Little Monica Goes to the Big Apple

We have returned home! Seth and I spent 5 days in NYC over Christmas this year, and the experience was many things. It was magical! and fun! and amazing! but also exhausting, expensive, and crowded. 

What I LOVED:

1) I LOVED all the parks we went to. We walked down High Line Park Christmas morning, which was amazing. This park is an old elevated subway line that was no longer in use so they turned it into a park. So it's really long and skinny, but it gives such a different perspective of the city and the park itself is beautiful. Everything from the benches to tree placement was very thought out. Then we made our way down to Washington Square Park, which has the really big iconic arch. So beautiful, nice open space amongst the sky scrapers. Lastly, of course Central Park. We didn't spend a lot of time walking around, and the park is HUGE, but the small section we saw was so beautiful. I found myself wanting to go for a nice relaxing jog through it. 

2) LOVED eating. Fav eateries:

       -George's. It's a little hole in the wall family owned diner, and the food is delicious but nothing   too unique, but it's right around the corner from Wall St. by the World Trade Center and Battery Park so it's a good people watching place. All the Wall St. businessmen and big shots of NYC seemed to eat at this little po-dunk diner, so it was fun little experience.

       -Angelo's Pizza. AMAZING pizza and its right above David Letterman's studio on Broadway. So not only was it the best pizza I've eaten, it was in such a cool spot!

       -Maison Kayer had french food. We just happened to meander in here starving, and were very happy with our Christmas brunch here. Really delicious and something unique, but a tad on the expensive side but not too bad.

      -The China Village. We ate Chinese food in Chinatown for Christmas dinner, and how cool is that!? Enough said there.

      -Serendipity. Such a whimsical little place famous for their GIANT sundaes and frozen hot chocolate (also featured in the movie Serendipity with John Cusack and Kate Beckinsale!). It looks tiny on the outside and is easily missed, but you go in and the decorations are just over the top and it goes back forever. They take reservations if you actually eat food, not for dessert though. We waited almost 2 hours to have dessert. Although totally worth it, either make a reservation and just eat dinner there too or put your name on the list, go somewhere else to eat, then go back. 

3) The 9/11 Memorial. There are no words. It was just beautiful and moving. I was in 5th grade, Seth in 6th, in Alaska when it happened. We have always known it was a big deal obviously, but we were so far away and didn't even know anybody who lived in NYC, but to be there and see people's names who died inscribed around the reflection pools of the old World Trade Center foundations was touching. As we were riding the ferry out to the Statue of Liberty, I was just looking at the skyline trying to imagine being there on 9/11/2001. It's just another day and all of a sudden you look up and planes crash into each of the Twin Towers. I just couldn't even imagine the horror. 

4) The Ballet. Oh. my. goodness. Not only the actual ballet itself was amazing, but I think it's beautiful to see people dress up in there best dresses and suits they have to go celebrate somebody else's incredible talent. I was in awe of the beautiful Lincoln Center, the stage, and the experience. It was beautiful. People are beautiful, and I love that we create beautiful things like ballet and plays. 

Things I DID NOT love

1) It was a holiday, and with that comes 1 million extra people in the city, and it was CROWDED. There was a line for everything. To see the 9/11 Memorial, to skate in Central Park,  to go in Serendipidy, etc. 1 Hour Minimum. Note to self: if we go back, go on a random week when there's no holidays, because the city was PACKED and we were always waiting in lines. 

2) THERE ARE NO BATHROOMS. You can be guaranteed a bathroom in Starbucks (and there's one every block it seems like), but the line for the bathroom is at least half hour. If you go, scope out churches (most of them are just open so people can look in them), and TGI Fridays. Those are go to spots for bathrooms, otherwise NOBODY has bathrooms. I spent a large part of the week doing the potty dance, because I had to pee!

