pass the paneer!

thankful.

2010-11-23T23:49:00.005-05:00

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.

2010-10-21T22:03:00.002-04:00

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.

2010-10-17T20:28:00.008-04:00

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.

2010-10-17T13:03:00.007-04:00

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.

2010-08-22T20:17:00.017-04:00

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.

2010-08-16T22:47:00.007-04:00

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!

2010-07-20T21:22:00.004-04:00

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

2010-06-20T19:06:00.015-04:00

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.

2010-06-19T14:46:00.009-04:00

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.

2010-04-01T20:04:00.003-04:00

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.

2010-02-25T22:10:00.002-05:00

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

2010-02-24T20:05:00.007-05:00

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.

2010-02-22T22:23:00.008-05:00

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.

2010-02-05T20:39:00.002-05:00

(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.*

2010-02-02T21:13:00.006-05:00

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.

2010-01-01T17:13:00.008-05:00

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.

(guest post)

2009-11-20T15:28:00.012-05:00

oh hey. you there? mmmmm. hi? it's callie.
mary thinks i've been sitting on her lap just watching the cursor move the whole time, but really i've been studying these "words" and this "typing". now it's my turn... to tell you about how terrible the day was! really, you may want to send help.

i thought we were having a nice, relaxing day. mary has a little something called "vacation", which mostly means she sits on the couch in her pajamas and i help. i jumped right into bed for a good long snuggle in the sun at around 8. purr. my fatal mistake was that on wednesday, i slipped and let her catch me scratching my ear. dagnabbit! she stared at me for a while, but nothing happened so i thought i was in the clear. nope. today she scooped me up mid-snuggle and stuffed me into my carrier. i tried to argue my case ("no, really, my ear wasn't bothering me! foot spasm! learning a new dance!") but it was too late and i don't think she understands me anyway. just kept saying i was a "good girl". whatever.

so the long and short of it? ear drops for 3 more weeks! but, my friends, that is not the worst. well, ok, there are two bad things.

bad thing #1: i have chin acne. god, how embarassing. now that handsome tom across the way will never ask me out. but, worse yet, they shaved. my. chin. i mean, honestly. a lady cat can only suffer so many indignities.

ok, and bad thing #2: i might be getting all these ear infections because of allergies. food allergies. which means no more iams, and certainly no more fancy feast. let's hope that's not the case. although i did hear them talking about duck as an option, so maybe it wouldn't be that bad...

i tried to reason with mary on the way home, but she was mumbling something about "a hundred dollars" and having to board me at the vet while she goes on vacation. i don't know what these "dollars" are, but she sure does grumble about them every time we see dr. o'hagan. and i wonder what boarding is? i hope it's like string.

oops, mary's coming at me with acne medicine and ear drops. must go. nighty night.

oh my god i love autumn.

2009-11-08T10:34:00.006-05:00

now that i'm on my community medicine block, with FULL WEEKENDS OFF*, i decided to take advantage of my new bon appetit subscription and start cooking again. what with the crisp leaves and the cool air, i embarked on a dinner in celebration of my favorite season. if i do say so myself, it was a resounding success. the key elements:

number one: pumpkin soup.
i went ahead and added some diced onions at the beginning and a little extra sugar at the end. also, i couldn't stomach the idea of dumping in so much half and half, so i went with whole milk, but i thought it was just as creamy as it needed to be. i was doubtful as i was spooning in the curry powder because it ended up to be my whole jar of curry powder! that's a lot of curry powder! however, it was also a lot of soup. (friend's comment: "oh my god. we made a lot of soup.") a lot of delicious soup that i will reheat and savor! i ask you, is there anything more quintessentially autumn than pumpkin soup? i think not. and yes, i do feel like a cheater for using canned pumpkin, but sometimes roasting a whole pumpkin just isn't in the cards.

number two: these little turnovers.
now let me tell you, these are like autumn in new england rolled into a puff pastry. and while they seemed a little intimidating at first, they were actually a snap to make and so exceedingly delicious. i may have to refine my turnover-filling skills, since i only ended up using about half the filling and they were not quite as stuffed as they might have been, but there were no complaints (comment: "you should open a bakery."). i ended up using gala apples, which i think worked just fine. oh, and about the cheese...

... while i was shopping for the ingredients, i discovered a little something called raw milk cheddar at trader joe's. normally, i poo -poo raw milk as something for the hippies, especially since the one time i saw a kid who nearly had to go to the OR after complications from raw-milk-related food poisoning. but then i remembered that time i went to kripalu and joined a drum circle, and i realized it was really a pot-criticizing-kettle situation to pretend i'm not a hippie at heart. long story short i bought the cheese and HOLY SMOKES. it was soft, almost a mozzarella consistency, such that you could roll it almost into little sweet balls, but with a delicious mild cheddar flavor. if campylobacter is the price i have to pay for eating this cheese, well, sometimes a girl has to do what a girl has to do.

so, happy autumn everyone (even if it's autumn in your heart and summer outside)!

*so long as my pager is strapped to me at all times and i'm never more than two hours from the hospital, just in case someone gets sick and i have to cover for them on a moment's notice. i hate being an intern. also, please excuse the stock photos, i was negligent on the photo front.

holding hands.

2009-11-07T12:04:00.007-05:00

as you may know, i have a cat. she is the loveliest little cat in the world, i think. it breaks my heart to think that when i first got her, she was so scared of everything that the noise of me taking a shower would send her scurrying under my bed for hours. now, however, we are great friends and she has captured the heart of her "grandparents" such that when i say i'm coming home for thanksgiving, they ask "would your little friend like to come, too?" and i have to explain that she's not really a weekend traveler.

anyway, the dearest thing she does is this: while not generally not interested in sitting on my lap for long periods of time, she does like to be constantly touching me. so while i sit here, typing, she rests her little tail on my wrist and twitches it ever so gently. like so:

it's so sweet that it almost makes me forget that i came home from a long day of work yesterday to find kitty puke waiting for me on the carpet.

trust me, i'm a doctor.

2009-10-25T22:34:00.009-04:00

well, i outdid myself tonight. i went out to dinner tonight with some friends, and when i got back into my car to leave, it wouldn't start. it would kind of light up and the radio would come on, but it just wouldn't turn over. i lept out of my car to stop my friend from leaving and in the process locked my keys in the car, battery running. (curse words!)

fortunately, my trunk was unlocked so after i shimmied through the trunk and hurled myself over the back seat action-movie style, i retrieved my keys and aaa card and called ... my father. (yes, i am 27 years old. why do you ask?)

"well, it's probably your battery." he pronounced. "they go without warning. you need a jump."
"but the headlights came on!" i protested.
"not enough power to start the car, probably." he countered.

so i called aaa. the kindly tow man showed up with his jumper contraption. despite my feminist sensibilities, i put on my best damsel in distress look.

