1.43 pounds and growing

So first day today. It was a first day. They are always slightly chaotic and you ask stupid questions and never know where to find anything or anyone. The NICU doesn't even have labels on the bed so you just have to find the right area or the right nurse and look at the labels on the chart. Fortunatley it is a very enclosed space with maybe 40 babies so your numbers are limited.

Plus it seems like it's own little world in there. They have different acronyms and different lab trees for recording stuff. And super crazy calculations to figure out food and electrolytes and growth and total fluids etc. etc. I need to figure out how to figure. It looks like plug and chug once you have the formulas and concepts down...neither of which I do yet.

I have eight patients. They range in acuity. The smallest is 1.43 lbs. She is a tiny peanut. Her fingers are about as big as the earphone plug on my iPod. I am afraid I'm going to break her. It's like everything in miniature. The nurses are really great...thank goodness. They really run the place I think. And ask us to write orders.

Which brings me to the next thing. I get to write orders now...orders that don't have to be cosigned. It is a strange thing. I still feel like I should be finding someone to put their stamp of approval on my thoughts or changes. I pretty much do ask, they just don't have to sign it. And hopefully soonish I will feel comfortable and knowledgable enough to not ask about every little thing.

I love the VA

Yesterday we also had our VA orientation. It was like no other VA orientation I'd ever been to or imagined. Granted I have only attended the one in Ohio before. And it was extremely painful and drab. So, even though our VA here is like the cadillac of VAs I expected more of the same orientation-wise. I was pleasantly surprised.

Once I actually found the place and go my car valet parked for free (they won't even accept tips if you offer), I hurried in and asked the super nice volunteers at the front desk where the orientation was. I'd met them the day before when I was there for computer training, they were welcoming and introduced themselves. This day I was in a hurry so asked them where I could find the housestaff orientation. It was in the auditorium.

I could hear the slight roar when I got in. The place was decorated all in a Hawaiian theme and all the people helping us where dressed in Hawaiian shirts, some with white sunscreen on their noses and visors. It looked like a festive bunch. And, even better, they were all very friendly and helpful and energetic. I registered and was immediately asked for some paperwork that my file needed. They were organized, too. Nice.

To my right were some of my classmates standing around a semi-circular table with strange huge white space mask-looking things over their head. Through the clear front window I could see that they also had on their respirators (for TB protedtion) and the instructor was spraying stuff into the headgear through a hole in the front of the plastic. I would be in their shoes less than an hour later.

Before that, however, I got to get some new scrubs and my own prescription pads...wow! And we watched what turned out to be a very heart-warming video. "Help people. It is addictive." "Privlaged to take care of this population." "Give it your best." And an echo of what my vallet parker had said the day before, "If you're not going to do something well, why bother doing it?" Even better than the message of the video though, was all the staff lined up and focused on the video and the message. You could tell they believed it and really gave this job their best. When it was over, I saw one of the employees put her hand over her heart and then raise it to the sky and smile at her co-workers.

I work at the VA during my first medicine month in October. I'm looking forward to it. I love the VA.

NICU Saturday

I start in the NICU on Saturday morning at 6 am. I keep getting badges that say "MD" on them now. Don't these people know?!? I'm terrified. And exhausted. And a little under the weather. And pretty stinking stoked on my life overall right now. Parents are now "hopeful" of working things out. S's dad is okay (no melanoma). J is excited about his new place still (though not the nati so much). M will be in FL tomorrow. C is getting married. Have to plan a shower. Will be in SD so convieneint. Still, though, TER--IF--IED!

Bliss

I was running/walking back from the gym I joined which is about a mile from my apartment on the beach, thinking to myself, "Wow, this is the life. Why would anyone ever live anywhere else?" Any other city? Any other state? Any other block for that matter. I feel like the stars are aligned. Things are just about perfect.

Okay so it's hard work and I never get enough sleep and I'm afraid I'm going to kill someone, but it's what I signed up for...and it's what I want to do. And hopefully I'll learn how to not kill anyone.

And what better place to do it?

Places to Play in and Pray In

I love it here.

I arrived in San Diego around midnight on Monday night. P. was waiting up for me since I didn't yet have my keys. It had been a long couple emotional and driving days and I was still anxious when I got here. Not quite knowing how the living situation would work and how P. and I would get along, etc. The weather, of course, was beautiful (and has been perfect ever since).

