limited for now

I'm finishing my third chocolate oatmeal and marichino cherry cookie of the morning thinking about how much there is to blog of the last week.  Things that I want to write about include getting a new adorable puppy, the beginning of summer with its mania-instilling weather and my fantastic birthday bbq that all happened this week.  We have had guests over including my best friend in the whole entire world Lauren who drove all the way up from Portland, and my fantastic photographer friend Melissa who drove out from Walla Walla.

I've been working on writing in detail about all of this and weaving it in articulately with a reminiscent story of a previous birthday.  However, I think that this is probably why more people don't write blogs, we are just too involved with enjoying the company around us and also keeping up with the obligations that maintain life that there just isn't any time left in the day to write eloquently or with intention.

So unfortunately, with these short sentences and the last ten minutes this is all that I have time to write about for now.  I will write with more detail when I have time.  In the meantime, I'll post a photo that makes my heart smile.  It's our friend Becky at my birthday bbq with our new puppy.

awarded

In a crowded auditorium full of smiling nurses, doctors, medical assistants, colleagues and their friends, my name was called yesterday to a round of applause.  I stood up, completely surprised and, as most people do in this situation, stopped being able to think, then embarrassingly crept to the stage.   I positioned the awaiting residents on stage into two rows, each with one hand outstretched towards the middle of an imaginary column that I ran through, jubilantly "high-fiving" them on the way to nab my award.

Every year, the interns in the hospital elect one resident that they feel has "unmatched qualities of encouragement, dedication and tireless contributions" which made their learning experience better.  I didn't anticipate that I would be chosen yesterday, there are many other excellent and deserving teachers.   But I will try not to disparage myself in deprecation.   Instead, let me describe how every person in this program deserves recognition for the job they do.

There are nights in the hospital when admission after admission keep coming in, and the clock indicates I've been working for eighteen hours, with twelve still left to go.   I question how to keep my eyes open and organize another complex admission, but then my nemesis, the pager, promptly informs no-time-to-think, another admission has arrived.  I head to the E.R. to find the patients chart, quickly skim through a hand full of their medical records, or encyclopedia, scan the wall for their bed number and then identify myself as their doctor.   I link together multiple medication interactions, disease processes, surgical histories and current symptoms to solve the mystery of why they are who they are and why they are sick.   In minutes I've made an educated guess which key will fit their lock and attempt to jam it in.  Sometimes the door opens and they get better.  Sometimes the door stays locked and I need another key.  Sometimes I'm interrupted by an unrelated death pronouncement on the third floor of the hospital a quarter-mile away.

My task now is to traverse the darkened halls of the night-time hospital and knock gently on an large wooden door to enter a room and evaluate a potentially lifeless body.  This is intimidating with my hand on the handle though, because I'm unprepared for who is on the other side.  Most times, it's a confused, tearful family who called the nurse when the agonal, arrhythmic breathing of their ailing loved one calmly paused.  Then, I must listen and look for signs of life in a sterile bed, only to announce in moments that indeed, their loved one is dead, and then figure out how to politely leave the room to get back to work.  Other times I enter a still and vacant room, to a bed an eighth filled with the frail, cachectic corpse of an unknown elderly woman who's died by herself.  I put my stethoscope on her sunk-in ribs, grab her delicate wrist, notice painted or unpainted finger nails, and check for a pulse.  I wait the three minutes for single heartbeat, or chest rise of breath.  With none present, I hold a solemn, personal vigil for this person who has departed the world utterly alone and pray this never happens to me.

Once I've completed my third, or fifth or I've-forgotten-how-many-and-don't-care-anymore-because-I-just-want-to-go-to-sleep number of admission, I slump my way back to the basement sleep-room.  Only, on the way down the echoey concrete stairwell a Code Blue is called on the overhead speaker.  My sore body scavenges for reserve somewhere, finding adrenaline left only in my pinky-toe.   Half-open eyes crack slightly wider and I GPS-locate on a mental map, where in the hospital I need to be for the cardiopulmonary arrest.

Once there, I enter the room where chest compressions are underway on a middle-aged overweight father who had abdominal surgery earlier in the day.   He wasn't my patient.  Only the current environment and the questions I ask now will help save his life.  Stop, breathe and organize.  What do I see?  Nurses are attempting to place large-bore IV's into his bouncing body, crash-carts are being opened and displayed on the foot of his bed, vital sign machines are alarming, gaping-mouthed wife and adolescent children are corralling, squeezed by incoming staff, into the corner,  pharmacists are drawing solutions into syringes, defibrillator pads are being applied to his chest and respiratory therapists are bag-masking breath into a life that is circling the drain.  Amidst the chaos at 430am, my job is to say "I'm doctor Ford a I will be running this code."  Like it or not, I will be running this code.   I will now purge every detail of advanced cardiopulmonary resusititation I can recall.

