In 2013, I ...

... survived a 2,122 mile road trip with my mom.
... survived another 926 mile road trip by myself. 
... flew 55,032 miles.
... conducted some pretty exciting research and created life-long mentors.
... presented said research at 3 different conferences.
... had frivolous fun during the research year. 
... read A LOT of books (thanks to checking out kindle books from the public library).
... completed a whole bunch of knitting projects!
... watched my classmates match into residency and graduate medical school.
... had my heart broken into splinters.
... finally, after over 6 months, am beginning to feel my heart mend.
... celebrated with multiple friends as they [finally] gave birth to very much desired babies.
... grew comfortable riding a bike and then completed a 70 mile bike ride.
... moved back to the South, and found it better than I remembered. 
... reconnected with old friends and made many new ones.
... embraced the last full year of my 20s. 
... stepped out of myself and took chances  - with mixed outcomes.
... began to internalize and eagerly anticipate the excitement that 2014 promises!

Happy New Year ya'll!  May 2014 be full of blessings and dreams come true!

Pride

I was sitting in the car this afternoon with my mom on the way home from the airport (I'm home for a quick weekend between finishing my research year and resuming MS4), when she retold a story about an encounter that happened this week where someone wanted her to sign a "gay rights" petition.   She retold how she told the organizer "yes, I support gay rights, my daughter's gay."  

I've been out to here for 13 years and never once have I heard her say those words.  What a long way we've come...

Happy pride ya'll!  Instead of going to dyke march & pride, I'm spending this shabbos resting and enjoying some quiet time (& kick the cold that has been trying to attack all week).  The next 11 weeks are going to bring a whole heck of a lot of transition back to med school and being my best on away rotations.  Time to rest up before the fun begins!

The wheels on the bike go round and round

I did it!  I rode 65 miles on my bicycle over the past 2 days.  Sure, I walked some hills, and swore as I struggled to ride up others, but I still managed to do it!  I gained confidence on the downhills and learned to appreciate the modernity of flat roads through cow pastures.  There was only one small, almost comedic, fall off the bike on the second day when I was way past exhausted.   And you want to know what?  I got up and rode 16 more miles afterwards. 

All and all it was a beautiful weekend and a successful ride.  I challenged myself to do something I never really could have imagine doing before.  I gained confidence on my bicycle.  I embraced being completely cut off from cell service and email for a full 3 days.  I ate copious amounts of delicious food that was very locally produced and cooked with intention, in a room full of Jewish environmentalist.   I led a tisch Friday night that filled my spirits with songs, torah, and blessings.

At one point over shabbat, I realized that I was very much surrounded by the community that I have built over this past year.  This research year really has brought a lot of unexpected joy and connection.  Such a wondrous experience to end a year of personal growth.  I feel so very grateful.  Sore.  And grateful. 

Now, what next big ride should I train for next? 

Goal: stay up right, don't get hurt

The charity bike ride is this weekend.  It will be the biggest physical challenge I think I’ve ever attempted.  That is assuming that I ride more than 20 miles.  Therefore, I’m terrified.  I am so touched that my friends and family have donated so much money to support me, which I interpret to be either because they believe I can do it or they are in shock that I’m even trying. 
 

Seeing as I was basically a non-bike rider at the start of this (not learning to ride a bike until I was 19, never having ridden more than 2 or 3 miles at a time, and not having been on a bike in 3 or 4 years) I have 2 main goals:

1)      Stay on my bike

2)      Don’t get hurt

Actually, as long as I don’t get hurt, I’m not really sure staying on my bike is even that important.  The full ride is either 80 miles or a 120 depending on the course you choose.  My housemates are all doing the shorter 80 mile option and so that’s what I’m planning on too.  Even if I only make it one day, 40 miles, that will still be a new achievement for me.  Need to focus on small victories and not be disappointed when I don’t complete all 120 miles… that can be next time, right?

I just want to have fun.  Really, I want to not be anxious about this ride and to have fun.  Sun, endorphins, friendship & comradely, a post-ride massage scheduled – this really could be fun! 

7.7!

While not the best number ever, and not even the goal, I'm proud to announce that my A1C last week was 7.7!  This is 0.7 lower than it was at my last visit.  In fact, lower than it has been since I started medical school!  It's been a long time since I've had my A1C in the 7s...

Controlling my diabetes in medical school has been challenging at best.  I don't test my blood sugar nearly enough.  I keep myself slightly high on the wards out of fear for hypoglycemic episodes while dealing with patients or in surgery, or just fear of taking out my pump to bolus in front of residents and attendings.  I don't change my pump often enough and therefore have a higher than average rate of kinked tubes, pulled out sites from tape giving up, and ketonic episodes. I use expired insulin because I don't have time or energy to refill my prescription.  Stress alone bumps up my numbers because of excess cortisol release.  Basically, I am so busy trying to learn to take care of others' health that I neglect my own. 

