thankful.

i have so much to be thankful about this year, though i may complain. i am thankful for all of the babies who have arrived safely this month (and that their moms are safe, too!). i'm thankful that i am not spending the holiday in the hospital like some of my patients are. i am also thankful i am not spending the day in the hospital like some of my coresidents are.


callie is thankful for the chair that i dragged out of the trash room, which she uses as her combination bed/jungle gym/scratching post. i am so thankful that her fur is growing back that i let her scratch it. (plus, i got it in the trash room.) i am also thankful that we did not get bedbugs after that adventure.


i hope you all have lots to be thankful for! happy thanksgiving!

flashback.

i want to address something i saw at at the mall the other day. what the hell is this ? are we in 1988? is the gap really selling acid-washed-stirrup-legging-jeans? where's my debbie gibson tape?

more disturbing, perhaps, is that i can kind of see how it would be practical to wear them under a knee-high boot. kind of.

share your thoughts, please. i don't know how to feel.

pea soup gets such a bad rap.

you know what i love in the fall? a big bowl of soup. i made some soup tonight, to distract myself from the horror of vacation ending. ugh, what a pile of papers awaits in the office, to be sure. anyway, you, too could make this soup. it involves an onion, 4-5 carrots, and a package of baby portabello mushrooms chopped up and sauteed in olive oil for a while. with a few cloves of garlic. then, some curry powder (6 teaspoons from the indian store will make you a fairly spicy soup). then, add a little water - just to cover the veggies - and simmer for a while. then, take about half the vegetables and blend them in the food processor, and then dump them back in the pot. with, oh, let's say 6 more cups of water. add a pound of dried split peas. and simmer the heck out of it, adding more water as needed. salt and pepper as you please. mmmm. hearty fall soup. maybe next week will be squash soup!

ok, it may not look like much. but i liked it. enough to make it twice.

you know what really made my night, though? this pillsbury bread i found at the shaw's:

is it bakery bread? no, not exactly. does it have a touch of hydrogenated oil? yes, even though it claims 0 grams of trans fats. is it a glycemic nightmare? i suppose. is it pretty awesome to pull a piping hot loaf of bread out of the oven with essentially no effort? yes, yes it is.

so lazy.

sorry to be so absent for so long. mostly i don't have much to report. i took step 3 last week, then i went on vacation. part of the time i was in sunny FL, pina colada in hand, but a lot of the week looked like this:

in case you can't tell, this is me with both cat and laptop on my lap, watching movies from netflix. with parker posey in them. actually, it was kind of awesome. back to work tomorrow! next vacation in t-2.5 months.

south beach, bringin' the heat.

in an effort to keep my reading relevant, and on the heels of reliving the gilded age in newport, i decided to head next to miami, the closest i could get to cuba without violating embargoes and/or my love of capitalism, and (re)read the old man and the sea.

ok, fine, that's not why i went to miami, but i did go to miami (and west palm beach) this past week. nothing like florida in august! let's be honest, west palm beach was kind of a letdown. i forgot that it's made for old people and golfers. the nightlife was... nonexistent. we thought we'd missed the downtown, but it turned out we drove right through it. oh well. i have higher hopes for palm beach in the winter when it's... POLO SEASON!

i did, however, really enjoy the John D. MacArthur Beach State Park. right in the midst of condo-filled north palm beach, it's got a beautiful beach (Photo taken through my sunscreen-streaked phone):



with nary a tar ball in sight, and beautiful, warm, clear water. i wish my skin were better suited for the sun, but after two hours and several applications of spf 50-80, i was spotting new freckles by the second. and i had to go. to get to and from the beach, you cross this beautiful freshwater area, full of all kinds of waterfowl, giant catfish, and schools of other fish jumping out of the water. they promised manatees, but i didn't see any.



i also was too hot to take advantage of the nature trails, but i'm sure they were lovely... and a bargain with admission at $5 a carload! seriously, if you find yourself in the area i would recommend stopping by.

and, while i am a long-avowed hater of florida stemming from the Great Blistering Sunburn of 2001, i did really like miami. it had such a nice latin american feel with empanadas in the bakery and ... the mojitos, oh the mojitos. darnit, massachusetts, why'd you have to go outlaw happy hour? what's so wrong about 2-for-1 pint-sized mixed drinks at 11 am? not a darn thing. in the end, this tried-and-true new englander almost became a convert. but, i had a little friend waiting for me at home (and a pesky commitment to residency) so here i am.