"alright, start it!" he commanded.
[rumble, rumble, rumble, sputter.]
"try again."
[rumble, sputter.]
(me, internally: "crap, this is bad! how will i get to work tomorrow!?! i can't afford a new car right now.")
"um, step on the gas?"
[continued rumbling/sputtering.]
"this is what it's been doing?"
[nod]

mechanic: "so, uh, how much gas is in your car?"
me: "um, not much, but the light's not even on and after that i still have like 60 miles!"
mechanic: "yeah, but look at the hill you're parked on. all your gas is in the back of your tank."
me: [sizes up car parked at 45 degree angle.]
mechanic: "get out."

so, he put my car in neutral, rolled it down the hill until it was nice and flat. then he started it without incident and i followed him to the garage, where i filled my tank right up and drove home.

honest to god, i'm a smart person, i swear i am. put your life in my hands. you'll be fine.

excellent patient interactions (#3 in a series)

2009-09-28T20:39:00.004-04:00

me: 'so, you probably want to stay away from white bread, because it can bring your sugar really high and then it comes crashing down.'
diabetic woman: 'it does?!? girl, hush!! oh. sorry. i mean, i didn't know that.'

(me, silently: what was your old pcp doing all these years?)

mothwatch 2009

2009-09-27T19:24:00.005-04:00

we are in full blown moth elimination mode here. my closet, once overflowing with textiles, is a barren wasteland:

callie has taken the position of foreman on this job, and is overseeing the work while snuggling into my winter comforter:

i think she's judging me a little, don't you? i see it in her eyes.

well, there's been some good progress here today with the freezing, the ironing, the washing of washables, the mothballing, the packing in cedar. i think there have been some silver linings to the moth cloud.

1. i found a new laundry detergent. mrs meyer's clean day, lavender scent. so far it smells heavenly and has cleaned my clothes well. and i have done all of my laundry. all. i even washed out the hampers.

2. i'm weeding out the clothes i never wear. i always feel so guilty getting rid of them, but now i realize they were the problem. those sweaters just sitting back there, month after month, never being moved or shaken or worn? moth playground! not only can the clothes i don't wear be worn by others, but i won't be ruining my own favorite clothing by keeping them. win-win.

3. as i was getting ready to vacuum, i thought about how it smells like burning rubber sometimes when i vacuum and how that can't really be a good thing. so i found my vacuum manual and did such things as change the belt and clean out the hepa filters. that was probably about 18 months overdue.

4. i am organizing my downstairs storage, heretofore not well-utilized. i even assembled the garment rack i bought a few months ago.

so, you see? what's one old (actually, rather new) wool coat compared to all of this gain?

sigh. i liked the coat.

confession.

2009-09-27T00:04:00.002-04:00

i have something we need to talk about.
i know, i haven't always lived an exemplary life. there have been indiscretions. i know, sometimes, in the stresses of life, i have let some things slide. still, i didn't think i deserved this. i wasn't prepared. it's hard to say.

i have moths.

moths!

now, i didn't think people GOT moths. i mean, i know there are these things called 'mothballs' and that my babci and dziadziu's 'shoe closet' sometimes smelled like them. sometimes, big moths would fly into our house in the summer and it was kind of gross. but never in my life have i heard of someone actually having a moth problem in their house. until now.

i have to admit, the signs were there last winter. i sent a few of my fave wool sweaters to the dry cleaners and they came home with giant holes in them. at first, i was furious with the dry cleaners, but then i pulled another sweater out of a pile and it had a similar hole. i had the thought that it might be a moth situation, but i had a lot going on, ok? things were kind of rough in my life last winter. so i honestly didn't think much about it. until the other day, when i pulled out a newish cashmere cardigan and found a teeny, but slightly too big to be chance, hole in the back of it. oh, and sure, maybe i had seen a little moth or two flitting around the apartment, but again, who cares?

well, today, i gave moths a little google. i saw the pictures of moth larvae! barf! surely nothing like that could go on in my house without notice. well i reached back into the depths of my closet and pulled out this old sweater my mom knitted me, and boom! it was in shreds. TELLTALE MOTH LARVAE. next, my lovely camel wool coat. PATCHES OF BALDNESS. i went down to the sweaters i had put in storage in rubbermaid. THERE WAS A CATERPILLAR IN MY CLOTHES. i immediately launched into my tried and true strategy for dealing with such situations: a finely balanced blend of panic and overreaction.

(grooosssssssssss.)

the good news is, my closet is clean now. all that wrapping paper i was going to reuse? POTENTIAL MOTH FODDER. GONE. (sorry, trees). that old mattress cover? down the trash chute. those wool sweaters i was thinking about keeping? on the next boat to the goodwill. now, a multipronged approach:

1. i have a lot of silk dresses. you don't go to 4 weddings a year without accumulating some, you know? and sweet fancy moses, you want me to dry clean them all? heck no. they're in my freezer. yes, that's right, and i will have none of your ridicule.

2. i am washing everything in the house. everything. i'm sorry if anyone in this building wanted to use the washing machines this week, but they will have to wait.

3. chemoprophylaxis. there seem to be two schools of thought. first is to seal up your clothes with old fashioned mothballs. effective, but may also kill you, your pets, or your children if you get too close. second, cedar. i'm turning the downstairs storage into death-ball territory, while limiting callie's upstairs world to cedar.

game on, moths. you think you're up for this? talk to the fruit flies who tried to take on my kitchen this summer. oh, that's right, you can't! because there were no survivors.

va(stay)cation: day 3.

2009-09-14T16:15:00.000-04:00

(in which i learn about hawk-watching.)

i was lounging around drinking my second cup of coffee today when i thought to myself, it's really beautiful outside. i should do something nice today. after all, the point of this week is not to sit on the couch, incessantly refreshing my email. a hike seemed to be just the right early-fall activity. heck, i'm making my own mountain day here. so up i went, to the top of wachusett mountain! it was a lovely climb, quite a bit more rocky than good old money brook, but good. the best part, however was at the top.

backtracking just a bit, i sometimes forget why i went into family medicine. when you get to the very bottom of it, it's because i think people are fantastic. no, not everyone. but in general, i love how weird and funny and fascinating people and their lives and passions are. it's the same thing that keeps me coming back to this american life week after week.

so. up at the top of the mountain were a whole lot of people with binoculars and telescopes. a motley crew, some with long hippie ponytails and canvas vests, others with denim shirt tucked neatly into denim pants and glistening white new balance sneakers. one sidled up next to me while i was eating my apple in the sun and politely answered my questions. it turns out they are from eastern mass hawk watch and they were there to count the hawks that are migrating south for the winter. heck, i didn't even know hawks migrated. but they do, all the way down to south america. apparently thousands of them pass by our very mountain. and these folks were up there counting them all! just like they do every year.

when you start asking people about their hobbies, well, i think for the most part they love it. and when some total hawk-novice like myself starts asking all sorts of probably foolish questions, all the better because they can demonstrate their superior hawk-knowledge. and you can tell that these people live and breathe hawks. by the end, the guy was forcing binoculars into my hands and sighting hawks in the telescope for me while he told me all about how the hawks ride something called "thermals" all the way past the equator and shouted intermittently across the lot, 'paul, occipiter tracking left!' 'paul, how many in that last kettle?' paul appears to be quite the ringleader.

all in all, it was a marginally disappointing day for hawks. only about two hundred today, and not that close to the mountain. ('some days they come so close we're arguing over whether the total's 475 or 477, but today's not going to be like that', hawk-watcher #2 told me with a touch of dismay.) however, it was a lovely day for climbing a mountain, eating a nice crunchy apple at the top and learning a little something new.

vacation: day 1.