3) Consumerism is hard. We went in the big famous Macys, FAO Schwartz (big famous toy store), and many more stores just to see, and all I could think about is all the STUFF. There was just so many THINGS in each of those stores. Macys was kind of neat, because whatever you could ever want was in there, which is convenient, but that's also heartbreaking. I want a coat, but do I really need 500 (literally) different options? Is my life so consumed by having EXACTLY what I WANT? Those stores just screamed "I WANT THINGS. I WANT STUFF. I WANT I WANT I WANT!!!!" We just consume things and don't even think twice about where it comes from, who made it, was it ethically made, do I really need it, why do I want this, etc. 

4) Times Square was meh. Cool to pop in for 5 minutes and just see it, but when you really start looking around it's mostly just typical advertisements with lots of sex, more stuff to get upset about not having, and propaganda. Meh. 

Overall from our visit to New York, I can't decide if I'm in awe of the creativity of human beings and our innovation to make a place like NYC or if I'm in total horror of the fact we have basically laid one solid slab of concrete over such a large surface area. My inner Alaskan who is used to untouched land and big open spaces cried a little inside. Regardless, it's always good to be home. I missed my dog and cat a lot. 

Hodge Podge Post: Being nice to students, diabetes, lying, and NYC.

I have a random assortment of things to address today.

First: Be nice to medical/PA/nursing students. Often people will ask me outside of my rotations what I have gotten to do. I'll then elaborate, explaining that I'm further learning suturing, coming up with my own treatment plans (ex: what antibiotic a patient should be given for xyz symptoms), giving injections, etc., and it seems like responses are almost always followed with a horrific facial expression with some comment like 'Have you ever done that before!?' or 'You could really hurt someone!!' Yes, there are potential for fatal allergic reactions to medications. But my preceptor sees everything I suggest and discusses it with me before a final decision has been made. No, I haven't drained an abscess before but I did for the first time the other day. I've only sutured wounds up a handful of times, and yes I did it for the first time by myself the other day. Before that joint aspiration yesterday, no I'd never done one. People are just shocked by this, but please explain to me how I'm supposed to learn how to do anything if I don't just DO IT!??!?!? I can watch and watch and watch but eventually, I have to just DO IT. Anyone who is an expert at anything had never done it before at one point too, so please be nice to students. We have to learn somehow, and if you are going to ask us about it, please refrain from being judgmental or in utter disbelief. We're already nervous enough, we are trying to learn, and please trust that our preceptors wouldn't let us do anything they didn't think we could do well. With that being said, please also let students do things on you. We are sincerely sorry for the additional pain we may cause that an experienced clinician may not inflict, but just think of it as an act of altruism. The next person I do it on will be better! :)

Second: I need to make a confession. I get frustrated with diabetes (type II to be specific), and this is bad. First of all, I want to make it a point to say that anybody can get type II diabetes, not just overweight, generally unhealthy people as often the stereotype is. "Oh you got diabetes because you're over weight and eat poorly." Sometimes true, sometimes not true. Type II diabetes is certainly very much influenced by those things, diet and exercise is the cornerstone of treatment, and with our country's obesity problem diabetes has skyrocketed, but there is actually a stronger family history component with type II diabetes then type I. This seems counterintuitive considering type II is so strongly affected by extrinsic factors like diet and exercise, where as type I is an autoimmune disorder, but even skinny healthy people can get type II diabetes. But back to my confession. Type II diabetes is the #1 cause of  adult onset blindness, non-traumatic lower limb amputations, and kidney failure. Diabetes is also a HUGE risk factor for heart attacks and stroke. So my frustrations are this: I know eating well is hard.  I know exercising is a pain in the butt and takes time and money and is difficult to do. I know taking medications is hard to accept, costs money, and easy to forget. But I get frustrated, because if people with diabetes don't do these things, the consequences are dire for them and their families. I don't want to see anybody go blind or anybody have to take care of their spouse who had to get their limb amputated just because they weren't willing to do the hard thing. It's hard for me to not be judgmental and think people are selfish when they don't at least try. Be brave! Be courageous! Be bold! Do things you never thought you'd ever do! Try medications; explore eating better; explore different types of exercise you might enjoy. Nobody is asking you to eat lettuce for every meal or become an olympic triathlete. So anyways, I get incredibly frustrated and my entire day gets consumed by these frustrations, which I really need to work on. Seth and I have multiple family members with diabetes, so we see first hand how difficult it is to deal with, but I just know how worried we get about them, so to see somebody with diabetes not work on it I just want to say "Do you KNOW how worried your family is!?" How long is grandma going to live? Is Uncle so and so going to get his foot amputated and need living assistance? Is/when is dad going to have a heart attack? My end message is this though: be nice and encouraging. Sure, our country is obese and many people have diabetes because of that (fat tissue is an endocrine organ all in itself, but we won't go there today), but nobody WANTS to be obese, have diabetes, heart problems, etc, and nobody is inspired to make life changes by being told how terrible you think they are. They already feel bad enough, so be nice. Celebrate little victories and always be aware of your own biases and judgements.