[in the interest of full disclosure, i did start the old man and the sea, but i haven't gotten very far.]

addendum: the park is on jack nicklaus drive, and while i do know who jack nicklaus is, i have to ask... does anyone else picture this when they hear that name?


... anyone?

book report.

true to form, it's mid-late august and i am just hammering out my first summer reading book - the great gatsby.



did i even read books in high school? what was i doing? i remember barely being interested enough to keep the characters straight, and vaguely confusing jordan and daisy. i don't even know what was going on. but what a great story! i feel like the writing was really... vivid. or something? i just felt like i was really in the valley of the ashes, you know? or on gatsby's lawn staring off at that green light. (pardon. while i used to be a very literate person and even know how to say things like "organic metaphor" in spanish, i know mostly write in medical style. which is to say, almost entirely lacking in subjects for sentences. so much for that liberal arts education.) but my point was that i got way more out of it the second time around. also, reading all about the gilded age dovetailed perfectly with my trip to newport this weekend for a wedding. so pretty. such gorgeous houses. such a gorgeous wedding! (congrats, amy!)



also, check out this video from the times. this looks like so much fun! i don't care if nobody is under 50, i want to join them.

next up, old man and the sea.

summer reading!

probably, you hated summer reading. i have to tell you that my first experience with summer reading was horrible. i was in between 8th and 9th grade, gearing up to leave tiny st. mary's school for Public School. i wasn't sure what happened in Public School, but i was pretty sure that people lit things (or people) on fire and gangs roamed the halls, preying on the weak. or so they said in catholic school. anyway, i was pretty scared about the kind of crowd i'd be running with in (nerd alert) Honors English, Honors Global Studies, and Honors Earth Science. and what would i wear without uniforms to fall back on? (answer: flannel shirts and overalls. i know.) and what if everyone knew more than me? if i had no friends? one thing i hadn't thought to worry about though. nobody told me about the summer reading! and one day, in august, my horseback riding friend who was already a public school ruffian mentioned summer reading and i was like, what the heck are you talking about? a downward spiral of anxiety and defeat ensued, but i went to the library, found my five books (five!) and hammered them out before school started.

after that (nerd alert) i have to admit i kind of liked summer reading. and think of all the classic books i read! i think i underappreciated them. sure, the great gatsby and the old man and the sea are slim novels with a fairly limited vocabulary. but did f. scott fitzgerald really write for acne-ridden 14 year-olds in hormonal overdrive? no he did not.

so, my point. there is a lovely little theater near me called the strand theatre that on monday nights in the summer has "monday night classics". this monday's feature was to kill a mockingbird. i was in the hospital, so i couldn't make it, but it got me thinking. i know that i read that book a million years ago, but what was it even about? and then...

1. i should do something more meaningful than updating facebook or watching whole seasons of 30 rock.
2. i've been meaning to read more.
3. but nothing too serious.
3a. definitely nothing medical.
4. and i hardly ever use my library card.
5. and i have that $20 barnes and noble gift card.

and so i am going to reinstate summer reading. i think i'd like to start with gatsby. and to kill a mockingbird. maybe some john steinbeck. so many options.

tell me, what would you reread in your free time?

quin-overload

i am back to cooking! cooking and writing. this won't last long.

my project tonight was a little quinoa salad from bon appetit. it's f-ing hot here, and i couldn't bear to eat anything warm. also, we tend to fall into a pasta rut so i wanted to try a new grain with some extra protein. cold quinoa, corn on the cob, and perhaps a cold steel rail sounds nice, doesn't it?

it promises to be delicious... i love the combination of mint and feta. but be warned, it makes a lot of salad. a lot.

here i started, innocently enough. a nice bowl full of vegetables and chickpeas, mint leaves patiently waiting...



