Here I go

I'm gonna run.

That's what I do...when I get frustrated, bored, excited, angry, ambitious, sad, energized.

It's in my blood. Is that bad? I grew up running. Always new places, new people, new experiences. Running was the answer to anxiousness. Get it out.

I feel it coming... My leg is constantly moving like a sewing machine. I'm ready to run.

Where next? Hawaii? Atlanta? Patagonia? Alaska? Greece? Australia?


I'm gonna run.


Come and get me.

3 a.m. bedtime stories

I should be passed out by now. I've worked the last 3 nights in the ER so even though I'm tired...my body wants to stay awake. Just watched a movie...thinking it would help me fall asleep...nope. A car just pulled up outside at the neighbors. I guess I'm not the only one up.

Last night in the ER (around 3 a.m.) a girl came in after a "cat fight" at a restaurant. Her opponent had taken off her stiletto and hit our patient in the eye. She had a nice laceration across her eyelid. Fat was oozing out and her eye and cheek were swollen like a balloon. The X-rays showed a "blow-out" fracture, meaning the thin bony socket that holds the eyeball got cracked in several places. You can't really put a cast on that. We called ophthalmology to come suture up her lid. The resident that came was from Loma Linda. She did a really good job.

The night before that we had a half naked girl brought in by the police for assaulting his sergeant but that wasn't before they broke up the "cat fight" she was in. Her wound was a nice meaty bite mark on the back of her arm. Apparently biting is still allowed when you're an adult...or maybe just when you're drunk. That same night I sutured up a laceration on man's forehead. He had also been brought in by the police and not only was he intoxicated, he was very upset with the cop that arrested him for possession of cocaine and felt the need to verbalize this...over and over again. This certain policeman was a young and cocky fellow who preceded to purposely aggravate the man and for some reason had taken a liking to me and was asking me questions about myself as I prepared for my suturing procedure. With the patient hand-cuffed to both sides of the gurney, laying on his back, his line of sight was limited but the officer chose to stand directly over him across the bed from me. This made my job difficult as the drunken man kept turning his head to scold the officer and ramble on about injustice. The cop smugly ignored him as he continued to "interrogate" me. My tolerance level was declining as I thought, "this officer has just as much common sense as this drunk man." I took a plastic syringe of normal saline to irrigate the wound. My plan was to push the fluid gently into the laceration to clean it out but as I pushed on the end of the syringe...it wouldn't budge. I pushed harder...And like a shotgun going off, the saline shot into the wound and ricocheted out the other direction splattering blood all over the wall, the sheets and...the policeman's face. He looked at me in shock as his hand slowly wiped a few drops off his cheek and out of his eye. With a serious tone I said, "You should probably go have the doctor look at that." He walked out. I honestly felt bad for the mistake but with him gone my patient quieted down, fell asleep, and I sewed him up in peace.

Gray or Blue...lyrics

I feel so helpless now, my guitar is not around
And I'm struggling with the xylophone to make these feelings sound
And I'm remembering you singing and bringing you to life
And It's raining out the window and today it looks like night

You haven't written to me in a week I'm wondering why that is
Are you too nervous to be lovers, friendships ruined with just one kiss
I watched you very closely and I saw you look away
Your eyes are either gray or blue, I'm never close enough to say

But your sweatshirt says it all with the hood over your face
I can't keep staring at your mouth without wondering how it tastes
I'm with another boy; he's asleep, I'm wide awake
And he tried to win my heart, but it's taken time

I know the shape of your hands because I watch them when you talk
And I know the shape of your body 'cause I watch it when you walk
And I want to know it all but I'm giving you the lead
So go on, go on and take it, don't fake it, shake it

Crazy eyes have you. Are they gray or blue?

I won't make the move
you must make the move
if you make the move
I will then approve
if you do not move
we will surely lose

Don't second guess your feelings. You were right from the start
And I notice she's your lover, but she's nowhere near your heart
This city is for strangers, like the sky is for the stars
But I think it's very dangerous if we do not take whats ours

And I'm winning you with words because I have no other way
I'd love to look into your face without your eyes turning away
Last night I watched you sing because a person has to try
And I walked home in the rain because a person cannot lie

Temporary Madness

"Love is a temporary madness. It erupts like an earthquake and then subsides. And when it subsides you have to make a decision. You have to work out whether your roots have become so entwined together that it is inconceivable that you should ever part. Because this is what love is. Love is not breathlessness, it is not excitement, it is not the promulgation of promises of eternal passion. That is just being "in love" which any of us can convince ourselves we are. Love itself is what is left over when being in love has burned away, and this is both an art and a fortunate accident. Your mother and I had it, we had roots that grew towards each other underground, and when all the pretty blossom had fallen from our branches we found that we were one tree and not two."
-St. Augustine

Congratulations to two of my favorite people, Rika and Aaron, on the beginning of your life together. Oct. 18, 2009

feeling rich

Generally I don't care for rain. Overcast days can bring my mood down but today is different. SoCal is mostly sunny so a dreary day is refreshing. I am introspective today. I feel like sitting by a window covered in rain drops and writing. So here I am. I feel content. I just had a long conversation with a good friend, received a post card from another, and got a package from my mom filled with tea, chocolate, and licorice...some of my favorites.

