each other voice mail on our birthdays, the annual cousin Christmas play, dying eggs at Easter, red velvet cake on my parents’ birthdays in Feb, Red Lobster for my sister’s, advent calenders, trivia at the dinner table, lunch after church and I could go on. We mark our milestones and holy days as a family with joyous rituals always remembering years before variables on a common theme.
Preparing for major orthopedic surgery in my family has familiar rituals too because its been a somewhat frequent occurrence in our lives. Some are very practical, some are down right silly. Its been a while but one would think it was just last year if you watched how quickly we all fall into the roles we know so well. My Mom sets out arranging things even with me signing consents and doing most of the arranging now she still finds ways. Dad reassures Mom, me, himself with daily pronouncements that everything is going to be ok. Emily and Tori shuffle in and out of the dialogue offering books, chocolate and wanting to know long i will monopolize all of our lives (my primary question as well) particularly my parents’.
I go to the library stock up on books, DVDs, audiobooks, stock up on food. As I packed my car this morning. I packed pillows. I went to target and bought new undergarments and socks. I found my one pair of shorts that I own and stuff them in my suitcase. I plan the traditional ‘last meal’ via google and decide on wine and crab cakes (it is Maryland after all). All the paperwork has a folder, all the appointments are made and all the necessary items are purchased. I then of course am now taking the traditional joy ride which has expanded considerably since childhood with my driving ability and all terrain vehicle. This time it will include a week of visiting, going to the beach and general traveling.
And just like with all rituals and traditions…I remember. But they are strange memories as I suppose all childhood memories are to some degree when we looked back at them with adult reason and knowledge. The last time I had major hip surgery I was 13 and although some times I thought what it would be like 10-50 years from now, most of the time I just wanted to be able to go through a whole year of school without having to be on home-bound. I wanted to get through a Spring where I didn’t break a major limb to pieces over something ridiculous like walking the stairs. I wanted to be able to stand for a whole play or walk my dog or go hiking with my family like I had when I was younger (5 yo- 10 yo). Frankly, my life was pretty awful between the pain, the social isolation and lost of the abilities to do many, many things I love. I was begging for surgery. It made so much sense.
But now my desires are so much bigger, I haven’t been ’sick/injured’ from Kniest in a decade other than an occasional minor mishap. I have traveled the world, graduated from college, live independently, drive a car and do crazy things like ski and play doctor. And I don’t want to stop any of those things, moreover I want to do more like live overseas, complete a residency, get married, have kids, raise them, etc,etc… Handing over my life to the hands of a surgeon is so much more difficult now. The stakes are higher, the leap is so much scarier. Its not about just making it off the ground it, its about finding my way back to the lofty altitude I have been cruising at for the last 9 years.
The roles are the same, the rituals are the same but the dance is so much more complicated than I remember.
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| The things we tell ourselves… |
[05 Sep 2009|11:20pm] |
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Originally published at Perches in the Soul. You can comment here or there. I have whiplash from this week. Last Friday I went to my mailbox and was surprised to see my Peds AI grade sheet three weeks early. I was even more surprised to see an negative comment on my evaluation after getting nothing but positive feedback. I panicked, my residency application was pending, my Dean’s letter. I was also convinced for a variety of reasons that the comment most likely came from the Chairman of the Peds Dept who had been my attending for three days. at the very end of my rotation. I freaked and drove in the pouring rain to Blacksburg to visit Jessica and cry my bloody eyes out over the ridiculousness. I appealed the comment t of course. My pent of anxiety of my Sept TO DO LIST: apply to residency, have a hip replacement, learn to walk again for literally the 8th time, turn 25 (Oct 4) and make it back to school by Oct 5th overwhelmed me that night. I cried and cired the whole drive up there and the first hour of being there. I needed to cry, I needed to for a moment not be strong, to let down the facade that I am holding everything together.
Child Pysch exploded this week with the start of school. We got a new attending and new third years and one of the acting interns went a-wall. We had three sexual abuse cases that nearly had us all in tears. I got my NICU grade which contradicted my negative comment. I submitted my residency application after agonizing over whether to wait for the comment appeal.
My pain doubled from the stress and from what seems to be ever worsening hip health. Sleep is difficult and I keep having wild dreams from the pysch floor, the surgery and the general state of upheaval of my life.