Moving on...

Third: I'm a big liar. I swore to never run again, but I have been. Just 2-3 miles every few days so nothing quite like the half marathon training. I want to exercise, but even though I don't LIKE to exercise it's important to my health, and I feel better after I exercise even though I don't particularly like it while it's happening. And! I don't feel quite as guilty about all the cookies and candy I eat (calories in = calories out!). So! I'm also doing those T25 videos once or twice a week, but those really are designed for you to get strong, and I am currently not strong so they are difficult. I also don't care to be strong, which makes it hard to make myself do them, but running is easy now! Post half marathon, a 2-3 mile run is easy peasy, only takes 20-30 minutes, burns a lot of calories quickly, and sometimes I can get Cooper's exercise in too (half the distance is typically spent trying to find the perfect place for him to poop. He's a diva about that...). So in my daily struggle to find time, energy, and motivation to do some physical activity, that is where I'm at.

Lastly: Seth and I are going to NYC in 6 days for Christmas, and I am so excited I can't even stand it!!!!!!! That is all. :)

Old People

I've started my second rotation, primary care, but it's actually in an urgent care. I don't mind that though. We aren't doing a lot of chronic disease management (ex: high blood pressure, diabetes, asthma) that you would see in primary care, but the environment is still very primary care 'esque.' All the staff know all the patients, because the patients continue coming back to them over and over and you can see those so very valuable provider-patient relationships you get working in primary care. I am enjoying it. I love that I actually have time to talk to people, they genuinely are so grateful for what we do for them, the staff are all friends (quickly discovered liking who you work with highly surpasses importance of where you work), and since it's a privately owned office, one of the doctors is able to bring his little dog with him, and who doesn't love that!?

So this post is about old people, and I mean OLD people. 90 and 100something year olds. We see a handful of them everyday, and I am intrigued and sometimes horrified by the sheer difference of actual 'age' people can be. For example, I saw two 75 year olds back to back. One of the 75 year olds was just as agile as I was, easily standing, sitting, laying down on the exam table, etc. Their mind was still young and lived by themselves, and only on one medication. The next 75 year old I saw was brought in by wheel chair, could barely sit forward so that I could listen to their lungs properly, in chronic pain, had a long long list of health issues and medications, and the poor thing had lived in an assisted living home for many years already. And the terrifying part of these two people is that they were both the same gender, same prior occupation, same number of kids, neither had ever smoked, both grew up and had lived in/around Roanoke their entire lives, both widowed recently, etc. They seemed to live fairly similar lives and yet they could not be on farther ends of the spectrum as far as health.

I like to think that Seth and I do a fairly ok job taking care of ourselves (aside from the atrocious amount of candy/sweets we eat (btw, I haven't had a candy bar in 3 days. This is a HUGE deal for me)). We both are fairly active. Post-half marathon, Seth has began lifting and I've started these 'T25' videos my sister lent me. We eat well. We try to make meals proportionally heavy in veggies, we do our best to buy organic meat, only eat whole grains, and really if we even need a fat source to cook we use olive oil. We really just drink water; Seth occasionally relapses as a recovering sodaholic but nothing crazy, and I'll have some tea a lot of mornings. Neither of use tobacco, once in a blue moon I'll have some wine and Seth will have a beer, and otherwise don't really have any bad habits. With that being said, I hope we become old people who are not old, but meeting people like the last two I described really makes you wonder. You can't do much to control your genetics. Seth and I both have a handful of healthy older people in our families and instances of longevity, but we both have a handful of really not healthy people in our families. So who knows. Hopefully our lifestyle choices now will help us out if we didn't win the genetic lottery.