2009-09-12T16:04:00.002-04:00

today is a lovely day for the first day of vacation. lovely because it's miserable and grey outside, making it the perfect day to stay in. currently, i have a pot of soup simmering in my new cuisinart pot (a lentil-vegetable experiment, we'll see how it turns out) and some sweet potatoes roasting in the oven for the gnocchi i plan to try, maybe tomorrow. i've had two cups of coffee and am making some tea, and the cat is cuddled up next to me.

bliss.

p.s. i thought the green background, while previously nice as a photo backdrop, was becoming a little tough on the eyes. i hope the navy is more soothing.

how i learned to love the bomb.

2009-09-05T11:14:00.000-04:00

or 'steamed tilapia appetizer in a delicate broth.'

those of you who know me might know that for some time, fancy feast has been a bit of a joke. i do not feed my cat fancy feast, as it is something that other cats - cats that i have loved less, dare i say, not loved at all - have eaten. my beloved callie has refined and specific tastes. she really loves, for example, her iams dry. she, as a rule, will not touch the pureed type of wet food. she also does not particularly like the "chunks in gravy" variety. she does not even like leftover fish that i bring to her from fancy-pants restaurants like the sole. she does like stonyfield farms vanilla yogurt, balsamic vinegar, and soy milk.

also, there's something satisfying about bringing home a 10 pound bag of iams and scooping some into your cat's dish every day. it's like feeding your children cheerios rather than some crazy dried-milk-already-added cereal bar. like buying them a nice l.l. bean backpack rather than some plastic barbie number. sensible. nutritious. wholesome.

as a third point, i would mention that my family likes to eat. we get together and we eat a lot. there is constant worry that people are not eating enough. 'have you lost weight?' my mother would ask with a critical tone every time i came home from college (i had not). in med school, checks started to appear in my mailbox. 'buy groceries!' read the accompanying cards. my father has a tendency to hover at the end of a meal, serving spoon in hand: 'do you want the last scoop of pasta? it's not enough to save, but we don't want to waste it! just a bite. there!'

now, back to my original point. about 3 weeks ago, my cat had some unfortunate tooth extractions. particularly unfortunate for me, since i had to pay for this. as a result, she was ordered to have no dried food for 7 days. i tried all sorts of tricks with iams canned food, adding water to her dried, no luck. she was practically on hunger strike. my previously overweight cat was melting away in front of my eyes! desperate, i stumbled across a little something called fancy feast appetizers and bought an assortment: the steamed tilapia, the wild alaskan salmon, the flaked skipjack tuna. she ate them! they saved my cat from the brink of starvation (also known as 'achieving a normal weight')! this stuff basically looks like something you or i might mix a little dressing in with and smear onto a pita. so that was fine for a week, and then i thought we'd just go back to our normal diet. but now she's not eating enough! i can't tell if her teeth hurt or if she's just spoiled. so i crumbled in the grocery store and bought more steamed tilapia, the shrimp and seabass blend, tongol tuna and flaked chicken. to further compound the craziness, the whole time i'm thinking of the card i got from the environmental defense fund detailing the impact of each individual fish choice.

in short, i am now someone who buys fancy feast.

tell me. am i crazy? am i resigning myself to a life of half-empty cat food cans lining the fridge? should i stand my ground or am i slowly killing the cat? if she's otherwise bopping around the apartment like normal can i assume she isn't in starvation city?

finally, what the heck is skipjack tuna, and is it really so different from tongol?

reentry phase.

2009-09-02T21:47:00.000-04:00

oh, hi, here i am! it's been a long month, as evidenced by the results of my duty-hours logging:

Duty Hours Statistics Between 08/01/2009 12:00 AM -
09/01/2009 12:00 AM

Total Hrs Worked	Avg Hrs Per Day	Avg Hrs Per Week	Avg Hrs Per 28 Day	Days Not Logged
329.75	10.64	74.46	297.84	4.0

yes, that's right. i worked an average of 10.64 hours per day this month. not per work day. per day.

eesh. this is how you wake up one day (say today) and look at your checking account and realize that you have SIX DOLLARS (and sixty-two cents) in it. and then you realize that you didn't lose the bills you thought you lost, you actually mailed them in some post-call stupor. and that when you then decided to pay other bills with that same money, and mail the other bills when you found them, well, actually, you've doubly used your money and are very near to overdrawing your bank account. and have about $194 dollars less in it than you thought you did (for example). i was scraping coins from under my couch cushions in a panic when i remembered the atm card attached to my savings account and made a transfer, narrowly averting a crisis. phew. do other people live like this?

this month i am doing surgery, which is comparatively a vacation. if your idea of a vacation involves debriding enormous, gaping, necrosing wounds. hah! oh, medicine, with your neverending laughs!

on a much less revolting note, i went to the farmer's market at school and bought some lovely fresh basil! i just wanted to stick my nose into the giant cart of it. mmmm. gosh i love basil! then, i decided to take a chance and i threw together some pesto. fulfilling life-long dreams here, people.

ok, not the best picture ever. i took it with my phone. but trust me, it smells like heaven! i even went old school on it, since i don't have a food processor, and made it by just cutting all the ingredients together over and over with a pair of knives. so easy! basil, garlic, olive oil, parm, and some almonds (since i didn't have walnuts). i'm torn about what to do with it, but i'm envisioning a nice summer lasagna tomorrow. maybe some yellow squash and tomatoes? what i'm not torn about is wanting to buy heaps and heaps more at the farmer's market next week. i bet this will freeze well.

anyway, it's good to be back.

excellent patient interactions (#2 in a series)

2009-08-06T20:04:00.000-04:00

"are you having any diarrhea?"
strong worcester accent: "not exactly, but it's like... i don't mean to be crude, but ya know that joke about when you get old... nevah trust a faht?"

excellent patient interactions (#1 in a series)

2009-08-05T22:12:00.000-04:00

(90ish demented lady)

"oh, look at all these nurses! i never went to college. i think it's great you're going to be nurses."
"mrs. x, we're your doctors."
"you're learning to be a nurse?"
"we're your DOCTORS."
"you ARE my nurse?"
"we're your DOCTORS, ma'am."
"oh!!" (claps hands.) "you're learning to be a doctor!"
"yes!" (-ish)

ponies!