I have a proposal to write today to get approval for my small group to paint an old thrift store that is going under. We are going to try and revive it by giving it a major face lift inside and out. They give their profits to the nursing scholarship at Loma Linda so we would like to get them back on their feet. Soon the drab grey metal building will be bright red and white like a barn and hopefully new signage will come next.

The adult psych unit is interesting. We have patients that think they are the Hercules and Zeus, one that sees angels and demons, another that is "being followed by the pentagon because he found the solution for the world", and one that thinks all the staff members are different famous people. I'm Helen Hunt. It is never a dull day on the unit.

I can't explain the way I feel right now. It's sort of like the feeling I get when I watch the movie, "Away We Go." Do you ever feel like your life could be a movie? Or that you are watching yourself as an outsider. The soundtrack for my life right now is a Ray Lamontagne song and my day has been a contrast of melancholy feelings and happy/quirky/unexpected experiences.

I love it.

What I want out of life...

I want to be a grandma in a rocking chair that reads books to her grandchildren on her lap and then goes and climbs trees with them.

I want my conversations with my Father to continually get longer and deeper.

I want to always be full of love for people around me.

I want to wake up next to my husband when I'm 80 and we'll smile at each other, knowing we have had an amazing life together.

I want to speak gently and love unconditionally.

I want to kiss my husband every time he comes home.

I want my children to be thinkers but not afraid to feel. I want them to spend more time outdoors than inside and be known for their kindness more than any other attribute.

I want to get good use and wear out of everything I own and if I don't I want to be able to give it away without blinking twice.

I want to wake up to the words, "Good Morning Beautiful"

I want to go jogging with my fiance' on the morning of our wedding.

I want a slack-line, a tree house, a hammock, bird feeders, and a rope swing in my back yard.

I want to randomly go grocery shopping at 1 am with my husband.

I want to always be a loyal friend.

I want my day-to-day expenses to be very simple so that large amounts of money can easily be given to those in need or used for travel.

I want my door to always be open and friends to come over unexpectedly.

I want to live near a few close friends that become our family.

I want Sabbath to be the best day of the week for everyone in my home.

I want to run a marathon.

I want to live in Hawaii again.

I want to work in my garden barefoot, in a skirt.

I want to wear flowers in my hair at my wedding.

I want to regularly communicate with my husband from across a room with our eyes.

I want to live near water.

I want to take evening walks with my husband and hold his hand.

I want to always be able to feed who ever walks through my door.

I want family time be filled with laughter and teasing whether we're playing in the snow, on the beach, or cooking together in the kitchen.

I want to be my husband's biggest fan.

I want to let my kids keep any animal they bring home and help them raise it.

I want to regularly camp with my kids in the back yard and make blueberry pancakes in the morning.

I want to learn how to dance.

I want to travel.

I want my wrinkles to be from smiling so much.

I want to have soft sheets.

I want to ride a train a long distance.

I want my children to go climbing and snow shoeing with my dad.

I want to read books that enrich my life.

I want to spend more time building relationships than a career.

I want to live someplace sunny.

I want to be a missionary.

I want...

Psych!

2nd rotation of 12. Psychiatry. I'm working on the adolescent inpatient unit this week and have been very fascinated and saddened by the mentally disabling illnesses out there that affect our youth. One girl in particular was a well functioning, straight A 15 year old with only a history of bipolar in her family to be her downfall. So the combination of faulty genes and large amounts of cortisol building up in her brain from stress (she just broke up with her boyfriend) causes her to have her first "break". A "break" in bipolar disorder means a manic phase of this disease. (Bipolar being the combination of depression and mania). So after a few days of not eating or sleeping because of the heartbreak she begins to become hyperactive and hypertalkative. Her parents realize something is different with their daughter so they put her in the car to go to the ER. On the way to the hospital the girl gets out of the moving vehicle and precedes to remove all her clothing while walking out into traffic. (She has now "broken") At the hospital, the girl tells the nurse that she is 4 years old and has no orientation to where she is at or what day it is. From the hospital she is admitted to the unit I'm working on. She is now my patient. The doctor and I go in to talk with her. She is still undressing herself and so she is kept in an isolated room. She is wrapped in a blanket sitting on her bed. It is obvious that she is "checked out". She can't answer our questions. She can't remember anything past 1st grade and when we sit in silence she will space out and then be surprised to see the doctor sitting next to her. She reaches out to touch his shoulder to see if he is real. She can't delineate between reality and the hallucinations she's seeing. Thankfully this is bipolar and not schizophrenia. Bipolar is treatable with meds and people can function normally if they are compliant with taking them. My heart aches for her and her family. These few weeks will be some of the hardest for them. But there is hope. Hope that she will improve. Hope that our Father will come soon and restore us all with new minds.

embarrassment

So the past 2 weeks have been the start of my clinical rotations. I'm currently doing "family medicine" which means I go between the urgent care and the family clinic. Most days, it's pretty mellow. I've had the opportunity to incise and drain several MRSA abscesses from peoples underarms and inner thighs. Those days, I go home feeling like I need to jump in a bath of bleach water. Other times I come home rather amused by the patient encounters I've had.