I unloaded the backseat of my car that night and got my bedding in so I could make my bed and sleep in it. I got to sleep in the next day, but didn't as late as I should have because I knew I had a lot to do. I unloaded my trunk and then went out on errands.

First I went to the post office in the fancy part of town. I live right on the boarder of two zip codes so I am officially in the fancy part, but much closer to the more surfer part. Anyway, the post office was a little difficult to find. I drove through the village where everyone was very dressed up and very privlaged acting. They drove really badly actually. But the sun was out. It was 75 degrees with a slight breeze. On my left I'd catch glimpses of the palm trees and ocean every few blocks. I couldn't believe this was my life now!

While picking up my boxes, I asked how to get to Ikea to get a few pieces of furniture and a trash can and other random stuff. I got lost several times getting there, ended up somewhere north on the freeway. Stopped to ask directions a few times. It was okay, though. I had the windows rolled down and it felt wonderful. Plus I convinced myself that I was familiarizing myself with the areas.

I did eventually find it. And (bonus) it was nearby a Costco so I could do some broad strokes of grocery shopping while I was at it. I found a couple piecies of furniture that I liked and got some help loading them into my cart and then into my car. The loading guys tried to tell me I had to tie it on my bike racks on top, but I thought it would blow off on the freeways, so I convinced them we could fit it inside...which we did...barely.

On the way back I got groceries and a cool new iPod thing and a router for wireless at Costco. I reversed my directions to find my way back to my new place. Once I started getting close all the signs started saying "Beaches" and they were all the exits I had to take to get home. Have to love that!

So to get home, I follow the "beaches" signs and arrows. To get to work I follow the "H" (hospital) signs and arrows. It's like the road people know how much I get lost. That was nice of them to put up signs just for me. Or maybe I just go to fun and necessary places...I guess that's it. I like to have fun and be needed, so that works out well, too.

I stopped to set up a new bank account on my way back, too. I already had my cell phone number, driver's licences and car registration changed. I wanted to feel like I was totally home...back where I am from. Back where I breathe easier. Back where the sun shines. Back where perfect strangers smile at you just because. Back where I feel safe on the streets. Back to the ocean.

While it is a round-about homecoming for me. There is also a lot of newness and changes. New place; new area; new job; new people; new hospitals; new friends. So far, despite all my fretting, it is really good newness. Really good.

Once I got back, a kind-hearted, gong-using, construction-working, loud-depressing-music-playing gay neighbor, T., helped me unload my car. He offered to help me build the pieces if I needed help. Said the place was really safe and he's lived here ten years and loves it. I love it, too, already.

Our apartment is part of a large complex that is on a fairly busy street that has fancy houses on the other side and then the water just on the other side of those. There is a cliff part directly across. I walked down there when I was here last month and there is an access point where you can look out over the beach and surfers and areas just down the coast. Our place is on the edge of the complex closest to the water, close to laundry, on the ground floor. It's pretty perfect really. I told P. that and she said, "I'm glad you like it," with a smile.

She's been great at helping to oriente me to the area. Telling me how to get to the freeway faster, recommending a good bank, baking really yummy strawberry bread, etc. She even helped me build some of my furniture. She put together all the drawers on my semi-complicated chest of drawers.

It was a lovely sunny afternoon so I was building the pieces outside in the sun on the back patio feeling the slight breeze and listening to the aformentioned neighbors music before I decided that I needed my own iPod to drown it out. I was wearing my new cool Rainbow sandals that B. decided I needed as soon as I got here and surprised me by having them delivered. P. came out when she'd finished baking to help and visit. She was great.

I learned that she has two older sisters and that her dad is in HI right now getting medical care. I met her mom when I was here last month. I caught her up a bit on my background and personal life. She's really interesting. I love to hear her talk about her travels and experiences. I can live vicariously a bit. Plus she seems really easy going. At first I thought we would be good to cohabitat but now I think we could even get to become friends also. I'm already feeling comfortable here (which is saying a lot for me since it usually takes me a while to settle in). I think part of that has to do with her welcoming me so well.