2009-08-02T21:24:00.000-04:00

my new senior resident is lovely. rather than heading back to our little separate call rooms last night, she and i set up camp on the reclining ends of the sofa in the conference room and slept there for the night so she could field calls with me. this was exceedingly nice of her. so while we were passing the hours in our little conference room, she mentioned that she rides at a nearby barn, and they're very nice, and very accomodating to her schedule, etc. etc.

this set my mind totally racing. polo had already gotten me thinking. then, i started looking at boots and breeches and whatnot, and i was practically drooling over my laptop. i'm torn.

pros:
i love riding
i don't get enough exercise
i need more hobbies

cons:
so expensive!
along those lines, i'd need all new equipment
do i really have time for a new hobby?

i might reassess at the end of this month when i have more time. but it might make me happy.
thoughts?

recipes by dr. mary

2009-07-31T20:42:00.000-04:00

or 'cooking as therapy'.
i've been joking recently about how this blog has turned into 'things i cooked while in denial about my life.' whatever, i'm embracing it.
i think i had a peanut sauce breakthrough today. i was futzing around the other day attempting peanut sauce with a mixture of lime juice, peanut butter, soy sauce, ginger, garlic, and sesame oil. it was fine, but nothing spectacular. i tried to marinate tofu in it and cook it up with some chinese noodles, but i was kind of rushing and really cooking more because i was in a bad mood, and it turned out kind of meh.
so today, i decided to spice it up with some green onions and shredded carrots, and maybe more peanut sauce. i thought i would make some over the stove this time. well, i heated up some oil, then added peanut butter, and was kind of all melting it together when i squeezed in some lime juice and all sorts of sizzling took place! i don't know what happened (should have paid more attention in orgo, less time running out the side door 2/2 hangover) but i think i caused some sort of carmelization? it turned all clumpy but smelled really good. kind of like the stuff that sometimes comes on top of your noodles. aha! so then i mashed in some ground ginger and brown sugar with a fork, and sprinkled it on top of the noodles i am packing up for overnight call.

oh, yes, i have suprise overnight call tomorrow. you knew i was cooking to avoid something, didn't you?

anyway, this is what it turned out to be in the end. i think it looks not too bad. certainly better than before. the tofu is totally in need of more crisping, i know. but i think the peanut topping was a breakthrough. certainly tasty.

the list.

2009-07-17T20:10:00.000-04:00

a concept totally foreign to anyone who's never been on overnight call, and far too familiar to anyone who has, is The List. you see, when the day team leaves, and the night team takes over, you get a list of all of the patients, with their name/problems/medications/allergies/pending labs etc. you clutch this like the lifeline it is. mrs. jones in room 123 needs something for pain? let me just check her allergies first. they're right here!
it looks something like this. except not so blurry in real life.

most people -at least here- then will fold the far edge of the list over (note the crease), making an elaborate system for tasks to be completed (usually with an empty box to be checked once done) as well as calls you've received overnight to be passed on to the day team when they come back. i prefer a three-part system for coding things, involving red pen and yellow highlighter. you might note the red pen notes scrawled in at signout. i like important checkboxes in red, 'fyi' sort of information in black, and yellow highlighting if things are blending together too much and i'm afraid i might miss them. this explains why every time i bend over, 6 different pens fly out of my pocket and down the hall, rolling along next to the nutragrain bars i've been stashing for 3 a.m., when i will become inexplicably frozen and ravenous-verging-on-hypoglycemic and the cafeteria is closed. and i take piles of blankets out of the warmer and huddle under them.

what was my point?
oh yes.
i decided last night that i need a check-box system for my life. the list never seems to fail. also, it's so satisfying! checked the 3 am hematocrit and it's looking good? check that box right off! cardiac ezymes trending down? check! so maybe i should be implementing this for myself. i'm envisioning check boxes like, "dry cleaning. dentist. eye doctor. cat to dentist." except i'm fairly sure that in real life, unlike the hospital, i would a) lose the list and b) probably never check anything off. plus, people would wonder why i was clutching a stapled packet of 8x11 paper at all times.
sigh.

LOOK AT THE COLOUR!!

2009-07-07T21:39:00.000-04:00

one of the really nice things about family medicine is that people really want to all about you. i have played 1000 (ok, 5) different get-to-know-you games over the last few weeks. the unfortunate thing is that everyone brings up hobbies. what do you do for fun? what do i do for fun?

i've decided that i like to cook. i find all the chopping and stirring kind of meditative. (callie, meanwhile, becomes increasingly more infuriated that i'm standing SO FREAKING CLOSE to the cabinet with her snacks and not giving her any.) so anyway, the other day i was at the indian grocery with a friend from mumbai who's doing his residency here, and i found instant rava dosa mix. for those unacquainted, a rava dosa is something like this:

(courtesy of http://www.sailusfood.com/2008/04/09/rava-dosa-a-photo-tutorial/)

crepe-like in appearance, but savory and delicious. in india, i was especially drawn to these when my little american tummy just could not handle any more curried fiber. anyway, the "instant rava dosa mix" had me convinced that any monkey could pull this off, so i set to work this evening.

what a catastrophe! my dosas were getting fissures, they were turning into piles of glop, they wouldn't flip, they were not good. finally, i enlisted the help of this man on youtube. i'm putting the link up because i know you're bored and i think he's hilarious.

still, though, i was struggling. cursing. "i'm trying to make a bleeping dosa and it's not working!" i screamed at my poor friend on the phone, who clearly did not deserve to bear the brunt of my culinary failures. i switched oils. more. less. i let the batter sit longer. i mixed it more. i mixed it less. epic failure, as evidenced by this dosa graveyard:

i guess my mistake was that i was thinking it would be like making pancakes, when really it was totally different. i went smaller. and then, magically, i turned the heat up and it made a difference! check out this humble, hard-won success.

doesn't look like the one up top? shove off, i say! close enough. of course, by this point, i'd eaten so many corners of oil-soaked dough that i wasn't even hungry, but the next time, i'll be ready. which leads me to my point. maybe it was the mojito i was sipping all the while - the indian grocery also sells really cheap limes and mint - but i really kind of enjoyed that little adventure. now i just need an idli pan.

oh, and yes, i am seeing patients these days, and i really kind of love it! it's really hard, and i'm in a constant state of "where do i go? where are the lab slips? are you the nurse i'm working with? what the heck is going on here?" but once that subsides, i think it's going to be really great.

desperate housewives.

2009-06-28T19:29:00.000-04:00

as many of you may know, i have recently been expressing interest in abandoning medicine and becoming a housewife. unfortunately, i'm not married, nor do i have plans to be any time soon, and thus am lacking a way to feed and shelter myself while paying back the tens of thousands of dollars of debt i racked up becoming a doctor. fine.