One of my first days in the urgent care, I was asked by one of the PAs if I would like to come watch an incision and drainage of a cyst. I happily accepted and followed her blindly into a room with a closed door. To my surprise and more to the patient's surprise was that I recognized him. The look on his face when he realized he knew me was one of mild horror. The first thought through my head was, "Where is the cyst?". At that point I could have chosen to turn around and leave out of respect for him but I made a quick decision to act professional and stay. This was a good learning experience and good practice for future encounters with patients I might personally know. Within seconds the PA had him on his belly with his shorts half way down his bum. The cyst happened to be nestled in the superior portion of his butt cheeks. I think at this point, both the patient and I were probably blushing but neither of us could see the others' face. So we chatted as if were sitting in a cafe' having coffee together, all the while I'm helping to hold his cheeks apart while the PA performed the procedure.

Another day, at the Family clinic, I was helping out a resident by seeing some of his patients. I picked up a chart on the outside of a room. On the line where it says why the patient is there, it read, "Suppression Therapy." Not really sure what that meant, I walked confidently into the room to find a 30 something, good looking gentleman with a very nervous look on his face. He was expecting to see a male doctor but instead a young female student walks in and shakes his hand. As a I sat down with my clipboard and asked him why he was there, he crossed his legs, and his arms, and with hesitation told me he was there for suppression therapy for his Herpes. Once again, I practiced my "non shocked, this happens all the time" demeanor. I asked him questions about the history of his disease as if it were a common cold. His body language opened up over a few minutes but when I went to listen his heart and lungs, I could see that he was sweating profusely. That was the extent of my exam. I didn't ask to see the herpes. I believed him and I think he appreciated that.

Headed for Zion

This last weekend I took a trip to Zion National park with my friend Josh. I first met him when I moved to Bend, Oregon 4 years ago and since then we have kept in touch off and on. This trip was a spontaneous one. We haven't talked more than 5 or 6 times in the last 3 years so I knew it would be interesting to spend 4 straight days together. One of my favorite things about Josh is that he is different than most of my other friends. He considers himself to be agnostic and has led a very different life than me and my fellow Adventists. This creates wonderful discussions about life, God, origin, love, relationships, and standards. We challenge each other and it causes us to think and re-evaluate our beliefs.

One thing I gained from this trip was a more defined set of beliefs. It's not often that you get challenged to defend yourself when you hang out with people that believe the same things you do. When someone is pushing you from the opposite direction it causes you to run around in your head and pick up all the pieces that you thought you knew and try to fit them together to form a clear picture. Some of those pieces, you throw out, but others you pick up, dust off and remember how valuable they are to you. I loved the challenge of hanging out with Josh but by day 3 I started to miss my Christian friends. Not because they are comfortable and don't challenge me but because they understand and strive for the same things I do. We have the same struggles and enjoy the same victories. We have the same purpose in life.

This just helps me understand culture and group loyalty a lot better. People like to congregate with others that believe the same way they do. It's tough to be challenged and have your beliefs questioned. But I think it's a good thing. It keeps you sharp and keeps you thinking. Even though Josh doesn't consider himself to be a Christian, this weekend he helped me strengthen my faith and solidify the reasons I walk with God.

His Heart in My Hands part 2

What have I done? Another man's heart sits broken in my hands. I don't know how to fix it or what to do next. Was I being selfish? Was this necessary? God, you are the only one I have to lean on now. Please hold me. My heart is broken too. The only thing that connects us now is the pain. I feel so lost and confused...but I trust you.

His Heart in My Hands

I lifted out the cold solid mass and examined our work from the last 30 minutes. We had just played surgeon on a dead guy and performed the first half of a heart transplant. It began with the whirring sound of the electric bone-saw as we pushed through the medial ends of the clavicles. Next came the stainless steal clippers. They looked like the hand-held shears my mom uses to trim her roses. Instead of flower stems, we clipped along the side of the man's thorax, crunching through his ribs like they were crab legs at a buffet dinner. Stopping at the bottom of the rib cage, we left the diaphragm muscle intact to act as a hinge for this doorway into the man's chest. As two of us strained to break open the chest cavity, a third assisted the ripping connective tissue with a scalpel. Inside, revealed the pinkish/gray spongy lungs... but no heart. Where was that red, fist-sized muscle that we value so much? Apparently, it doesn't sit openly on the left side of the chest like I was led to believe. Carefully nested between the lungs in a sac of greasy fluid was the treasure we were searching for. With nimble fingers we reached around the heart and sliced through the small and large vessels that were tethering it to the rest of the body. Then...for the first time in this man's existence his heart was literally pulled out of his chest. I took it over to the sink and began washing out the dried blood. It felt like a rubber pliable toy as I stuck my fingers into the hollow atriums and felt around for left over chunks. Little fountains were created as water poured into one tube and shot out of another. My lab partners sat behind me discussing the latest "Bachelor" episode and the 3 women that were left, all striving for the man's heart. Too bad they weren't in lab with us today. It wasn't that difficult.