But, oh, at last!  The golden 7.0 A1C is in sight!  The even more allusive 6.0 [in order to contemplate pregnancy] is right beyond it.*  Between ordering a shinny new continuous glucose monitor (that I hopefully wont be allergic to), a new bicycle to exercise on, and adopting a low-er carb diet... I guess we'll just have to see what my next  A1C has to say for itself.

*Not that I intend to get pregnant right now, or anytime in the near future. But it might be on my 5-10 year plan... It better be, after all, I'm already 28 and well aware of the risks involved with increasing egg age.

Ugh!

That moment when you have a brilliant and inspired research idea, only to search google scholar/pubmed/etc to find that it has already been done,  and done exactly the way you wanted to do it.  Ugh! is both validated that it was a good enough idea to be published and yet disappointed that someone beat me to the punch. 

2013, mixed feelings

I have totally mixed feelings about this New Year.  2012 was an emotional roller-coaster.  The death of my grandmother, a rather jarring car accident, 2 trips to the Emergency room (as a patient), all the emotions of 3rd year clerkship, a hard break-up, then meeting someone new (and extraordinary), deciding to take a research year, moving to a new state, 2 cross country road trips, a trip to India... it has been a BIG and overwhelming year.

2013 was supposed to be the year I graduated medical school.  A huge part of me wishes it still would be the year I graduate medical school.  Instead, it is now becoming the year I figure out 4th year electives, begin residency applications, and try to *hopefully* get a publication out of all this research.  Ideally it will also be a year full of seeing my family, nurturing my relationship, taking better care of my health, and finding time to have fun.  Maybe I'll also make some art and learn some Spanish. 

And the nightmares begin...

I had my first residency nightmare last night.  I don't remember all of it but there was an element of not getting ob/gyn interviews, having apply in another specialty I don't want to apply in, and not knowing what specialty I was going to match into come match day.  There were also lots of tears shed in the dream.  What in the world does crying in one's dream mean?!

It doesn't help that today was another interview day for the program I'm spending my year with.  The marching line of black suits, my peers, flowing throughout my daily rituals at work were a constant reminder that I'm not there yet and have so much longer to deal with uncertainty...  After spending his year with some of the top, best, and brightest in ob, I'm going to feel pretty awful if I end up unable to match.  BUT, I have a year plus to go.  I sure as hell better not be having these nightmares straight through until March 2014! 

In other news, I need to learn Spanish.  Or remember the Spanish I used to know plus learn some medical terminology. Something.  It is a huge goal for this year and while I'm nearly halfway through my research year, I haven't even begun.  All the residents here speak Spanish.  I think I can, I think I can, I'm [not so sure] I can...

What a difference 4 years makes

Election night 2008 is a vivid night in my memory.  I arrived back at my house around 6 or 7pm from 2 long days of medical school interviews to find a house full of friends watching the TV and an envelope from a school I had recently interviewed at.  I opened my first acceptance letter surrounded by the love of my community and with the optimism of change in the air.  The night was spent intensely watching returns, having both light hearted & deep conversations, coloring in maps, and day dreaming about what the future would hold.  I went to sleep with the certainty of Obama’s victory and my long awaited admissions ticket to medical school in the fall. 

[However, learning about the prop 8 results when I woke the next morning was heartbreaking and felt like a personal attack.  And now, 4 years later, we’re still trying to untangle the mess it created.  Hopefully, tonight’s vote on marriage have an opposite outcome as prop 8 did.]

4 years later, I am wrapping up medical school.  I would be on the interview trail again right now had I not elected to take this year for research.  I am anxiously awaiting the news tonight will bring in a new city with a new community.  I am uncertain about my future – about what our healthcare system will look like tomorrow and how it will affect my career.  While the economy is likely to continue to improve (assuming we don’t start another war), healthcare, women’s reproductive rights, and queer communities in the United States are resting on a precarious ledge. I pray that I go to bed tonight with the same optimism and certainty that I did 4 years ago. 

Health care blues

We had a discussion yesterday on the Affordable Care Act and how it affects women's health care, especially contraception.  I left the talk totally depressed.  This was further amplified by watching the 3rd presidential debate last night. 

I recognize that the ACA is not perfect, but it is a HUGE step towards affordable and comprehensive health care in this country. I believe that health care is a right, not a privilege.  I also know that we can not continue to afford the rising cost of health care as we can't even currently afford it.  I'm sickened by the fact that politicians play political chess with people's health.  I can not understand that level of disregard for another humans welfare; but I guess that is why they are politicians and I'm a (future) health care provider.