There was strange good moments like James’ brilliant debut of his two new shows and Corinne’s beautiful new baby boy who seemed to whisper to my soul why that God is faithful and why I signed up for this insane profession. The comment appeal went through and the comment will not be included in my letters. It will never leave Wake.
By Friday I was just grateful that it was over. That I could just get on with this surgery and the rest of my life. I was sitting waiting for my research adviser when it came. AN RESIDENCY INTERVIEW INVITATION at Emory in Atlanta, GA. I had heard that peds got early interviews BUT STILL. In four days?!?!?!?! I sat there and was ecstatically happy and grateful. Not so much that I had an interview but just that there was forward motion. God saying HERE WE GO.
hold on to your hats. Sept is going to be bonkers.
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| The view from ZSR 6th floor on the eve of the rest of my life… |
[31 Aug 2009|06:42pm] |
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Originally published at Perches in the Soul. You can comment here or there. 7 years is a long time.
I am sitting curled up in one of my favorite places in the world. The ZSR library on the Wake Forest ugrad campus. Its nooks and crannies and huge windows and high callings have facilitated my studies, my imagination and my dreams for the past 7 years. It was here I studied for my first real exam EVER, memorized latin poetry, poured over novels, drew out organic mechanisms, took MCAT practice tests, discovered libreation theology, painstaking dissected the New Testament and the Koran and eastern European folklore. I learned EKGs and neuroanatomy on the 6th floor. I learned Rheumatology and Endocrinology over in the new wing. I dreamed of traveling and medical school and later medical missions. And like most young women day dreamed occasionally about boys and the future and all that is to come. This place is full of friendly ghosts that remind me of where I have been, who I am and where I am going. Its not just nostalgia and books that live here but a sliver of my identity and the woman I have become will always find a home here. Of all the places on the Wake Forest campus I think its the place i will miss the most when I finally physically leave Winston in May.
And that is about to come to a head. Tomorrow it begins. I submit to the powers that be my residency application. Countless cups of tea, late nights, long hours, books, papers, notebooks, itunes, sutures, progress notes and surgeries. seven years, six pages of resume and essay, five agonizing standardized board/admission exams, four summers loving Eastern Europe and four babies delivered, three years of med school (1 to go), 1.5 degrees, it all been for tomorrow so I can go get a job somewhere in the United States that wants a gimpy pediatrician to be with a strange love for all things from the Black Sea to the North Pole, a more than passionate obsession with disability rights who is in love with children, Jesus and comparative religion.
up, up and away.
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| Childhood is Sacred |
[23 Aug 2009|09:55am] |
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Originally published at Perches in the Soul. You can comment here or there. Inpatient Child Pysch is a cross between Jerry Springer and a Jodi Piccoult novel. It can be a very dark place filled with hopeless situations, broken families and gross abuse and neglect of children. I have learned about the gang wars of Winston-Salem, the myriad ways to get high off crack, marijuana, XTC, acid, glue, you name it. I listened as parents cuss their children out and their children cuss right back at them. I watched parents give up their children to the state and listened to the tears of children whose parents don’t pick up their insulin for their childhood diabetes or take them to doctor’s appointments or leave them on the pysch ward so they can go Disney world or the beach without having to worry about their bipolar kid or their child with Autism complicating their vacation.
But the most important I learned is that play is the thing. No really it is. I’m talking about finger painting, mud pies, water balloons, swimming in a pool, in the ocean, games of tag, checkers, chutes and ladders, Candy Land, dancing, singing loudly, running through grass barefoot, coloring, drawing, riding your bike, basketball, baseball, flag football, going fishing with your Grandpapa, making cookies with your Grandmama, running around with your dog in the back yard, wiffle ball, hiking through the woods becomes an adventure, going down the slide, climbing up the slide, swinging so high you are sure your toes touch the sky, make s’mores and weenies over a campfire, make believe of pirates and princesses and shipwrecks and hospital (if your parents are in medicine this is inevitable) or army men or playing school, playing with dolls, playing with cars,/trains/trucks, building the tallest tower of blocks, or making a space ship with legos, playing with play dough, dying Easter eggs or sitting down and listening to a story. Sticky hands, muddy feet, paint all down your clean t-shirt, Easter egg dye from your head to your toe, mud in your hair, clothes soaking wet because you fell in the lake fishing, paw prints on your shorts from playing with the dog, a crown of daises that make you so sure that its made of diamonds and rubies, a sword that to some resembles an dirty stick you found behind a bush, the bad haircut you got after playing beauty shop, the stuff animal whose appendix you tried to take out who needs his stuffing put back in (that is for you Karen)…..