Ten to fifteen minutes into the code through the percussion of chest compressions and IV pump mechanics, I hear ribs begin to crack.   The vital sign machine alarms its high-pitched "oh my god there's no pulse" ding as the smell of defecation permeates the air.  Pale skin turns cold, and the gaping mouthes of family members begin to wail.   I've exhausted every tool I've been taught but I do it all again hoping to offer some solace to a family who's only just beginning to grieve.  I stand defeated and start to question, "Did I do this right?  Did I miss something?  Do I even know why this person has died?"

These are sometimes easier questions to answer though than the ones that come later, "Will I be forgiven when for what I've done?  Will I be forgiven for tying this person to the bed, for stabbing them with IV's, for injection unearthly chemical compounds into his body and snapping all of his ribs as he attempted to leave this world naturally?"  Is modern medicine anything like what was intended for the human soul?  I often can't grasp if what I'm doing in the name of medicine is appropriate and many times I'm too fatigued or shocked to think clearly about it. At the end of these excruciating shifts, sometimes the only hand reaching into the black depths of despair is that of a coworker who was there with me.

With that in mind, let me reiterate how much I appreciate this award.  What an honor to be told my contribution is "unmatched."  But I'm compelled to offer this recognition right back to everyone who does this work with me, the nurses, doctors, pharmacists and therapists.   But mostly, I identify with the residents.  No other coworker has climbed this mountain step by step with me, from day one through year three.

Thank you to each of you for everything you've done to help me get by.  Thank you for listening when I don't know what to say but just need to talk.  Thank you for your rested touch when the world seems like it's been awake too long.  Thank you for pushing me out the door when I don't know where to go next.   Most of all, thank you for telling me it will all be okay.  All of the residents in our program have worked their asses off this year and none of us would have gotten through the sleepless hours and weekendless months without each other.

And I can't extend this thanks without overwhelming gratitude to David, who's been there through all of the ups, downs and everything in-between when I finally get home.  Thank you, David, for being my support, my constant companion, my biggest source of laughter, and the love of my life.  Thank you for your patience with me when I come home grumpy and tell you to "go to hell" when all you ask for is a kiss.  Thank you for texting "Do you need time alone?" when I text you that I shattered a cup on the floor for no reason.  You give me and everyone you touch selfless joy, friendship and humanity.  Thank you for being you and thank you for being you with me.  I love you.

three days, two beds, one couch.

This week has been a typical week of my life as a resident.  Time constantly folds around itself such that it's hard to know if I'm coming or going.  My sleep-wake cycle is nonexistent and days seem to blur into each other.  Some days are great, other days are not, but everyday goes by so fast I fear I'll lose the good ones forever.  With that, here are the details of my week.

I woke up well rested, but alone Monday.  The bed I slept in we call The Big Bed because it occupies most of our second bedroom.   Rich pumpkin-colored paint by Martha Stewart cover the walls of that room, with a darker tangelo accent wall.  The bed's comforter is triple thick and complementarily autumn colored and there is a heated mattress pad above of course, a pillow top mattress.  Southeast facing windows catch the morning sun with a shimmer through broad deciduous leaves.   It's the quietest room in the house and thus the calmest to wake up in, uninterrupted and refreshed.  I woke up alone because David had exercised that morning.  Our room is crowded with workout equipment and if we had slept in there, I would have been kept awake by Tony Horton, of our work out video, screaming for me to "DO MY BEST AND FORGET THE REST!"

David had been babysitting Violet, the Gerber-poster-child daughter of The-woman-who-stocks-the-music-for-Starbucks, for several hours when I finally ventured out of the house Monday.  I earned the day off for working a holiday earlier in the year.  The-woman-who-stocks-the-music-for-Starbucks' house is four sliding glass doors and a window long.  Four sliding glass doors to capture the entire width of Lake Washington in their vantage and a window for the city of Bellevue's skyline, a view of millionaires.  After sunbathing on the home's one hundred foot long wooden deck for an hour, David, The Gerber-poster-child and I drove to Seward Park.