The other part has to do with me growing up and becoming more comfortable in my own skin. And learning to take the important sources of strength with me. I know what I need to do with make myself settle down and feel at home. I can spoil myself a little and find places that I love and that recharge my soul well. I stay in close touch with my wonderful friends who love me even when we are far apart. Plus I have been traveling so much in the last couple years that I know what I really need to have with me to make me feel connected and happy. And the rest is just there.

After P. and I built the furniture, I made pasta and we shared that and some bread. Since I cooked, she cleaned up while I continued to unpack my stuff. I was up late because the next day (today) I was starting my first day of orientation and (predictably) I was nervous...shocking. I still didn't have internet on my computer because I ran out of energy before we could get the router set up. But earlier in the day I'd discovered that my cell phone was accessing the internet to send pictures and my bill was out of control so I decided to pay for unlimted internet access from that. It is slower and smaller screened, but it was enough to get online to make sure of the place and time for the next day and get directions to the compter training place.

I checked my email on it also and found that there had been a tragedy in my cousins' family. My aunt's brother had been murdered two weeks ago and was just found dead in his house. His girlfriend is suspected because she had lied about being pregnant and having a baby and had continued to live with him while he sat there dead. Wierd and sad. No one had told me about it because they thought I had too much going on already. It was pretty shocking to learn about. I can't imagine what they are going through. I never met this person, but I'd heard them talk about him many times. It is just unthinkable. The stuff that people do in real life is sometimes so much more horrific than the stuff you see in movies. It is just in comprehensible.

My the time I'd finished writing her back with my profound sympathy (which is even more difficult to do on the little phone key pad), I was exhausted and headed to bed. I had to get up semi-early the next day and it was already to the point where I wasn't going to get anywhere near enough sleep.

I set up my new alarm with the iPod thing, but it didn't work in the morning (user error), so luckily I awoke myself in time to take a shower and recheck directions and hit the road. I left early because I didn't know how traffic would be. It was fine, though, and I made it in plenty of time.

We were doing computer training and I met the three other people in the combined program. They all seem really nice and real and smart and kind. Just the kind of people I like to surround myself with. I know this is first impression and I will get to know them much better in the coming years. I'm looking forward to it.

The computer system for the University Hospital is great, too. All computer order entry; all we still write is daily progress notes and history and physical. Being back in the atmosphere of the hospital made me want to get started again. I really enjoy what I have chosen to do with my professional life and I realized that, despite all of my performance anxiety, I have missed it. I am looking forward to being back in the hospital and taking care of patients. I have a lot to learn, but I have also already learned a lot. I feel well-prepared and excited.

The four of us went to meet our program secretary after the four hour (slightly mind-numbing) computer session. I will not use it for four months because of the way my rotations work out, so I will definitely need a refresher course. Our program secretary welcomed us. I also got to try on my long white coat! It feels really cool to have a longer coat now. They give us three and we can pay to have them embroidered if we want; I'm still thinking about that.

One of the other interns lives near me so we will carpool tomorrow. The other three are in serious relationships and either moved here with there significant other or just moved in together. I am living with P., does that count? It's okay, though.

The hospital sits up on a hill and is a tall white building. The lawns are green and it is surrounded my eucalyptus trees. I think it is pretty for a hospital. Or maybe the sun shining on it just makes everything look better.

I drove back to my apartment (following the "beaches" signs), had lunch, talked to a few friends and family, then was exhausted (that relieved sort of exhaustion) so decieded that I would take a nap. This will be my last free afternoon for a while since from here on out we have full days of orientation along with at least three evening events. It gets busy, I tell you. Then I start work at the Children's hospital on the 24th...and am on overnight call the first day. I knew that would happen. I'm actually sort of glad, though. That's how I started third year of med school and that worked out pretty well. It lets you hit the ground running.

As I feel asleep the ocean breeze rustled the blinds on my window and the gardeners chatted outside. It was a good drifting off...and a good nap.

When I awoke I decided to go for an exploring run to find the closest beach access. When I headed out the front door, there was a beautiful bouquet of lilies, roses, tulips, and gerber daisies out side. And the card had my name on it. They were from Michael. He misses me and loves me. We're still talking and things seem so much better. I kept wanting him to be better and I think he might actually be doing it. I'm suspicious still...and we'll see what happens. I can give him another chance, I just worry about my friends and family not doing the same. I honestly haven't given it a ton of thought lately. Things feel good and I'm just sort of going with that for now. It is a pleasant (if still slightly uncomfortable) relief.