'but mary', you say. 'i've been to your house. it's... how do i say this? it's not clean.'

ahh, but you haven't been to my house recently. you haven't seen the coffee table that actually has room for your coffee, with coasters just begging you to set your mug down! or my newly cleared desk complete with message center and my new fish bowl. the thing is, when i have nothing to do, i actually like to clean.

side note: meet ginger.

but this is neither here nor there. by this time next month, callie will be buried under a pile of journal articles that i'm going to get around to reading one of these days and ginger will be peering out of his bowl into the pile of possibly-dirty or possibly-clean clothes resting on my desk. in the meantime, perhaps you'd like to see the couscous-stuffed peppers i made for dinner tonight.

they're baking right now. i had some regular old store-bought couscous mix lying around as well as half of a can of chickpeas. i threw in a little zucchini that i sauteed with the tops of the peppers and garlic, and some parmesean cheese. i think it's going to be tasty. i'll let you know. not that you care, but doesn't the pepper-zucchini-chickpea mix look so lovely in the skillet?

now, back to medicine.

day one.

2009-06-23T22:30:00.000-04:00

today, i received a host of things that i do not think i deserve. these include:

1. an office. (to be shared, but nonetheless it had my name on the door.)
2. a box of business cards. not someone else's. cards with my own actual name on them.
3. a 14-hour day. nobody deserves that.
4. this:
hah.
still, as nice as all of these things are (well, 3 of 4), they pale in comparison to the day when i actually get paid.

still here.

2009-06-22T14:36:00.000-04:00

hello? hello? is anyone still there?

i've been thinking to myself, 'keeping that blog in india was kind of fun, and people actually seemed to read it.' and, with my emailing time about to be very limited and friends scattered across the country, maybe it would be a good idea to keep it up. so here i am.

for those of you playing along at home, orientation starts tomorrow. i'm facing this with a heavy dose of denial. since i came home from mumbai, i've been living a life of leisure. jaunts to vegas, assorted other weddings, drinking on boats in boston harbor (thanks, tori!), and wading into knee-deep mud in formalwear in williamstown (so fun, by the way). and i've been doing things like growing herbs and making pancakes and orzo salad. (again, so fun.)

also, in that time, i managed to graduate. see below:

i've also accomplished a lot of less fun things, like going to the dentist. perhaps i should have done this two years ago, and then maybe i wouldn't be scrambling to schedule fillings on my postcall days before my teeth fall out of my head. but whatever, i was busy. let's not even talk about how supposedly my cat needs dental care. someone tell me when i'm supposed to fit that in?

which leads me to wonder, as i struggle to keep the panic at bay, how do residents ever go to the doctor? i mean, i'm not really a sickly person, except for my hypochondriasis, but how will i ever go to the dentist again? am i doomed to be scheduling my dental appointments and physicals during vacation? that doesn't seem like a vacation to me. someone who's already done this, please advise.

well, anyhow, i just wanted to let you know i'm still here, and might intermittently be for the rest of the year. maybe even with funny, hippa-compliant, stories. check back!

xoxo. mf, md.

still on mumbai time.

2009-05-05T05:05:00.000-04:00

i had been putting on a brave face ("no jet lag at all! i'm doing great!") but i may, in fact, have jet lag. i passed out at 8:20 last night, only to wake up at 2 am in horror after realizing i hadn't taken my antimalarials. i tossed and turned for a few more hours, but my hunger got the best of me. i've not actually gone grocery shopping yet, so i am eating marshmallow peeps from my easter basket in bed. don't judge.

so, for any of you still reading, i thought i would share some more pictures. on our last full weekend in india, we flew to delhi and then drove to agra, to the taj mahal. it was, i think, the best idea we had. delhi is huge, but it had nice wide streets and much less obvious pollution, and seemed so orderly. it was also filled with lots of interesting tombs, etc. and the taj was the most beautiful thing i have ever seen. seriously, the pictures you see do not capture it. we also stayed at a lovely bed and breakfast run by a wonderful woman who orchestrated a friendship between us and two other medical students from unlv, and it was overall fabulous.

so, some pictures:

this is the area outside the qutb minar in delhi (ca. 1300's).

next, water buffalo roaming the streets in agra. this was taken from our car with no zoom, i would like to point out. the water buffalo are everywhere!

in addition to the taj and water buffalo, agra is also home to the agra fort, built roughly around the same time as the taj (started earlier). the fort is enormous. here is a tiny corner of it. if you had x-ray goggles on, you would see the taj on the riverbanks just behind this tower.

finally, the taj. if you ever have the chance to go, seriously, take it. from a distance it's spectacular, and then when you get up close and see the work that went into it, it's even more spectacular. interestingly, the government's banned traditional cars and other pollution within a few km of the taj to protect the marble, so you have to take little battery-powered shuttles over to it. one of my favorite parts was the way they designed the entrance gate to frame the entire structure, so that when you're walking in, you come up to through this giant sandstone structure and all of a sudden:

so, as i said, a weekend well spent, and a nice break from mumbai. look, delhi is even having it's own mini-green revolution!

congratulations, bombay, you win.

2009-04-23T05:02:00.000-04:00

we were having one of those days yesterday, you know? my computer was supposed to be coming back, fixed, and when i got there it hadn't even been sent out yet. so we tried to go to the internet cafe and get the address of our hotel in delhi (we're going to the taj mahal this weekend!) to bring to the travel agent, but the internet cafe did not have internet. we had a list of errands, including getting fabric and meeting the tailor who is making us dresses. we were supposed to meet the tailor outside a cinema, but when he called to give us more specific directions, the taxi driver refused to take the phone and talk with him, then attempted to overcharge us. when we met the tailor's man at the cinema, he ran us through some back streets of the city and i almost got hit by a car in the process, at which point i was so angry that i started shaking my bags at the driver while an old man behind me clucked in dismay. i'm not sure who exactly was the object of his dismay. probably me. we hopped back into a taxi to go to the travel agent, in dalamal tower, but neither we nor the driver could find it. seems everyone was directing us to dalamal house. after three loops around nariman point we got out and walked (it was actually right there) and all went smoothly inside, but we couldn't find a cab willing to take us home. perhaps they were waiting for some rich businessman to head out to the suburbs. and then, just when i thought i couldn't take anymore, i felt something hot hit my arm.

yes, the pigeons were fighting back.

yes, a pigeon pooped on my arm.

fortunately, we carry purell and tissues at all times for bathroom emergencies. generally, we do not expect these to be pigeon-bathroom emergencies, but what can you do?

technical difficulties.

2009-04-21T05:38:00.000-04:00

we're having a technological meltdown over here. my computer is succumbing to the virus and the memory card on my camera has stopped functioning. with any luck, we will remedy these things soon.
until then, we were in the times of india on monday. page 2!
unfortunately, my picture didn't make it to the online version, but you can read the article about how we spent our sunday:
http://timesofindia.indiatimes.com/articleshow/4422124.cms

comfort me with mangoes, for i am sick of pigeons.