... while the quinoa cooks.

all was well until i realized that i had yet to add the four cups of spinach leaves. holy hell. no way i was going to fit 6 more cups of food into that tiny red bowl. this forced an upgrade (downgrade?) to the none-too-fancy yellow tupperware usually reserved for vats of potato salad at cookouts. but i snuck a little bite and it sure is tasty! i did substitute regular old red wine vinegar for sherry wine vinegar and regular old paprika for smoked paprika. the shrewsbury shaw's only has so much to offer.



perhaps if you're making it for less than a party, you'd like to halve the recipe. i fear we will be eating this for days.

and, for my horsey friends, this is sarah. she refuses to stand still for photos (too busy trying to figure out how to eat the crossties while she is on them), so most are a blur, but she says hi! isn't she pretty?

sustainability.

for once, i'm not talking about the planet.*

my life is unsustainable. look at this poor blog, so neglected, such a wasteland of communication for the last two months. it seems like i'm doing a bad job at everything - taking care of my patients, keeping in touch with my friends, getting to the barn, changing my oil, and cleaning the house. oh, cleaning the house.

the thing is, i like clean houses and sometimes i like cleaning. however, i do not like it more than, say, sleeping. more than anything, i hate laundry. i hate lugging it down the stairs, i hate having to have cash to put on my laundry card (no $1 bills, $20 is a risk because what if you then lose the card, LIKE I JUST DID), i hate needing two hours of uninterrupted time to get it done with out some lunatic huffing at me because i was ten minutes late getting to the dryer. i hate. it. all.

this is why i have moths.

a long time ago, when i lived in williamstown (nostalgic sigh), the laundromat had a pickup and dropoff service for laundry. some day, i thought. some day. of course, when i was 23, i also imagined my late 20's as a time of relative wealth and glamour, possibly with a husband and child. HAH.

so anyway, why am i rambling like this? well, sometimes when i drive down towards the target, i drive past a laundromat here that has a "wash, dry, and fold" service for 75 cents per pound. i don't know how much a pound of clothing is, honestly, despite trying to gauge it by hefting my hamper around, but at this rate i spend $3.50 to wash and dry a load here, so if that load weighs about 5 pounds, i'd come out even.

so f*ck it, i'm having someone else do my laundry.
and with that, i venture out with my first hamper of clothes.

*talk to my poor boyfriend, though, who got the silent treatment for half of game 7 the other night for continuing to bring me bottled water even though the tap water is perfectly good. sorry, that was crazy of me.

when work makes me smile.

today, in the icu, i logged into our electronic medical records to look up a patient from our practice who was admitted to the unit. my "task list" greeted me, and i noticed a message to call back a patient i didn't know: "she knows you will be her new pcp, and won't say what her question is." one of the residents is just leaving, and i'm inheriting some of her primary patients.

i scanned through and saw some telephone notes from the last few times she had called in. once, she'd had to go to the er. good lord, i thought, i've been doing obstetrics for the last two months. my medicine skills are rusty.

i called her up. "hi, mrs smith, it's dr. flynn, what can i do for you?"
an elderly voice answered, "well i knew you would be my new doctor, but i didn't remember if i had ever met you, so i wanted to know who my new doctor would be. i just wasn't sure who you were. "
and then:
"dr (old resident) would come to my house to see me. do you do that?"
yes, our residency still makes house calls.
"mrs smith, do you have any problems you need help with now?" i asked, still not sure i was understanding.
"well, i have trouble with my back, and my doctor wanted me to wear stockings because my legs swell, that's about it."

so yes, she was just calling in to find out who her new doctor would be, bless her heart. we had a nice little chat.

bear with me.

i got bored today and decided i needed a blog update. i was so taken by the little doodles on this one. i realize that pieces of it are totally nonfunctional right now. for now, i am going to bed.

xoxo. m.

risotto

man, it has been a looong time since i talked about anything i cooked. it's been a long time since i cooked! anything more than spaghetti or soy barbecue wings, anyway. mostly because most days i come home feeling like i've been hit by a bus. however, today was a slow day. not one pregnant woman all. day. long. you would think a little snow wouldn't stop something like labor, for pete's sake, but it seems it does.