Located on a peninsula in south Seattle, Seward Park is one of my favorite parks in Seattle.  In it's incredible history the park was once an island prior to the surrounding lake being lowered by 9-feet to make a connection to the ocean in 1916.  The Park boasts a prominent old growth forest with trees aging up to 250 years old, young by comparison to Seattle's millennium-old ghost forests that were here before white man arrived.  Nonetheless, it's soaring canopy is breathtaking and begged me to stare straight up, each tree carrying its own ecosystem of small animals and ferns suspended 200-feet in the air.  I was affixed in upward gaze.   Below I have posted images of David and Violet in a field at the park's interior.  Monday was one of those days I wish I could slow down into an eternity or at least remember that long.

Tuesday morning began with the thud of my phone hitting the floor as I attempted to silence it's alarm.  This was accompanied by a realization that I was getting sick, sore throat and chest tight.  Amidst the long, but relatively benign shift that followed I described my symptoms to a coworker who forewarned that I might have an impending asthma attack.  I, however, told her my peak flow meter was normal and posted on Facebook that my symptoms were due to The Plague and not asthma. When it was time to leave around 10pm I was feeling worse and decided to stay the night at the hospital rather than commute both ways only to be back at work 7 hours later.

Wednesday arrived frigidly with me in a jail cell cot half covered by our heavy hospital bedspread.  These come in one color, beige, and provide no warmth.  They're made of some sort of wicker hybrid and cover your entire body only if you lay still as a corpse, an eerie thought in a hospital.  I woke up disoriented, in the pitch dark of the windowless 8ft by 6ft Doctors' sleep room, showered away the lung tightness in the Doctors' shower and pushed through another day of work despite feeling more ill.  By the time I got home, it was as if I'd worked one huge shift starting the day before.

That night knew no sleep.   Turns out I didn't have the Bubonic Plague, it was asthma after all.  During the one hour I slept, my small airways tightened and constricted in a cascade of overactive immune inflammation that led to an asthma attack.   I awoke breathless, pushing air through a mile-long coffee straw.  You'd think I would've panicked, but I'm getting used to this.  Last winter I drove to the ER for similar symptoms, but this is the third episode this year.  Instead, I monitored my symptoms with a peak flow meter, finding solace in watching it improve to normal within half-an-hour of puffing my inhaler. Netflix further calmed my nerves until daybreak.    

No pillowtop, no comforter, not even genetically engineered wicker sheets, just couch and Netflix when my alarm went off Thursday.  Sleepy-eyed, I zombied my way through another shower and commute.  I spoke winded at patients who offered me their beds in exchange and eventually got to the end.  I told the clinic not to expect me back the next day... today.  As of yesterday it had been a two-day week, instead of the calenders version of four.   Monday was succinct and amazing, Tuewedursday was long and enduring. 

Today is Friday.  I stayed up again last night in order to anticipate the attacks, my peak flow dipping and raising in a waltz with my inhaler.  When the sun came up, I curled up next to David and Norma Jean.   After David left for work, I watched more Netflix, emptied the dishwasher and got back in bed, Norma Jean is currently snoring and softly warming my legs.  The week has been lost to a virus, old-man-lung and work, next week will be better.  It will be sunny, I will be healthy, the gay pride parade is that weekend and it's all going to be great.  One day at a time and I'm going to be done with residency and living a well-rounded life.  It will and must get better.

As proof, we picked out a new puppy today.  After a year, Norma Jean's parent dogs, Smiley and Fifi, had another litter and we will be getting Professor Guy Lavern Littleford, Dr. Norma Jean Littleford's little brother, pictures posted below.  We're very excited and he'll be arriving in early July, barring a testicular dissent issue.





David and Violet in Seward Park








Professor Guy Laverne Littleford

the week.

Tons of activity.
Doing P90x for at least an hour each workout.
Sore everyday.
A car alarm is going off outside.

Monday and Friday were long shifts.
730am to 930pm and 730am overnight to 9am the next day.
Other days were by contrast shorter.
Tuesday crows kept me awake from the crack of dawn.

Hiked poopoo point.
2000ft up, 4 miles roundtrip.
Hard but worth it.
A thunderstorm got me wet.

Watched the world cup drunk with coworkers today.
3 scoops vanilla frozen custard with peanut butter, hot fudge and whip cream.
Sunbathed in the park after.
Norma Jean shit on the floor when I got home.




2 archive blogs today:

DONE!!!!
them

Norma Jean

the sun

In good new blog form, I am excited about my new venue for self expression and want to post again. You know, until I get lazy and something less interesting to me now peaks my interest later. That said, here I go, here I go, here I go again, girls what's my weakness? BLOG.