2009-04-18T07:53:00.000-04:00

as i was getting ready to leave for india, my mother asked me if it would be monsoon season. of course not! i said. i was mostly hoping, as i had no idea when monsoon season actually is. but it is not monsoon season. it is something less widely publicized, but infinitely better. mango season!

these mangoes. they're stacked in cases all over the place. and they are so good. sweet, and soft, and juicy. nothing like the mangoes at home. foolishly, we bought only 6 at first. those set us back 50 rupees each, and i think we were ripped off. the next time, we bought a case of 12 for 450 rupees. we ate those in about 5 days. last night, our main fruit man was not there. he had promised our hosts that he would not rip us off just because we were not indian, but his underlings tried to charge us 600 rupees for a box! we protested loudly, and they explained that these were "bigger", and "settled" for 500. pshaw! these were the same mangoes, but we wanted them so we agreed to 500.

just look at them.

i am on a two mango a day plan. mango and yogurt parfaits for breakfast. mangoes with ice cream. mango milkshakes. this perhaps is helping me to ward off sickness. or so i tell myself when i want mangos and ice cream. speaking of sickness, though, our computer has something viral going on, so while i run symantec over and over, please ignore any emails offering weight loss, male enhancement, or the ability to help out a nigerian prince whose bank account is frozen.

next topic: pigeons. i am being driven to the brink by the pitter-patter-scritch-scratch of tiny pigeon feet as they pace on my air conditioner. it makes a god-awful noise that started this morning at 6 and didn't stop until 7:15 when i got out of bed, threw the windows open and banged on the air conditioner. now when i hear their gnarly little feet land i run to the window and scream. i'm turning into that crazy lady.

tonight, earplugs.

tell me more.

2009-04-16T08:16:00.001-04:00

tell us more about the hospital, you say.
well, fine, i will tell you about our morning on saturday.

on saturday, we came into the hospital to round on the patients. as friday was the team's admitting day, there were now about 60 patients on our team (one attending, one intern, one resident). in our ward , which we share with one other team, there were over 80. it was overflowing, and they had resorted to mats on the floors again. as we were waiting for the attending, an old woman came up to the other american student, who is indian, and dragged her over to an old man. we saw the intern and a nurse go over, too, and so we went. the man wasn't breathing and didn't seem to have much of a pulse, either, and the intern was doing chest compressions while waiting for the airway stuff to arrive. chest compressions are one thing we can do, so once he was intubated, us three students started to take turns doing compressions while the nurse attached the bag to the tube (you know, the giant bag you squeeze to give breaths). but the bag wasn't working. so we kept rotating compressions on this tiny man's startlingly compressible chest. finally, (minutes?) another bag arrived. the intern was gone at this point, and the nurse hands the bag to the man's son and leaves. so to recap, we have three foreign medical students and one family member running this resuscitation effort. at one point, i saw the nurse coming back with a syringe of something. oh, good. epinephrine, perhaps? actually, it was meds for our patient's neighbor. then she left. so there we are, perched on this little rickety bed, compressing away with the son. there was an emergency kit, but it seemed not to contain much more than glucose.

once, as we were switching off (those compressions are tiring!) i looked up and saw that despite their meager efforts to pull a screen across the bed, we had the rapt attention of the whole ward. after a few minutes, the intern returned and decided this was futile, but what happened next remains a little unclear to me. as best i understand, we stopped chest compressions but left the son with the bag, giving respirations, because the family would need more time to process what was going on, and we would just tell them we needed time to see if he would respond. so we went to start rounds and left the son bagging.

incidentally, the first patient we went to round on was also lying in bed, deceased. 0 for 2, good start to the morning.
so, some time later, having rounded on the other 58 or so patients, we returned, and someone finally told the family that their continued efforts were futile, and, of course, they did not take it well. then, with the patients in neighboring beds each about a foot away, he stayed there until the morgue folks came up, and with the same futile attempt at screening and same rapt audience, stuffed his nose and mouth with cotton and wheeled him off. at least they wheeled this one. the other patient's family had to wheel his body to the morgue.

so that is what the hospital is like sometimes. it isn't that the doctors aren't smart, or that they don't care. it's just that they're overwhelmed and if two of your patients die, well, there are still 58 more that need your attention so they don't. so i guess sometimes you just have to accept your losses.

now i know how paris hilton feels. (sort of.)

2009-04-14T09:31:00.000-04:00

what i perhaps have not really discussed yet is how much we stand out. we really do. sometimes, when we're in touristy areas, there are other non-indians. for example, at easter services at the anglican cathedral, we thought for sure there would be a whole slew of british, etc. there were about 5. other times, like around our house or the hospital, there are none. this manifests itself in a variety of ways. charmingly, little children poke their parents and point at us or smile shyly. everyone stares and nobody tries to hide it. when i tried to feel an old woman's thyroid the other day, she jumped up and tried to run out of the room. "it's ok," said the other patient. "she just got scared because she was expecting to see brown skin." fair enough. the more tiring side of this is that we're a constant target for people trying to sell things or begging in the streets/ at our taxi window.

so, anyway, we had the day off today owing to the birthday of b.r. ambedkar (http://en.wikipedia.org/wiki/Ambedkar) and went out to the banganga tank, a very old water tank surrounded by temples. it was bigger than we expected and lovely and quiet, with not a honking horn to be heard. it was also pleasantly free from the begging/selling variety of attention, although a gang of cricket-playing youth did stop us to ask where we were from. they were overheard repeating our names to themselves as we walked away. the tank itself was full of all kinds of birds, and turtles and what seemed to be enormous carp. and swimming children. i don't even want to think about what sort of zoonotic diseases were in that water, but they were enjoying themselves. there was lots of people-activity, too, with women drying chilies on the side, and cricket being played, and prayers being said, and washing being done.

(the tank)

(aforementioned swimming children)

after that, we headed to see a jain temple, which was also very beautiful though hard to appreciate fully without knowing all of the jain stories that were depicted.

(statues outside)

we also stopped into the hanging gardens. the hanging gardens was full of families enjoying the holiday who immediately commenced staring at us. one little boy came up to us and asked "excuse me madam, one picture?". we thought he was asking us to take a photo of him and his mother, but in fact there is now a photo of us and some indian woman we don't know floating around out there. like taking photos with animals at the zoo, elizabeth remarked. unfortunately, i don't have a copy of that one.

we also were ambushed by an old man who, without warning, gave us candies, dabbed red paint on our heads, and wrapped red and yellow strings around our wrists while chanting a blessing . he then charged us 200 rupees (which is like $4 but an exorbitant amount of money for string, i think). short of slapping his arm and running away i'm not sure what we could have done. of course, even before the chanting commenced we had been the center of attention, but when this started, everyone around us fell silent and turned into one giant, gawking circle of mumbaikers. there was nothing to do but stand there and take it. the dye from the string is now running down my arm, making me look jaundiced. i think this totally makes us look indian, right?

i thought so.

brief musings on a cow.