in the call room i watched:
sleepless in seattle
say yes to the dress (x2 episodes)
what not to wear
income property
first time design
divine design
colour confidential
color splash (only intermittently. i got up to visit my baby-friend, but she cried too much, so i put her back in her crib and left. also, i actually examined a second baby at this point.)
dear genevieve
what not to wear, again
say yes to the dress, again, which was good because i caught the beginning of this morning's first episode, which had been eclipsed by the end of sleepless in seattle.

while it kind of sucks to be busy like a maniac at work, there is something different yet equally terrible about being trapped in a place for 12 hours with absolutely nothing to do.

anyway, so i left the hospital feeling like a caged animal let into the wild. what would i do?? i would cook! yet any respectable grocery store is way out of the way and i was too lazy for that. so i started to ponder what i had at home. i came up with:

frozen spinach
arborio rice
1/2 of a box of vegetable broth

and, then... the missing link: a small tub of pesto left over from this summer!

i have also been cooking with walnuts a lot - my friend clued me in to the fact that they're a great protein replacement in meatless pasta sauce. so i tossed in some walnuts and made myself a nice little risotto! it turned out well, i have to say. and while i always thought risotto had to be super creamy and fatty (and bad for you), it really doesn't. i only tossed a little extra parmesean on top and did the rest of the cooking with olive oil. and it's really so easy but seems so decadent when you're eating it.

mmm. i forgot how much i like to cook. next goal, working my way through the pounds of legumes my mother sent me.

bon appetit!

... like paper in the wind.

time sure is flying over here. on the one hand, it's good. i'm almost halfway through my six month pedswards-wards-ob-ob-ccu-wards death stretch. i'm 2/3 of the way through intern year, and the days are getting longer. on the other hand, it makes me a little bit sad to think that so much time has gone by while i've been huddled beneath a thin cotton blanket in some dingy call room.

oh my gosh that sounds depressing! well, it is. i'm a little depressed. but let me tell you something great! being as this is ob month #1, i was feeling a little unsure of myself when it came to babies and getting them out of moms. for deliveries 1-7, i would be going along, doing my thing, get to about when the head came out, and some kind (or perhaps overly -controlling) attending would see the panic in my eyes (or the shoulder dystocia, the tight nuchal cord, etc) and knock me out of the way. i was fine with that, for the most part, but it wasn't really getting me where i needed to go in terms of labor skills. until one afternoon a couple of weeks ago, which went something like this.

2:00: i check patient, she is 4 cm. call attending, call for nubain. saunter off to the nursery to hang out with some babies. her first baby? this will take all day.
2:15: nurse: "can you come to her room? she wants to push." me: "no, she can't push, she's at 4!" nurse: "i just checked her. she's at least 6." me: "mmm..."
2:20: arrive in room: nurse: "she's fully dilated". me: (internally: holy sh*t! what?) out loud: "um, let's page the attending. again."
2:22: me: "oh hey, dr x? she's uh... fully." dr x "what? hold on."
2:23: attending arrives. me, gloved and panicked. baby, top of head visible. nurse, with glee: "we're having a baby!"
2:24: head out, me sitting on bed, deep breathing. i am calm.
2:24:10: me sitting on bed, holding entire baby. attending attempting to finish putting gloves on.
2:25: pharmacy tech walks in: "i brought the nubain?" looks at screaming baby, leaves.*

so that, my friends, is the story of how i delivered my first baby all by myself. thanks, little mr. jayden/ brayden/ hayden/aidan/whatever your name was... (don't worry, this isn't a violation of privacy. all of my babies are named something rhyming with maiden. though no maiden's yet, come to think of it.) and, actually, this story would repeat itself more than once that week, so should you think you know which precipitously-delivering patient i'm talking about... well... i bet you don't. the attendings are joking that i specialize in rapid labor. what can i say, lots of babies were in a rush to meet me.

it was awesome, though :)

*for those of you unfamiliar with the world of OB, that was some speedy labor.

they aren't kidding.