Its 11am. Today's the first day I've gotten to sleep in since last weekend. Only in my mind it feels like everybody else gets to sleep in all day everyday and I'm the only one who ever has to wake up early. I'm the martyr and everyone else's bliss is my torture.

Sunday and Monday nights I worked 9pm to 9am at the hospital. So Friday and Saturday before, I went out late with my friends Melissa and Brian to try to adjust my sleep-wake schedule. Melissa and Brian are a brother and sister duo that I met on Myspace circa 2004. I commented on Melissa's Myspace page back then because she looked pretty and was drinking a cup of tea. Ever since that photo comment, our 21st-century internet friendship has developed into an every-other-century amazing real-life friendship. Thank you internet and thanks Melissa for being so bold. The summer Myspace found me and I met Melissa was also the beginning to another chapter in my life that I want to write volumes about sometime. It was the summer that I moved to Phoenix to start the chapter titled Medical School. Since I don't have time to write about medical school, I'll just relive my first experiences dating Phoenix's sun.

Immediately upon moving to Phoenix I was introduced to it's sun. He was there when I arrived in spring. He's there when everyone arrives, it's his way. He greeted me with crisp, cool breezes. This was in contrast to my ex-boyfriend at the time, Tampa's sun who came with baggage: three thousand percent lung-choking humidity. Phoenix's spring sun also provided color contrast to the mountains and clouds. Royal blue set against the burlap brown ridges and whitest of white clouds. In Tampa, the scenery always seems dulled by water laden air and haze. It had a beauty to it, but it was foreign and I-just-wasn't-that-into-him. Not so with Phoenix's sun. He seemed so familiar, like we'd dated before. I remembered him from my youth in Seattle. He was warming, but not too warm, present, but somehow smaller in the big west sky. Something about sharper colors makes objects in the sky seem smaller to me. He also set in the same way. Though behind different mountains, Phoenix's sunset carried the same pinks and purples of home which darkened slowly to bright stars. Tampa sun always set to unfamiliar easter pastels and darkened quickly to pail blue with barely visible by stars. Phoenix's sun welcomed me with wide arms and I leaped into them. Then came our winter.

In a normal novel, the jubilant summer of a relationship cools into a fall of discontent followed by a frigid winter breakup. My relationship with Phoenix's sun is remembered with the seasonal clock shifted. Our summer was spring. Our winter was actual summer.

When I moved to Phoenix it was into my grandparents' 20-foot long 5th wheel that they let me borrow until I found permanent housing. They live in Yuma (still) and retired the trailer for traveling when they turned eighty-five. It was living in these close quarters that my relationship with Phoenix's sun began to sour. He turned up the heat - to 120 degrees.

On the trailer park clothing lines, he knowingly let me bleach the sunny side of my clothes after drying them 30-minutes too long in his care. He would force me to take the clothes off immediately after hanging.   Incredibly, they were already dry and again if I didn't, he'd throw bleach on them. He also used to wake me up sweating. He turned the RV into a 20-foot long metal rotisserie. I learned to accommodate him by swimming several times each day in an overheated-by-him pool just to "cool off." After which I would shower with ducked head in the cramped RV plastic shower-coffin using only cold water in order to acclimate to the sweltering air. The heat and shower humidity always brought sour memories of my ex, Tampa's sun.

Phoenix's sun was also cruel to his ex's. In that RV graveyard, my temporary home sat parked next to his lost loves. Fifty-year-old petrified mobile homes containing even older petrified people who once cared for him. Now, their marriages with him survived only by blackening the windows so thick with insulation that they couldn't see each other. His spouses never went outside unless they had to. Even then, they would shade their face with big hats and glasses so as not to see him, much of their skin scarred with scaly pink cancers. They served as a constant reminder of what a relationship with him could mean if I stayed. Ultimately our love had to end during the rolling brown-outs. Phoenix didn't have enough electricity that summer to power everyone's homes. L.A. was also experiencing the same problem that year. I came home one day to a note posted on my rotisserie that said, "Due to overwhelming electricity demand and a recent transformer fire your power will be turned off" and it listed a date and time. That date came.

While my previous description makes it seem like I had no climate control, I did. The RV A/C was our battered child. She choked and coughed on my roof through Phoenix's dust and did her best to blow something less than 120 degrees into the RV. She struggled so hard that I had to divide the RV in half with a sheet just to keep a small part remotely comfortable. Sadly, our other lovechild, the fridge, was on the wrong side of the sheet and curdled milk like he was a microwave. Well, when the power finally turned off and our neglected child-on-the-roof went silent it was time for my relationship with Phoenix's sun to be over. The rotisserie had been upgraded to a convection oven.