Other examples of interesting older people I've met:

-A 90some year old woman who is wheel chair bound, hasn't walked in years and can't lay down (has to sleep sitting up in a chair), but totally mentally intact and in high spirits, unashamed of her disability bossing me around to help her move her leg here, lift this, pull that, etc., still puts on lipstick every day and curls her hair.

-An 88 year old woman who still works a few days a week as a cashier, because she gets bored. Oh, and she gardens, manages a bee hive, cans her own honey, hunts, and lives by herself.

-One of the most beautiful things I saw this week though was an older gentlemen (70s maybe) who brought his father in for a cold, who was in his 90s. I don't know why, but I just found it so moving to see this older gentlemen himself taking care of his even older dad. He was in really good health, really high energy and super cute with his exaggerated southern politeness. His dad had a little dementia, so he was fairly unresponsive to my questions as I was trying to obtain the appropriate information I needed to develop a diagnosis and treatment plan, but when his son talked to him he answered every question, and they conversed rather normally. How amazing would it be to be in good enough health ourselves to take care of our parents when we're that old, and our parents to really be in good enough health in their 90s that we could do it on our own!?

So anyways, I've learned age is just a number. You could be a very young 70 year old or a very old 70 year old. I also want to take a moment to make fun of Seth as I close, because Seth is a math genius. Literally. I'm not just saying that. Sometimes I think he has some sort of super power. However, last night as I was telling him about some of the older people I've seen, he said "Babe...we could live to see the year 3000." ....really? The year 3000? Modern medicine is pretty good, but not that good. As I looked at him quizzically, he followed up with "Ya! We would be 110!" Ooooooohhh my. Then I started laughing hysterically and as he realized his mistake, he didn't find it quite a cool to say we could live to see the year 2100. This guy understands incredibly complex calculus, really advanced probability, and physics, but sometimes messes up on basic addition. Maybe he doesn't have a super power after all. :)

Retiring from the ER and Running

Well I finished my emergency medicine rotation last week and the final verdict is: the ER is not the place for me, and this decision really comes back to one of the many reasons why I chose to become a physician assistant rather then pursue medical school. One word: lifestyle. I decided I wanted a career where I could come home to Seth every night, I don't want to be on call all the time, I DID NOT want to go through 4 more years of school, and *gulp* here come's the 'k' word: kids. I don't foresee myself being a full time stay at home mom, but it really didn't make sense to me to go all the way through medical school and residency and then not really use all my training because I want to be at home with our kids more. So anyways, in the emergency room I wasn't even on a terrible shift (2pm-12am), but I never saw Seth except when I got home around 1am and went to sleep where he was already in bed. People in the ER complained (rightfully so) about the tough life/work balance, feeling as if they were neglecting their families, etc. So all I have to say is no thank you! I admire those who sacrifice their time to work in the emergency room, but I am selfish and want more time for me and Seth. :)

Other eventful things over the past couple weeks: Seth and I ran our half marathon last Saturday! In hindsight, the actual event wasn't difficult but the training was very difficult mentally. We trained for about 13 weeks, 4-5 days/week. I cannot think of a single training run where I thought 'YAAA! WOO! I get to go for a run today!" That definitely never happened. It was mentally difficult to force my butt to get out there, especially back in August and September when I had to run at 5:30-6am when it was 'only' 65-70 degrees out, because there was no way I'd survive in the 80s or 90s of the afternoon. And if I didn't run, all I thought about all day was the fact I needed to run. Not to mention the mental hurdles of adding distance along the way.