2009-04-13T13:17:00.000-04:00

we pass this cow every day on the way to the hospital. i wonder a lot about the logistics of the cow, and her neighbor who hangs out down the street. where does she live? where does she go in the afternoon? who takes care of her? does someone own her or does everyone share her? did the people of the neighborhood pitch in to buy her? do you even buy cows? either way, i'm pretty sure her existence is better than that of 95% of the patients we see.
i also find it to be totally wild that in this gigantic city there are still cows hanging out on the street.

rules to live by.

2009-04-12T06:21:00.001-04:00

i know some of you (those whose hearts have not been hardened by four years of medical school) are chomping at the bit to hear about the hospital. all in due time, my little grasshoppers. i've tried to write a few posts that encompass all of the aspects of the hospital, but it's just too much. so for today, we will start with signage.

i must first point out that the hospital is, in general, chaos. patients are in big old wards with upwards of 90 patients, which is clearly above capacity given that there are often people lying on floor mats in the aisles. their families are all in bed with them. the hallways, which are more like open-air porches, are packed with more waiting families, who apparently sleep there overnight, as well as stray dogs and pigeons. yesterday, on rounds, i heard a meowing sound and looked over to see a feral cat wandering amongst the patients. jcaho* would have a field day.

so, with all this chaos, how does one know how to comport oneself?
handy instructional signs! these are a source of of neverending amusement to us. i will highlight two of my favorites. first, this one.

should i just open my tiffin** and bisleri*** and eat lunch on the floor in the hallway? let me check the sign. X! you should not do this. instead, you should head to the canteen. i hear if you are a westerner, you should not, in fact, head to the canteen as you will regret this for the rest of your trip. however, the non-indian population consists of us, one other american, and two hardy-looking swiss students, so in general this strategy works.

next, with so many patients, how will we ever get in to see the doctor? waiting in line takes so long... perhaps that guard could "help us out". X! do not attempt to exchange money with the man in the khaki uniform. this is frowned upon (although perhaps not by the guards).

others include vigorous red check marks next to photos of a man tossing his trash and spitting appropriately into the trash bins, as well as one we can't figure out which seems to condemn both sitting on patients' beds and standing around them. unclear what the appropriate action is. although i can't speak about the illicit exchange of money, i do have to vouch for the fact that most of these signs go unheeded, but it's a nice thought.

p.s. happy easter to those celebrating it!

*joint commission for accreditation of healthcare organizations
**metal lunch tin
*** indian bottled water

bandra or bust? both.

2009-04-10T09:11:00.000-04:00

i want to start out by saying that the taxi drivers here in mumbai have my ultimate respect. they are a hard-working bunch of guys who probably don't get paid enough to navigate this humongous, busy city, and obviously it's not their fault that their english is less than perfect. after all, it's better than my hindi/marathi.

with that disclaimer, our excursion to bandra was a bit of a bust. bandra's in the north of mumbai (we're in the south) and we decided to venture out to see this highly advertised photo exhibition featuring the recycling sheds of dharavi. (india factoid: per our guidebook, anyway, 55% of the population of mumbai lives in slums/shantytowns - so that's like, what, 9 million people? - and the largest of these, in fact in all of asia, is dharavi, home to one million people. some of these people make a living picking rags/cardboard/whatever. think slumdog. ) so. we knew it would be a little bit of a drive but went with it. things were going well until we got into bandra, and told the address to our cabbie. he had no idea where it was. of course, neither did we. we handed him the slip with the address, but of course he couldn't read english (again, not like i can read hindi). so we've got the guidebook map out and he looks all nervous, clutching the scrap he couldn't read, and flags down a man on the side of the road, who gives us directions involving a barista (the starbucks equivalent) that we didn't see until later, when we had u-turned and were practically on top of it. long story short, we ended up stopping for directions two more times before safely arriving at our destination.

but the photos were worth it, right? meh. while they were nice photos of cute kids, there were about six of them hanging on the wall of the restaurant, and they looked like any photo i might have taken of kids anywhere. so, ok, at least we'll go shopping at this giant open-air shoe mart. (sam, you would have seized if you saw it.) well. that turned out to be totally overwhelming, with people tugging at us trying to sell pashminas, dora the explorer t-shirts, purses, belts, shoes, etc. it cleared out a little when someone yelled "police!" and all of a sudden handbags wrapped in tarps were being hoisted over the median, but we left there pretty quickly, too. i will say that we had a lovely dinner at this restaurant, a change of pace from our usual indian fare, even if the photos were a bit less that what we expected. so not a total loss.

the nadir of the trip, though, came as we were driving home. there's never actually a point in mumbai when you feel alone on the street (given the other 16 million inhabitants), but we had come to a reasonably dark/deserted stretch with a concrete wall on the one side and only a few pedestrians on the other when our cab driver pulled over and said something to us that was not in our language. of course, all we can say is "peddar road!" "yes madam, peddar road, but (something something something)." he's getting more agitated. we're yelling, "peddar road! peddar road!" hand gestures. i'm thinking, oh my god, this is it. he's leaving us here. he points to the sidewalk, says something that sounds like gun to me, and in my panic, makes a gesture that i think looks like firing a gun. and i'm like, "gun? you have a gun? you're robbing us? who has a gun?" then he jumps out and runs around the car, and we're like, oh dear god. and the poor man finds a post, squats down beside it, and relieves himself in the street. yes, he just had to pee. he delivered us home safely after that. did overcharge by 50 rupees, but we were too worn out to haggle over a dollar by then.

well, the food was good anyway, and i have some leftover mushroom risotto for dinner tonight.

i brought my camera in the taxi this morning.

2009-04-07T13:19:00.000-04:00

originally, i had great plans to write about the hospital. the hospital is interesting and different, in so many ways. but then i thought maybe it would be better to wait until i had some pictures to go with it, in case you get tired of reading and just want something to look at. so perhaps we can talk about the drive to the hospital (and taxi rides in general). while there is a public transportation system here in the city, it involves hopping onto an often still-moving bus with the destination labeled in hindi on the front, which seems less than ideal to us. similar situation with trains, though one would hope they come to a full stop. so with taxis being plentiful and cheap (about $1.25 each way to the hospital), they're our default option.

and what an adventure they are. first of all, they're these 1950's fiats or something. (dad? looking to you on this one.) but definitely not from anytime recently. when you get in, they pull a little lever to reset the meter that's mounted on the hood, but the meters are also from 1950 and so when you arrive, the driver pulls out a card that converts the price displayed to what you actually owe, based on 50-60 years of inflation. no seatbelts. we thought we hit the jackpot the other day when we got into one with seatbelts, only to discover that there was nothing to buckle the belts into. alas.

then, the driving itself. lanes, as far as we can tell, are optional, and there's only a rough sense of where the middle of the road is. the honking is near-constant, despite the establishment of so-called "silent zones" in the city. half the time, the honking is at pedestrians who are wandering across the street, although to be fair, that's the only way to get across. when we met our attending the first day, his words of advice were "two things you need to know. only drink that (points at our bottled water) and the cars will not stop for you. they will. not. stop." nay, they pretend to speed up, although if you walk forcefully enough they actually do stop (so far). so, in the road, everyone's honking and beeping and it's a giant cluster of motorbikes, buses, taxis, pedestrians, bicycles, and the occasional oxcart. sometimes, people on horses. i could not capture the oxcart on film, but i will. note the family of three holding their one helmet in their hands. i think the law is like lifejackets on a boat. as long as they're there, it counts.