It was a good run for those few months. And like anything that reminds you of home when you've been gone so heart-wrenchingly long, it felt so comforting while it lasted. He made my move to Phoenix much easier and gave me a reason to be excited to look up again, especially after my previous relationship with Tampa's Sun. Ultimately what he taught me though, was that I have more hope in my little finger than his sunburnt, petrified ex's do in their entire lives. Many of those people are probably still living in that RV graveyard if they're not already dead. For me, it was only six months.

As I look out the window now at the comparatively melancholy, well-shaded sun of Seattle I think of how far I've come. Seattle's sun is cool, often absent and seems to have a lot else on his agenda besides hanging out with me. Perhaps he suffers seasonal depression too. We will never be able to play the way we did when we were both young, but I still love him and always will. He was after all, my first sun love.
~~~

I wonder if I'm ever going to wake up early not feeling like life's martyr. In telling these stories and remembering how far I've come, I hope that I can live with more perspective and recognize just how lucky I am. I already feel better after writing this and want to run outside with my arms in the air screaming, "Thank you!" I probably won't and I'm not dressed, but just in case, you should come over to my corner. It could be interesting. Thanks for reading.

Related archive: hell, paradise

It's Settled

Today's the day I begin cataloging my life as more than just status updates, a new blog is born. I once blogged on Myspace ages ago, when people wore shirts of the same name and friendship rivalry spawned over who was in your top 8. Now, myspace is dead, much like my love of "the literal" and its time to journal my memories somewhere else, lest I forget them forever.

With that said, this is a place for me to look back on my experiences when I'm senile and for others to comment, thus motivating me to continue to post. Think of it like The Notebook meets the Truman Show if all the characters were in on it. As I post THE FUTURE I will bring in blogs from THE PAST and try to upload them with the right date. Expect a 2-4 year gap from when I wasn't blogging at all. Who knows, maybe I'll figure a way to post what I remember of the IN-BETWEEN-TIME with corresponding dates as well.

There will be no rules, except one: my grammar will deteriorate. I am a disgusting open trash can of details without a lid. My previous blog was titled "Train-wreck." Here goes nothing. Wish me luck. AND for good measure I will post an old entry today.

Archive: why i keep myspace

this is an email i just received from someone i haven't talked to in over a decade.

a long long time ago.
is this the same justin that lived in issaquah, wa in the four creeks development and one summer you, sarah and i took turns making out in a tent in my front yard?


if so, this is kathryn. i dont know if you even remember me, but that summer lingers in the back of my mind. ha ha. we were such weird little kids.

also if this is still you, how is your sister? she was the first person i smoked pot with. i was in the 5th grade. she was pretty cool.
~~~

Addendum 6/5/10: 
That was the summer of 1991 or 1992. You remember the year, when little homosexual boys made out with heterosexual girls by the handful, in tents, as if the action wasn't a mental interest-only loan. Needless to say, that bubble has long burst. I was only about eleven years old and completely naive about my sexuality. I knew nothing. That summer's learning uncovered age-related earth shattering conclusions such as that an erection didn't mean that I had to pee. The reality of ejaculation wouldn't be learned until a romantic evening with a jetted tub during a family vacation in Whistler. There was no discovery that year, however, that what I really preferred was a throbbing penis to a moist vagina.


The reality is that the majority of that summer was spent perched atop the narrow brick pillars at the entrance of our neighborhood. Sarah and I balanced, peeking over her backyard fence into her parents' bedroom trying to figure out just how sex was done. We would talk about whatever eleven-year-old peeping tom's talked about for hours on end while we waited. When the glorious moment finally came, it was a complete guessing game. It took place half a football field away, entirely under sheets and was lit by the only streetlight in the neighborhood. The only thing that was certain was that a lot of heavy petting and making out was involved. From there, we took to the tent.


In hindsight I'm not sure we were "such weird little kids." In my sentiment I like to imagine American youth as all being like us during that moment of sexual discovery, balancing on pillars in the dark, getting it all wrong, and having to pee.

Archive: DONE!!!!

OMG. 20 years of school total. For the first time in my life I am done with school. Yesterday was my last day of medical school. All of my tests are passed and I am DONE!!!!

Archive: two new videos: camping and amy (belle) winehouse

i find myself with an unexpected week off in nyc.  aside from seeing sites, i have used some of this time to make videos that i've been waiting to do for a few months.  the first is of david and i camping at penrose point state park this last summer.  the music is sung by david little with his college a capella group.  the second video explains itself.  the girl, belle, we used to babysit weekly.

1.