The half marathon was fun though. It's a pretty difficult route, basically weaving around every conceivable hill Roanoke has to offer. Good grief! It was amazing to see people of all ages, shapes, and sizes just running/jogging/walking along to reach this ridiculous goal of 13.1 miles. Kudos to marathoners, because at the end of the race I probably couldn't have ran another 100 feet let alone another 13.1 miles. But Seth and I both achieved our goals. I just wanted to stay under a 10min/mile pace and Seth wanted to be around an 8:50 min/mile pace. Now that this is all said and done, I don't really have any interest in doing another one or keeping up running. It was a bucket list item, and now I know I can do it, but I just genuinely don't love to run. I actually don't like working out at all. I like activities. I love mountain biking, kayaking, and hiking. I don't love going to the gym, but I do love being healthy and in shape so it is a necessary evil I suppose.

Also, my dad was here all week and rode my bike around the whole time the half marathon was happening to give Seth and I big yells and high 5's of encouragement along the way. :) That was the best. I can only hope my kids admire and love Seth and I as much as I love and admire my dad.

The World Sucks, and Medicine is Hard. Save Us Jesus.

I've had a few more days of experience in the ER and the burdens of the world have been weighing heavy on my heart. It is a rough environment, the ER, and as one of my professors put it "nobody comes to the ER on their best day." Here's a list of a few things I saw the past few days:

-A man severely addicted to alcohol and withdrawing (fyi: alcohol is the most dangerous substance to withdrawal from. Not cocaine, heroine, meth, or anything else you can think of, but alcohol)
-A woman who is 30 and has already been divorced twice.
-Numerous children with only one parent (those who are reading, don't get all offended by this. I was raised by a single parent, and my dad is a better parent by himself then most people are together, but one cannot deny that a solid, two parent home is the most ideal situation).
-A sexual assault victim needing a forensic exam.
-More foul and offensive language then I've heard in my entire life (not by patients I might add...)

The list goes on and on. And in the midst of all this, I am thankful that I became a Christian years ago, because it makes coping with all of this a little easier. Christianity gets minimized by modern society to a lot of rules and is portrayed as hatred (and I do apologize for those people, but hateful people come in all forms and flavors of Christian, Atheist, Islamic, Hindu, etc, and those of us actually trying to find truth have a huge task of cleaning up the mess that our particular flavor makes, so please be patient and kind to everybody. Disclaimer ended). But what does it mean to be a Christian? Why can I cope with all the things I see in the ER easier then if I wasn't a Christian?  It means to understand that people are broken, but that we don't have to heal ourselves or each other alone. What a huge task that would be!! It's difficult to fix something broken with something else that is broken. Everyone has there own struggles and ugliness, and broken people cannot fix other broken people. BUT!! There is a God who cares for and loves us, so much that even though people do the ugliest things to each other, He still wants to spend eternity with us, so his son, Jesus, who lived a perfect life, always kind, forgiving, and selfless, died taking all of our burdens onto himself. It means that I have hope that there can be healing and redemption of horrible situations, even as I'm inundated in one of the world's most desperate places, the emergency room.

And the alarming part of working in the ER is that almost every provider, whether physician, PA, nurse, etc., has made it very clear that they are not 'spiritual' as they like to say. They are not religious, and they like to make it known. So my question is, how on earth do they deal with working there? There is no higher being, no God, just people. Day after day with nothing but death, tragedy, and illness, where do they find hope?  Medicine? Medicine is really a big guessing game. Using a story a patient tells, a physical exam, and maybe some labs we make our best guess at what is wrong and choose what we think might be the best treatment for it is. That fails often, and we don't have medicine for many many things. Science? How does science fix the woman's heart who's husband of 60 years just died? People? Whether we like to admit or not, even the nicest people do hurtful things and have their own burdens. How to we deal with the tragedy and weight of working in medicine?