these things are sacred and they are worth fighting for….these are not just obnoxious or silly things…these are the things that teach kids how to laugh, how to talk, how to think and create, how to love and relate to others, to feel confident….these are the things that children who live on the streets (rather they be Bucharest or Winston-Salem) miss out on, these are the things that don’t happen in broken homes or homes where parents are more concerned of their own needs rather than those of their children that become twisted….
Childhood is sacred. Its where we learn everything and can lose more than everything.
so thats what I do in these family meetings and in group thearpy I fight for the right of childhood.
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| Free Falling |
[16 Aug 2009|11:07am] |
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Originally published at Perches in the Soul. You can comment here or there. I was sitting on the red sofa in the basement of my house on Wed night for bible study. I was in my favorite position with my left leg curled under my right one making me corner shaped sitting in the little sofa corner. I was in pain. It was a gnawing, angry, relentless pain that seemed worse than it had a week ago prior to the steroid shot. I was exhausted the pain woke me up several times a night and forced me to change position. I tuned in and out of the discussion on the temptation of Christ almost startling when my roommate the leader turned to ask me a relgion major related question. I was physically squirming changing my position every 5 minutes to no avail. In my head a flood gate had failed and my thoughts were swept in a gale of pain and anxiety. What would happen if I just didn’t want to do this any more? What would happen if I just pulled the trigger and said I want to get this over with it…..What would it cost me? graduation? residency? walking? What if it went perfectly what would it buy me? No pain? Actually enjoying my day to day life for my last year as a free agent?
As soon as the last prayer had been said I was up the stairs and curled up in my bed with my laptop. Kaniksha called, I answered and told her what I was thinking. She pushed me to just do it. I went to sleep (well in theory), woke up and went to school. I sat there on rounds with this torturous hurricane in my brain. In order to do this I would have to break one of my cardinal rules of AMYHOOD. I would have to admit that I was in pain to the point that I did not think I could function at my job or at my life. I disliked that idea immensely although my dislike was childish it still hurt to have to say that to someone. SO I sat there with this paralyzing inner monologue and interviewed little children whose inner monologue had landed them in the pysch ward. As soon I could steal away from post-rounds work I called the PA in Baltimore and left a short, cheerful sounding message on her voice mail. I slid my cellphone in my pocket with a smile. Sure I can try to change this but the odds were so against it working thus there was nothing to panic about. Three things had to happen: A. there had to be a surgery date in the first 8 days of block 6 (Sept 7-Sept 13), B. I had to switch my ED rotation (the only required rotation thus making it nearly impossible to switch because EVERYONE has to do it) and C. have something I can do FOR CREDIT instead in Block 6. I walked back to the pysch floor confident that I had passed the test.
The PA called me back within 20 mins. I hid in the copy room. It took effort, more than I care to admit, to tell her the truth. My voice wavered a bit but someone by the grace of God I managed to keep a surreal businesslike manner throughout the whole conversation outlining the various pre-operative studies and labs. She gave me the number of the surgery scheduler who I called and left a voice mail. I e-mailed student services with a bit of tachycardia. My fellow interns on the pysch floor sent me home early since I had stayed late the day before. As I was leaving I got a completely random and uncalled for e-mail from the pediatric rheumatologist. I had talked to her previously in the year about doing a rotation with her. It had not worked out. She had been asked to write a review on exercise therapy for kids with arthrits and myositis. She wanted to know if i wanted to do the project. I could most likely get research credit for it. I nearly melted right there in the middle of the pysch nursing station. Not only was a research project I could do from it home, it was a first author publication handed to me on a silver platter no strings attached. As I walked outside of the pysch ward I stared at the deep blue of the carolina afternoon with my eyebrows raised asking GOD what the heck was he doing?