After moving the flowers into my room (which immediately started to smell like the lilies), I headed out for my run. Weather is perfect. I ran toward the water and found access to the beach just a few blocks away. Running along the beach in the sand felt so good. It was my fairy tale vision of what I'd seen as my life here, but I wasn't sure it would actually be that way...but it is. I guess some dreams to come true.

I ran down to a pier and stopped in the shade it made to do my sit ups and some yoga in the sand. As I crunched up and down, the sound of the waves got louder and softer with my movement. The sun glinted off the ocean. There were people everywhere, playing catch, catching rays, walking, running, talking, eating, drinking, visiting, laughing, smiling. Ahhhh. No one looked at me like I was crazy. I just blended in with the overall happiness of the afternoon.

I brushed the sand off when I stood up and finished stretching. I ran back along the boardwalk and stopped at one of the many closely cut lawns to do some push-ups and more stretches. There was a cute young family picnicing nearby. The little girl was around 1 year and had a red polka-dot tutu on over her diaper.

I ran back to our apartment and P's cat met me at the door. He'd hissed at me once earlier when I first got home before he remembered who I was. I think he is warming up to me a bit. He's pretty friendly.

P. got hom soon after. After we caught up on each other's days a bit, she helped me set up the wireless internet. Yipee! I took a shower and now I'm sitting in bed eating beef jerky writing while she watches "So you think you can Dance" and checks on me when she walks by.

I love my life. Did I mention that?

Have I Been Forgotten?

When I was a sophomore in college I got a horrible kidney infection and my mom threatened to call the ambulance to come pick me up at my dorm...mortifying! A friend ended up being able to take me...thank goodness. I was a wreck by the time I got to the hospital at around 10 pm. They did all sorts of tests and admitted me right away.

One of the tests they wanted to do was a renal ultrasound to make sure I didn't have any damage or stones that were exacerbating the condition. They decided to do this test after they'd already taken me up to my room after hours of work up in the ER. I was exhausted and wished it could wait until morning, but no such luck. They wheeled me down to radiology department...by this time of night (2 am) a long deserted hallway with doors that all looked the same to me. I was placed in a room and told that it would just be a few minutes until the tech could come get me. I waited and waited. Those wheely stretchers are not nearly as comfortable as the beds in the room that I'd been on briefly. No one came. My IV started beeping because it needed to be plugged into the wall. Someone came to do that but soon left again. I couldn't get out of bed because my blood pressure was too low and I'd pass out. I was getting panicked and thought I'd been forgotten. I managed to pull my stretcher over to a phone on the wall and called mom who was still in California (I was in Washington) and whined to her for a while wondering if anyone was ever going to come get me. Or if they'd just forgotten me. She was probably comforting enough to calm me down for a few more minutes before I worked myself into a panic of being feeling left again.

So soon after that I started yelling down the hall, in my weak, sick, pitiful voice, "Helloooooo...Is anyone there?.... Have I been forgotten?....Helloooo...." Yeah, it seems funny now. At the time it wasn't. Yes, eventually someone showed up and apologized, explaining that the had three births that night and the ultrasound tech had been swamped. Indeed. Well, what was more important? I huffed to myself. Not really, but I was super tired and sick and cranky. And turns out my kidneys looked fine on the ultrasound.

It was not the first time I'd been forgotten or left. My dad forgot me at the video store once when we stopped there on the way home from school when I was maybe 10 or younger. I was so quiet he thought I'd just followed them out when I was still busy looking at some of those giant disc records that were all the rage then. I didn't even know they were gone until they came back for me.

Then there was some miscommunication about who was going to pick me up from gymnastics once. I was left sitting there until everyone else got home and looked around and wondered where I was. It was a half hour drive back up to get me. I was maybe seven years old that time.

When I was closer to 11 I was waiting for mom reading in the county office library when the librarians turned off the lights and locked me in. I had been too quiet and they forgot I was there. It wasn't until mom finished with her meeting and came looking for me that I got out. I remember thinking there would be worse places to be forgotten than the library. Although the benches wouldn't be very comfortable for sleeping.