So to wrap it up, my benediction, for the lack of better words, to my colleagues is this: If all you believe in is people (or science or medicine), I can only imagine how heavy the burden of a career in health care is going to be as we are the healers of the body, mind, and heart. Our job is to get involved and dig deep into people's lives, and what we often find is horrifying. People and this world are ugly, medicine fails, and there are severe limitations to scientific knowledge. I cope by knowing that Jesus heals and redeems all ailments, and that I am just privileged enough to get to help. I know that the burdens of this world are not mine, because thankfully, Jesus bore every burden when he died for us on the cross.

A Night in the Trauma Bay

Last night (Wednesday) I got to the the ER around 8PM and left at 5:30AM Thursday. It was actually a pretty quiet night. In the 9.5 hours I was there, I only logged 8 patients, none of which was a true huge trauma. Earlier Wednesday morning a stabbing victim came in, but I was not there yet (DANG!). So! That's good for the city of Roanoke but makes for an uneventful night for us. Thank heavens one of my classmates was with me and my preceptor is very friendly, otherwise it would have been a long long evening.

There was one really interesting case though. They had Boerhaave Syndrome.

Basically what happens in Boerhaave Syndrome is there is an increase pressure in the esophagus from over eating, eating too quickly, or severe vomiting, which then causes your esophagus to rupture, and all the food or vomit that was in your esophagus is now in your chest cavity. As my professor says in his heavy southern-rural-Virginian accent: "This is B-A-D not good. That is some BADNESS." This is a problem, because you chest cavity is sterile and has now been contaminated. Treatment? Crack open the chest cavity, clean it out to get as sterile as possible, fix the tear in the esophagus, and put them back together. If untreated, there is almost a 100% mortality rate because you get a massive infection all around your heart and lungs.

So to put this in perspective for this patient, the poor thing was eating dinner, they all of a sudden got terrible chest pain and felt like they had aspirated a piece of meat (which means they felt like it had gone into their trachea or bronchi towards their lungs) and couldn't get it out. After seeing the CT scan, that piece of meat was floating around in their chest cavity. So what should have been a pleasant evening at home eating dinner turned into calling the cardiothoracic surgeon and having their chest wall broken open to retrieve that piece of meat. The ER doc on that night said the patient would most likely fully recover and be home in a week. How amazing is that!! Also, I might add this patient was in zero distress. They basically just sat there for a few hours with some oxygen in their nose waiting to go into surgery. Also amazing.

So! That was the most interesting thing I saw all night. One other thing I learned:

People having serious heart issues don't look like they do in TV shows. Granted we didn't get anyone having a full on heart attack, but we had a few people who could be well on their way to that shortly. While learning about MIs (myocardial infarctions...or heart attacks), I really imagined people in a large amount of distress, quickly crashing needing immediate life saving intervention. Sure, I bet those people exist, but the few people we saw last night who could have a full on MI at any moment were in absolutely ZERO distress, not too concerned, just casually talking, with their only complaint "My chest just hurts a little and my arm feels a little funny."

SO! As we are going out and about living out our lives, I think being educated on the signs and symptoms of a heart attack are important. What if you saw somebody in the grocery store having one? Would you be able to recognize it and know to call 911? The Cleveland Clinic has a great link about recognizing a heart attack I would recommend reading. http://my.clevelandclinic.org/heart/disorders/cad/mi_symptoms.aspx

To summarize, it was a pretty quiet night, but an exploding esophagus is pretty interesting at least!

What's for dinner? Veggie Casserole!

Veggie Casserole
4 cups cooked brown rice (use beef broth instead of water)
1 bag frozen cauliflower
1 bag frozen broccoli
1 bag frozen whatever veggie you want! (I get a corn, green bean, and pea mix.)
Cheddar cheese

Make the rice using beef broth, mix rice and all veggies into a large casserole dish, shred some cheese on top, and cook until cheese is melted and dish is hot.

This is really more of a side, but I like to just eat a big bowl of it. It also makes for great left overs for lunch or dinner the next day.