I ran home, laid down on my sofa, tired from not sleeping and the constant gnawing. I had tried in route home to call both student services and the scheduler again both had been apparently gone for the day. I was fustrated. Kaniksha called to cheer me on. Finally at the point I was almost sleep my phone rang at 4:50 and I bolted off the sofa. Ms Long the 14th has one opening…does that work for you? Holy… its in the 8 day window. Give me till tomorrow. I called student services at 4:55 and demanded a meeting with the Dean for Friday. I got it. I then e-mailed my class expecting nothing but knowing I had to do this before I saw the Dean. Can someone please, please swicth ED rotations with me? Five minutes later someone volunteered. The Dean signed off on my swicth, my research elective/leave of abscence for block 6 without so much as a moment of hestitation, in fact he had already done before I even got there on Friday morning.
My parents thought I was slightly manic when I called them…maybe I was a tad bit crazed. Hi Mom, I having a hip replacement on Sept 14 think you drive me home on Sept 17? I explained or tried to explain that for once in my life I was excercising some level of self-perservation. My parents who know me better than most know that this is not characteristic of me…its far to what normal people with chornic pain do. They accepted it although they had a million questions most of which were medical rather than logistical.I had been the one e-mailing and calling the surgery team with my 20 million questions, I was the one who signed the dotted line on the consent forms. Now in the surreal change of roles I was the one explaining to my parents what to expect.
I’m still not exactly looking forward to it. In fact I’m still sort of terrified but feel oddly at peace with it for the first time since that fateful day in April where the surgeon walked into the room with that knowing gleam in his eye.
On Friday afternoon I headed to Atlanata to visit with friends (including my super, awesome, talented webmaster) and take the Clinical Skills boards on Monday. I stared at the peds rheum books stacked on my passenger seat, a reminder of the miracle of the last two days. It rained as I was coming out Charolotte traffic, a blinding sun shower that slowed the resceding traffic to 40 mph. I stared into the liquid blue and marveled at God’s grace and his occasional firm, gentle pushes off of our mental mountains of pride and fear. And how well he holds us as we fall into whatever ocean stands in the valley.
11 For he will order his angels
to protect you wherever you go.
12 They will hold you up with their hands
so you won’t even hurt your foot on a stone.
The passage that came to mind…oddly enough it is quoted by Satan terribly out of context in the temptation of Jesus in Luke and Matthew 4 which was the center of the discussion on the red sofa.
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| Surprising Beauty |
[28 Jun 2009|01:51am] |
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Originally published at Perches in the Soul. You can comment here or there. Is something beautiful because you love it or do you love it because its beautiful?? I don’t know. But if I did I could explain why I love Bucharest. Bucharest at first glance is a filthy, graffiti covered city made up of endless gray communist bloc apartments for as far as the eye can see. Beggars on every corner (although this is improving), stray dogs in every doorway. But if you look twice you will be surprised by the wildflowers that grow everywhere, the old trees spread throughout the city, the gardens in each balcony and each little yard, the children running down the wide sidewalks and colors of clothes on the line, bright curtains, ads that mask the gray. I love this city.
Maybe its because I love its people. I love to sit on the bus or the tram or the metro and watch people. Romanians are proud and always dress up to go outside their house. They are fiercely protective of their children (yes a bit ironic) and although they don’t smile enough for my liking at times when they engage you they are warm and will probably invite you to dinner.
Maybe its because I love the children. I am back at the baby hospital again this time. I could spend all my time there and be perfectly happy. These children resilience, their beauty, their capacity for love when they have not been loved has always given me a window to the divine yet also of the silence desperation of the orphans. I thought it would be harder being close to the end of my training but its better somehow. Even though I at times know the grim statistics these kids face, I also know of their potential first hand. I cling to that at times because I believe they cling to it too. They know what they want beauty and love over despair.
Perhaps its because I am an American and optimist that I see such beauty in the mist of such drabness and pain. I probably sound hopelessly naive but I am not as much it may seem. I know the dark side I am just surprised that there can be such dichotomy.
I hate to admit this but I need Romania far more than Romania needs me. This place has always been a place of such spiritual and emotional renewal for me. I think its how simply I live when I here.