(as seen on the door to the south 6 stairwell.)

let me break my schedule down for you.

monday - thursday: 7am - 7(:30)pm
friday: class at 7:30. clinic 8:30 - 12:00.
saturday: 7 am - 7am (sunday).
monday: repeat.

i do get one weekend off... sooo...
awesome. see you in march.

you've come a long way, baby.*

i went into family medicine because i'm all about continuity of care. watching families grow, etc. etc. please refer to my personal statement for the full details. i'm sure i was well-rested when i wrote it and i really meant all of the things i said. also i was not at a point where i broke down into hysterical sobs at the thought of starting another month.

i digress. it's been a long month, and thus i am just returning to you, my audience.

so today i was on essentially day one of a new rotation, the family medicine OB service. the sadistic bit about this rotation is that it is essentially me covering the patients all by myself, and having to call the attendings (who sometimes are not even in house) for help. no senior resident. hell, i don't know how to function on the OB floor, nevermind check a freaking cervix. (hence the sobs sunday night at dinner.) so there i was, day one. all of a sudden, there was a laboring patient and an induction. EEP! but the umass community came together. the senior resident, who had been my senior resident in august and was on overnight, offered to stay for the morning. my 1st and 2nd year preceptor was one of the attendings, and the other was my med school advisor and life model. when my cross-covering pager went off, and i answered, i heard 'this is dr. [life-model]' on the other end. she said, 'oh, hi mary! i'm glad it's you!' and i blurted out 'i have no idea what i'm doing!' 'sure you do,' she cooed.

as the other attending and i prepared to get the laborer pushing, she turned to me and asked, 'do you need a juice?' i flashed back to first year, when i passed out during a circumcision, and recalled how she subsequently spent the next year asking me if i felt okay any time blood was mentioned. 'i just had one!' i said firmly and we marched into battle. as we stood together at the foot of the bed, i remembered another time when she thrust a syringe of lidocaine into my hands in the patient's room, and then silently took it back from me when i couldn't muster the courage to inject. 'is this your first time?' the mother asked as dr. [preceptor] ran through the procedure. 'oh, i've done this a few times,' i said, 'but dr. [preceptor] is the pro,' and winked. dr. [preceptor] handed me a cloth for perineal protection.

in the end, one little slimy bundle of goo came out into both of our hands, and dr. [preceptor] passed it up onto the mom's tummy. mom cried, and commenced texting. we told her how well she'd done. dr. [life-model]'s induction was going nowhere, and she was still at the hospital, where she was planning to spend the night. i offered to bring her starbucks in the morning; she said she was more of a tea drinker. i'm sure we'll reconnect in the morning.

oh, so what i started to say about family medicine and continuity of care. it's one thing for me to care for families over the long haul. but what i didn't think about when i stayed at umass was how nice it would be for me to be cared for over the long haul. first year med school was a sweaty, panicky, faint-filled time, and somehow, when you reconnect with someone who saw you then, you realize that you really have made some progress, no matter how inadequate intern year makes you feel. if nothing else, you have gained the presence of mind to use an instrument when it's handed to you and learned to drink a juice before heading into potentially faint-worthy situations.


*obviously, i do not endorse the virginia slims advertising campaign that somehow equated carcinogens with women's progress. talk to me about quitting smoking! did you know that the average person needs to try 6 times to quit? have you tried the gums? the patch? set a quit date? would it help you to meet with our behavioral health team? i, your family doctor, can help!

my old man.

happy new year!

apologies for my absence. i've been fighting the battle that is inpatient pediatrics during rsv season. sheesh, that was a long month! some kids i even sent to the picu twice. they just couldn't get enough of those nice picu residents, it seems. next, on to adult medicine for the month of january. i don't think adult medicine has quite so much seasonal variation as pediatrics does, but i could be wrong. in fact, i probably am.

new year's resolutions seemed a little tricky this year. i already feel like i'm being pulled in a thousand directions at work and i don't need to put any more pressure on myself. so i resolve:
1. to eat a little piece of chocolate every day.
2. to more seriously apply myself to reaching the 1 drink per day target. it's good for my heart, you know.
3. to spend as much time as possible with this fellow:

everybody, meet cole. he's arthritic, yet not above spooking at the door. hard to get him to trot around the ring without stopping, yet he bolts at the canter. old enough to know better, too young to care, as they say. and we're in love. well, i love him. he knows i fill my pockets with apple treats. close enough.