I hate feeling left. I think now that everyone is going to leave me or choose someone else instead of me...short of my family because they are required to love me and stay with me. But everyone else. So I push them until they do it anyway. Maybe I figure better sooner than later.

Pop-isms

Shug = Sugar...a nickname for me and mom
Boob Tube = TV
Wonerful = wonderful with his boston accent
Bobwire = barbwire...and I thought this was the correct pronunciation until I was 11

I Miss my Therapist

I am worried.

I am worried about starting residnecy and worried about how I will do and if people will like me. Worried about starting over in a new place and meeting new people. Worried that I will mess up and hurt someone. Worried that I already have. Worried that I make bad choices in relationships and worried that it will happen again. Worried that I won't be able to sleep. Worried about my parents. I am worried I won't be able to get the refill on my Lexapro in time. I am worried I will get lost. I am worried about getting along with my new roommate. I am worried I won't know enough.

That covers at least some of it. Classic GAD (generalized anxiety disorder) characteristics. I get myself all worked up into a fret and then just think around in circles and worry worry worry and then can't see clearly enough to get back out of it. The trick is to derail my thoughts when I see it starting. Just sometimes it gets to be too late and I get stuck. Like now. Well, actually better now than yesterday. Boy was that a mess.

There are so many details to do with starting residency and taking care of things that I'm worried I will forget something important and I hate to mess up. I am hard on myself that way. I have a difficult time forgiving myself and letting go when I do something wrong.

I try to imagine what Dr. D or Dr. L would say. The last thing that Dr. L said to me was to work on figuring out what I want...and then not feeling guilty about wanting whatever it is. He is a lot like me, he said. I want to run far far away. "Please God, make me a bird, so I can fly far, far far away." "Run, far far away, find comfort in pain. All pleasure's the same. It just keeps you from trouble. Hide my true shape like Dorian Gray."

But I can't run away. I like the consequences of that even less than those involved in staying. I try to remind myself how very lucky I am. Shoot I got my top choice residency. I am moving to San Diego. It is beautiful there. I have an apartment right across from the beach. I am going to be a doctor. If I can ever calm down enough (which I know I will from past fret sessions...they pass) my patients will like me. I have good health (physically at least). My family loves me. My friends love me. My brother is getting married. His fiance is wonderful. I get to be in the wedding. I have more ceramics (that I made) than I know what to do with. They are bursting out of the seams of my room at the moment. I have three Rookwood pieces from my dad. My car runs. Pop is doing well. He got me new tires for graduation. I have some money saved. I will have an income soon. B. ordered me cool sandals that will come to SD.

This blog is a stream of consciousness/polar opposites. My mind is racing between one extreme and the other. And I need to actually get up and pack my car so I can be ready to leave tomorrow morning early with Becky so we can get to Monteray in time to see B. pitch in his baseball game.

My close friends are frusterated with me because they feel that they haven't made any difference in my life because I am still in touch with Michael. They ask why I still talk to him. What I see in him. If I still want to be with him. Tell me I should relive some of the hurt he put me through. I know I am frusterating. I can be inconsistant and that is annoying to other people. Annoying to me, too. I guess it just all comes down to figuring out what I want and getting that. The hardest part for me, by far, is figuring out what I want. Once I have the goal, I am tenacious enough to usually get it.

Perhaps that is part of the reason, besides loving him, that I can't seem to cut Michael loose. I hate to give up. Being with him was a goal for so long that is has become ingrained in me. The thing is that I feel more single than anything most of the time. I don't feel like I'm in a real relationship with anyone at the moment. And I don't feel like I want to be.

I told Michael that treating me the way he'd done was simply not allowed. That he was going to have to grow and change and become the person that he wants to be before anything further was going to progress with us. "I need to see proof," I told him. I want him to get into therapy when he gets to Miami. I want him to like himself and be proud of himself and not make stupid choices that mess everything up. We'll see if he does any of that. He says he feels like he is finally growing up. That he's tired of party boy life style and that it hasn't really been fun for a while anyway. "So do I just fit into this new vision you want of yourself?" I ask. "No, I want us to be together." He talks about transferring to SD after a year in Miami. I keep reminding him that, after all he's put me through, my being there to be with him again is conditional. I'm sick of taking his guilt trips and having him turn this around on me. He was going to come see me this weekend but had to study instead. When he cancelled on me, I told him, "This isn't going to work." He had a fit and begged and explained. We'll see what happens. I honestly don't know what will.