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| Why the world is messed up Part 1 |
[25 Jun 2009|02:44pm] |
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Originally published at Perches in the Soul. You can comment here or there. I love this country and only God knows why.
I walked into the pediatric oncology ward today and the first patient I met had a brain abscess of unknown pathogen origin but since she has cancer it could be a very, very bad bug. She was in a room with two other leukemia children one who was questionably neutropenic (no immune system). I was really, really upset. I get the whole limited resources concept. I get the whole this is not America concept but I can’t turn off the little doctor in my head that says this is a way to kill three children for the price of one. We painted their faces and make necklaces and bracelets and it was the only child life (hosp playroom) time these kids get. Their parents make their meals, give them all of their oral meds, wash them, clothe them and do all beside care that does not involve the IV pump. There are no portacaths so the kids get IVs perpetually. I was pretty saddened by the whole thing.
Especially in light of story number two. So ‘Mike’ is 16 and was my bosses’ first patient here back 1994. He has a stricture (a narrowing) of his esophagus. He needed surgery to fix it but he had to grow and there were no surgeons in Romania any way. Finally they found someone to do it after a more than a decade of suffering and being told that there was nothing to be done but wait for death, they found someone. Health care is supposed to be FREE for all children under the age of 18. And by FREE they mean that if you want your child to live the hospital alive after major surgery try a 3000 dollar bribe. That’s more than most families make here a year. And it needs to be in cash and by the way it’s all under the table so the doc will never pay taxes. The missionaries, the boy’s community and his parents have scrimped and saved and raised the funds. The boy survived the procedure and is in the ICU. The only words the surgeon told the mom was the esophagus was dilated before the stricture, we should have done this years ago. The mom has to pay a bribe every time she wants to see her son. 3000 under the table? And the mother can’t even be with her son???? 3000 untaxed dollars in a country where children with treatable cancer die because they can’t pay bribes for isolation rooms.
Don’t get me wrong I know America’s health care system is broken. But at least it is mostly honest. I mean insurance companies are evil but they are upfront about it. I would take truth even it means capitiolism runs health care over corruption running health care any day.
Also this http://www.wxii12.com/video/19854698/index.html watch it… and count the number of time they use the word inspiration or something similar. I know this girl, she is a friend of mine, and she is extremely kind and generous with herself. But I post this because it’s such a good example of America’s idea of disability. I can be a cursed beggar/prisoner of an institution or I can be a poster child for a Disney movie.
God Bless America……and Romania
Good grief. Dear God please tell me there is some happy medium in the world where gimpy people are not martyrs but rather teachers, parents, doctors, lawyers or whatever they want to be when they grow up. And no one finds it extraordinary that they managed but rather find it extraordinary that anyone would think otherwise.
….there are many kinds of freedom, and even more kinds of slavery.
End Rant.
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[23 Jun 2009|12:46pm] |
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Originally published at Perches in the Soul. You can comment here or there. It is a lovely Tuesday night in Bucharest. Emily and I have settled in well. We got our clearance for the baby hospital today, we start on Thursday. Emily has been busy with school, I have been busy with clinic. I already know at least one reason why God has brought me here this time. One of the new social workers at the clinic has a 22 yo sister with Cerebral Palsy who is brilliant but is stuck in the complicated system of being disabled in Romania. We will go visit her in a rural village on Sunday. I have done lots of physicals on missionary families, Romanians, Turkish, Dutch, English diplomats. Tomorrow we will do the whole Mormon missionary force in Romania. Its fun work. I assisted on a small surgery today. The only sadness is I cannot get clearance to go work with the disabled children from last time. The one child who I had a special relationship with though has been moved to a private Catholic orphanage and I am hoping to get clearance to go see him at least.
Things are slightly better accessibility wise here. There is a van with a lift to help one get off the plane and lift into the terminal. I actually rode down the whole street today by myself in the green machine, curb cuts the whole way. I almost had tears in my eyes. Such freedom, my people here have never known such physical freedom. I learn so much of spiritual freedom from these simple things. God wants to free us from our sin and our own selfish selves but we have to let him tear down the walls (the curbs) in our life. I think often of my friend who was my initial introduction to the plight of my people who died soon after I met her. I am sad she did not live to see these days but happy to know she is with the Lord. We still have a long way to go education and health care wise, but enviromentally they are making an effort.