and then, the sidewalks. the best way to describe what's happening on the street is that it seems to me like a giant anthill. people are pouring out of everywhere and everyone's doing something. folks are selling things, they're rushing off to places, they're leading cows around, and they have everything you can imagine on their bikes. we've seen bikes with bricks stacked across the whole frame, bikes with 20 or so trays of eggs strapped to the back (disastrous should he have a run-in with an unyielding taxi), bikes used to wheel plywood along. then there are folks like this guy. why does he look like he's working so hard?

oh, because he's walking downhill and holding this back.

finally, a topic i would like to address. begging. this generally happens when we're stopped in a bunch of traffic, and until now we've generally avoided handing out money and stick to buying candy for the cute street kids who follow us around. but after a man who was missing both arms and his teeth popped his head into our window, we decided to separate out our coins to have them ready to hand out. this seems to have backfired on us today, as giving a coin to one woman (who then lingered, disappointed, and waited for more) today prompted the three other beggars at the intersection to run to our car, as our taxiwallah shook his head and sighed/laughed. so, really i'm open to suggestions about how to best handle this, because i feel like a jerk for not being willing to give my money up to some double-amputee or a four year-old darting between cars, but once you start it spirals out of control. until, i suppose, the light turns green.

we don't need no dobi wallah.

2009-04-05T17:32:00.000-04:00

well it's 3 am in mumbai and i can't sleep. initially the jet lag thing wasn't too much of an issue, and maybe that's not even it, but this is the second time i've woken up super early and can't go back to sleep. so what did we do today? well, we didn't leave the house due to concerns over possible gi upset and also being wiped out after yesterday's adventures. what we did do was laundry. not as easy as it seems, mostly because we couldn't figure out where to hang it. BUT, my ingenious travel companion elizabeth macgyver noted that while we didn't have rope, we did have a lot of plastic bags at our disposal. so:

step 1: cut the bags in half.

step 2: loop them together in a chain.

step 3: attach the chain of bags to your freezer and faucet.

step 4: voila!

at the rate we're sweating through clothes, we should be doing this about every other day.

95 and smoke.

2009-04-04T07:45:00.000-04:00

in an effort to more objectively define the level of heat yesterday, i checked the weather for mumbai. the temperature was 95 (at 5pm), and instead of the usual "sunny" or "partly cloudy" the accompanying descriptor was "smoke". i might try to pass this off as some quaint mistranslation, but this was my trusty weather.com. and it's also pretty accurate. we took a boat out to the elephanta islands today, and it was like riding through a giant cloud. you couldn't even see the skyline of mumbai while riding back in because of the pollution. i have a lot of deep thoughts about this, and frankly it makes me a little depressed, but you're not here for depressing thoughts. you're here for pictures!

which leads me to...
these women. these are not sweet old village women. these are sharks.
i was pleasantly attempting to photograph a monkey when these women saw their chance. they kept posing, saying "madam, nice photo!" and surrounding me. there was a fourth. now, we all know i don't react well to being flustered, and these grandmother types were racing around me, and i had this fleeting thought of, well, i'll have a photo and i'll give them some money which they can probably use. oh heavens, no. i certainly should have negotiated my price first. i pulled out 100 rupees, the inital asking price, which then went up to 150. i declined that but they were not having any of it, circling me and yelling until i snuck past. they got me again on the way out, pointing and yelling, but i avoided eye contact. so i'm getting my money's worth out of this photo, and sharing it. to be fair, the monkey didn't like having his picture taken either, and tried to attack elizabeth, teeth bared and hissing. a kind stranger chased him off while i was running for the hills. the running meant we didn't actually get a good photo of him.

but the caves were nice.

hot enough to melt a jolly rancher.

2009-04-03T08:23:00.000-04:00

that's how hot it is today. we decided to carry hard candies around for the kids who beg from us, and when i reached into the bag, they were a sticky mess. that's hot.

our doctor friends warned us that we should stay inside between 12 and 4, but we pressed on. how bad can it be? at least i'm not the man standing at the end of our drive who irons your clothes in the sun. he has a reason to complain. also these guys, painting the outside of our building. note the scaffolding made of bamboo. note also the lack of safety harness. this kind of scaffolding goes up even the skyscrapers that are 30+ stories tall.

so, anyway, we ventured out into the heat. we got enthusiastic waves from the peanut and chickpea roaster as well as the fruit vendor. i suppose as the only white girls walking out on the streets, we make an impression. we stopped out of the sun into mahatma ghandi's house, bought ourselves some mangoes and watermelons and were thinking about other errands when all of a sudden, we just couldn't take it. so we came home and lay on the marble floors with the air conditioner running. i finally understand siesta cultures.

gandhi's bedroom (to prove i was there):

we're here!

2009-04-02T08:38:00.000-04:00

after 18+ hours of traveling, we arrived yesterday. bombay (as everyone still calls it), for its part, welcomed us with 106 degree weather. and no, it's not been a dry heat. anyone with curls can imagine what my hair looks like right now, and i choose not to document that photographically. what completely blows my mind is that everyone is walking around in jeans and long-sleeved shirts while i'm pouring sweat through my t-shirt. i guess not unlike when people from warmer climates are wearing their parkas in worcester in october.

what's fantastic here is that it seems like people will bring anything you want to your door. we literally ran into a man selling bags of snacks door-to-door here in our building - and then our hosts bought us plantain chips and roasted chickpeas and something else i can't identify. he'll be paying us weekly visits. we're also arranging for coconut deliveries on the weekends and fruit service from the fruit lady. and the tech support guy came right on over to connect us to the internet. lovely.

also, i'd better hope for some sort of gi bug, because at this rate i'm not fitting into an bridesmaid dresses when i get home. three kinds of paneer yesterday alone! and the naan! heavenly.

of course, the downside of having everything delivered today is that we didn't leave home today - which i think is justified, as we're dealing with a 9.5 hour time difference. so no real photos to share, but i will leave you with this one, of our water supply:

no ehec for us!

p.s.

2009-03-24T18:11:00.001-04:00

at some point in my life, i apparently made a blogger profile and named myself mcfly. a testament to marty? perhaps. but it's just me, mary.

welcome!

2009-03-24T18:03:00.000-04:00

since rachel's was such a resounding success, i thought it might be nice to have a blog while i'm in india. also, this way people (amy, i'm looking at you) can feel reassured of the fact that i have not been kidnapped, succumbed to malaria, etc. just because i haven't emailed. and, i'll even add pictures. it should be exciting, once i've actually left worcester ... so check back soon!