So back to what S. and J. have done for me: given me courage to demand what I want. Supported me when I crash and burn. What they want to do is to change who I am...for what they see as making me better for myself. I sometimes get frusterated with that because I'm stubborn and don't like to change unless I see it for myself. Granted I see much validity in what they want me to do. And it helps when they give me assignments and talk to me...it just seems to be going too slow for them. They don't see any changes I guess. And the only change they will really be happy with seems to be stopping all communication with Michael. That seems to be the only thing that will make anyone in my life happy right now...short of Michael...and me (most of the time).

So I don't want them to get hurt and frusterated. They are both too wonderful and I don't want to be the cause of anyone feeling that way...particularly my closest friends. So I push them away for (what I tell myself) is their own good. But maybe it's just me hiding my head it a hole again and hoping the sun will be back out when I bring it back up.

Engaged!

The climb up Mt. Shasta was beautiful and breathtaking (in more ways than one considering the summit is 14, 162 ft.) and brutal.

Only a couple from our group made it all the way to the peak and they were among only five the whole day. The wind was howling like mad up there and little people had the danger of being blown off the mountain. Yikes!

The biggest news, however is that my brother proposed to his girlfriend and she accepted! We are all incredibly thrilled. They are already planning the wedding and it looks to be a big affair. And she just asked me tonight to be in her bridal party...what an honor.

It was very sweet that he asked her with all of us there...I felt honored that he would include us in that moment. It was the most beautiful of the whole hike.

The Climb

Tomorrow I will set out with my brothers, their girlfriends, my mom, and a few other friends to climb Mt. Shasta.

It should be a beautiful, if challenging, climb.

Red Carpet

After four years in Ohio I have made it back to California...and not just to visit this time. My little red car was stuffed to the gills with my bike atop just at it was when I drove out east four years ago. This time Dad rode with me through the great midwest, great planes, great Sierras...it was all just great. We did the drive in three days, two nights on the road and tonight we made it home. I will stay here a few days to climb Shasta with my brother and a group he has organized. Then I will head down south to start residency in the middle of this month. Life comes at you fast.

A couple weeks ago when I drove down to see my new place and meet my new roommate, I felt at last like my soul could breath again. And driving across the country this time a friend texted me asking how was the road. "Like a long red carpet," I replied, "stretching out to home." Tonight, as we drove the low-riding car home, my heart sighed in peace. Perhaps home really is where the heart is...and the west coast is very much home to me. It is intoxicating for me. A heady combination of nostalgia, adventure, familiarity, and challenge. I don't really want to leave again.

Michael gave me a picture of me in Cincinnati looking west at the sunset. On the back he wrote something to the effect of "This is perhaps the most poignant picture of the bunch. Shawna looking at the sunset... Shawna looking west... Shawna looking away from Michael... I always knew you'd go back to California, even if it meant leaving me." "Why did you stay with me then break my heart?" I asked him. Reply pending.

It was somewhat strange to leave Cincinnati. I will miss my friends there most. It was hard to say goodbye to S., J., and (yes) Michael. It was time for me to go, though. Never did I think I would stay in the midwest. It had activities and people that made it good for me for a time, but that time has ended. Driving around town on last minute errands, I did not even catch myself getting sad or thinking, "This is the last time I will such and such. Or I may never see so and so again." Perhaps I thought at last that there was not point in fretting over the change because it would come with or without my anxiety. Or perhaps the Lexapro has dulled my emotions to the point where they are more stable and managealbe. Or perhaps I know that this is the right move for me and when moving onto something better, it is not as hard to say goodbye to the something before.

Speaking of saying goodbye...Sunday was sort of a big day. It was our med school Honor's Day when we celebrate becoming real doctors...no longer "student doctors" or "medical students." Crazy really. Wow. It was an amazing day. To see everyone so excited and having changed so much through medical school. Seeing their families there. Remembering all that we'd shared. Thinking of all the different places we'd go now. Knowing all the work and learning that still lies ahead for each of us. Parting ways. Saying goodbyes. Hurrying to introduce loved ones and then take leave of friends. Yes, it was a big day.