Comments on the level of healthiness of this dish:
1) Brown rice is better then processed white rice
2) Use low sodium beef broth
3) Thou shalt not eat canned vegetables.
4) Nix the cheese if need be. It's still a nice hot, filling dish!
5) Watching carbs? Use less rice, or substitute quinoa. I just personally like rice better, and it's cheaper.
6) Notice this doesn't have any meat in it. I love meat, but our perception of the actual amount of protein we need is way out of proportion. We (as in Seth and I...mostly I) have found that, in general, we just feel better by eating less meat. About a year ago we made the decision to only eat organic meat, and it is EXPENSIVE, so rather then compromise on the quality of the meat, we just eat less of it. As a result, I really feel a difference now that we're eating less meat and only organic. Not to mention if I eat a large portion of red meat or non-organic, I typically don't feel that great. I am a proponent of organic produce too, but I also realize that the cost associated with that so we just do what we can.


Enjoy!

the Beginning

Hi Everyone!
I've decided to start blogging as a way to process my experiences out on rotations, share funny newly married (can we still say that at 3 years?) stories, and life in general. :)

3 things to share about today:

1) CLINICAL YEAR HAS ARRIVED. I started my first rotation this past Friday. To summarize, physician assistant school is two years with the first year spent in the classroom and the second year out on rotations, 12 rotations each a month long. My first one is the emergency room. I was incredibly nervous for this first day. When do I get to eat!? Where do I go? Put my stuff? I've been studying my butt off for the past year with almost 40 hrs/week of classes and labs to prepare for the ominous clinical year, but am I really ready? I'm happy to report that every uncertainty went away once I started seeing patients. This is exactly where I'm meant to be in life, and although I didn't know every answer, I have been thoroughly trained on how to find out the answer. I loved talking to patients. I loved being able to answer questions. I loved DOING things!!! Draining abscesses, splinting, physical exams, I loved it all! Although I did not love the timing of the shift (2pm-12am), the hour drive to the ER, and surprisingly the incredibly vulgar, ubiquitous vulgar language among the staff, I am so thankful for this little bit of affirmation that this is just where I'm supposed to be. Ideally in future posts I'll elaborate more on interesting cases I see and experiences with colleagues, but first I need to feel out what is appropriate to share.

2) RUNNING. Seth and I have been training for a half marathon. I am not a runner. I don't even particularly like running. I have never ran in my life. I don't know what got into me this past August, but one day I just decided to find a half marathon schedule on Pinterest and stick to it. And all I have to say is almost 10 weeks later, I went from barely being able to run 2 miles to today, where I ran 11 miles and felt strong and healthy. It hasn't been easy. I haven't even really liked it that much. But the key is just put on those sneakers and get out there every day and accept that some days you'll feel like $1,000,000 bucks and other days you will feel like garbage. But I never knew these little legs could take me so far, but they have! And yours can too, but the key is you gotta just keep showing up and get out there. I PROMISE it gets easier. It's so nice when finally your lungs get conditioned and all you think about is if your legs will get tired, but it does take time. Patience. :) Also, the first rule of running/jogging/walking: thou shalt not compare your mile to anybody else's mile. A mile is a mile. Be proud of yourself no matter what, because the hardest part is just putting on your shoes and getting going.

3) MARRIAGE. I wish we didn't have cable. It's just so easy to turn on the TV. I love Chopped and HGTV, but I'm finding that quality time with Seth spent in front of the TV leaves me feeling incredibly unsatisfied. We had an awesome afternoon on the porch. It was really sunny, and we were reading (with intermittent guitar playing from Seth). Still not interacting as much, but there is just something about TV that makes you feel so unengaged and unfulfilled about the time you spent together. Goal for the week: keep the TV off more. Ultimately I wish we didn't have cable at all (and our lives pre-cable just seemed so much better), but of course it is college football season, and Seth loves his Oregon Ducks.

So this is the beginning of my blog. I don't know what will come of it, if anything, but I imagine as clinical year progresses I will have some interesting experiences to process through, and if anything, Seth does something really hilarious at least every other day that is always worth sharing. I've also been trying to learn to really cook this past year with some great successes and huge failures, so those things may be worth sharing too. Who knows!

Happy Sunday!