God is doing interesting things in my heart. I love this land and I love Eastern Europe. But Romania is chaning rapidly. Romania will need less and less missionary doctors over time. The medical missionaries who run the clinic are thinking about retiring. There is still much work to be done here but I am not sure if this is where God has me to come for the long term. So where Russia? Ukraine? Africa? I recently received an e-mail from one of my future supervisors in Africa he is asking for pediatricians with a passion for the disabled to run a rehab center in Tanzania, they want to start a series of these throughout the continent. I am going to work in one of them in Kenya in Jan. They were very clear, that my elective is a window to employment, they are almost recruiting me 5 years early it seems. Also on my way here, I ran into a guy who works for Samarthian’s Purse who gave me his card and wants me to e-mail their medical missions dept. It seems possible jobs are growing on trees at the moment…
,.,,,there is so much to tell about being back here and about Spain and Italy and France…but it will take me a while to get back to speed with my blog. I am also writing my reisdency personal statement wich is a painful endless process.
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[10 Jun 2009|10:36am] |
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Originally published at Perches in the Soul. You can comment here or there. Boards OVER.
Leaving Roanoke in less than 24 hours to drive to Dulles to fly to EUROPE.
Leave for Romania from Spain in T minus 11 days!!!!
so happy right now.
New photo site for the year of insanity:
http://amyadventuresabroad.shutterfly.com/
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| why freedom matters in Belarus…Georgia…Romania and Beyond |
[31 May 2009|10:00pm] |
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Originally published at Perches in the Soul. You can comment here or there. There was an article about Belarus in The Wall Street Journal this weekend!!! I am pleased to hear that people care. Because it really does matter and its not just the principal of thing. The article talks about how what happens with Russia’s future is an inside and outside political game. The outside is the former soviet republics and satellite nations like Romania. These countries are what separate Russia from Europe and really from the rest of the western world. These countries are small and most Americans probably couldn’t pick them out on a map but their freedom is essential to peace and stability in the region and really the world. Russia has cut down on religious freedom and freedom of the press in recent years, all NGO (charities, churches, human rights groups) have to register with the government, prominent journalists have been killed in the dead of the night. This may not make the evening news 7000 miles away in Washington but it matters.
Why you ask? The usual reasons things matter in foreign policy: oil, power and blood. Russia controls a big part of Europe’s oil supply and the oil passes through many of the former soviet republics. Russia has friends like Iran and China. Russia is becoming better armed all time and already has increasingly bad human rights record. I am not suggesting that we as the west should go in and try to mess around with the region and play police or micromanger for these corrupt, struggling infant democracies but we shouldn’t take them for granted.
Let’s all remember that it was our indifference after helping the Afghans win against the soviets that brought us the Taliban…
not the same situation, but the same principal. The battle for a free whole Europe is not over, its really only just begun.
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| ….I want to get off the boat. |
[28 May 2009|02:57pm] |
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Originally published at Perches in the Soul. You can comment here or there. I am exhausted by labels. I am exhausted by categories, by worldviews and clashing worldviews. I am exhausted by the need for debate for endless arguments for intolerance of tolerance of intolerance. I want so much for my beliefs for my walk with Christ to be nothing more than my walk with Christ. I try to peel off the layers of dirt, mire of pride of ambition, scabs and dressings of culture and politics in search of truth but I so often find myself lost amidst the gauze, plaster and mud. Where is a faith that is simple? Where is a love that is unhindered by politics, rules of decorum and a constant fear for our own personal safety and liberty? Where is a truth that is not seen through the lens of culture, not blurred by lines of indifference and by the institutions that we hold dear? Where is the church that is living in faith, loving in and out of their faith and seeking unobstructed truth?
There’s tarnish on the golden rule
And I wanna jump from this ship of fools
Show me a place where hope is young
And a people who aren’t afraid to love
This world has nothing for me and this world has everything
All that I could want and nothing that I need
This world is making me drunk on the spirits of fear.
So when he says who will go, I am nowhere near.
And the least of these look like criminals to me
So I leave Christ on the street
This world has held my hand and has led me into intolerance
But now I’m waking up, but now I’m breaking up But now I’m making up for lost time
Caedmon’s Call
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