In the discussion yesterday, we were shown a slide from the New England Journal of Medicine article "A watershed election for health care (2012)".  The chart dives up the likely results to the ACA depending on the election outcomes.  It is no shock that Romney winning would be a very large step back for health care in the US (a long with LGBT rights, abortion rights, and so many other things), but what did give me pause was what happens if Obama is reelected with a republican house and senate.  "Maintenance of near pre-ACA levels of uninsured Americans; no substantial growth in levels.  Less aggressive implementation of ACA health system provisions".  Shit.  So basically more political chess with people's lives at stake.  Nothing will be accomplished, will still be stuck in the middle of nowhere.  Lovely.

Needless to say, I'm very worried about this election.

I am also so grateful to be an insured American with unlimited access to quality care. This year off from medical school has been full of many more doctors' visits than I would have imagined. After the horrible car accident with trip to the emergency room this summer, I'm now dealing with a whiplash, a pinched nerve (upper trunk of my brachial plexus), and radiculopathy. Weekly chiropractor appointments in attempts to fix that. I'm also finally address my chronic anemia, fatigue, and constant general yuckyness by figuring out the trigger. A round of visits to a GI and a abdominal CT have ruled out my celiac as the culprit. [Even if I did read my CT as having a "speckled colon and a titled uterus" - thankfully a radiologist who actually knew what he was reading righted my incorrect paranoid diagnosis.] Good to know that I'm not being accidentally glutened. The GI's answer to this was that I'm probably allergic to something (or many somethings) and so I should take a low level steroid to blunt my immune system. Um, no thanks. I'd rather just figure out what the cause is so that I can avoid it. So, today I am finally getting much need allergy testing. Thank G!d that my comprehensive trusty health care insurance is along for the ride.

Existential Crisis

My research year has started like this: 4 weeks of work (in which my grandmother died & my car was totaled), followed by 2 weeks abroad for a conference, followed by a week road trip with my girlfriend. 

This week was my first week back, and the first week where it became clear that I'm here to stay, at least for the year anyway.  This week was also slow.  Painfully slow.  S-L-O-W.  I felt like I wasted hour after hour, day after day, doing absolutely nothing productive.  Research projects are in various stages of stagnation for various reasons- mostly sitting on other peoples' desks waiting for their necessary contribution.  I know, I know, this is the way research rolls.

Too much free time spent surfing the inter-webs meant that I began questioning my decisions.  Why did I decide to take a year off?  What if waste this whole year and get nothing accomplished?  What if I walk away with no abstracts and no manuscripts, nothing tangible to show for my year?  How many hours can I really spend on facebook, words with friends, and the sudoku app before I kill myself from going stir crazy?  I'm just slowing down my life- an extra year before I potential don't match in OB (even having taken a research year), another year in a long distance relationship (if it survives distance) with a megaphone of a biological clock, another year before I can settle down in one city and actually began making a real community... another damn year!

I'm still hoping this was the right choice.  The opportunity to live in a kick ass city.  A year to have some free time with priorities on improving my health and learning Spanish before residency.  Maybe I'll finally get around to fine-tuning my basal rates after 16 years on an Insulin pump!  A chance to reconnect with my Jewish identity.  A chance to engage in some pretty novel, and interesting, research with some of the best in the field. 

For now though, I'm hoping a restful shabbos will silence my existential questioning.

White [coat] privilege

Today I learned that medical students are not actually the lowest rung on the totem pole.  Research assistants happen to fall below them.  I became acutely aware of patients not wanting to me around and of staff feeling similarly.  It's funny though- nothing has changed about who I am, how I interact with everyone, my attitude, and my attempts to be helpful.  The staff very much knows that I just completed my 3rd year of medical school.  This being very much an academic institution, they are very aware of what that means, and that it puts me at the education level of a sub-i.  All that has changed is that I'm not wearing my white coat and my badge now reads "research assistant". 

I can't help but ponder why this is.  Is it that they're protecting their own students' education first?  Is it that they don't yet know and trust me?  Or, is it that people are just afraid of and/or intimidated by the white coat, and that we take full advantage of the privilege and authoritative knowledge that comes with it?  If so, how do we best own & deconstruct this privilege?

Let the research begin!

I had a weird dream last night about applying for a research year and realizing that I was running out of time and would graduate before I had the opportunity to do it.  There was a lot of anxiety in realizing that I had missed my opportunity to do funded research before getting my MD and moving on to residency. 

Then I woke up to remember that I'm actually here, now, starting my research year!  Sub-I was successfully completed (though evaluation of exactly how successful is still pending), cross country road trip accomplished, room unpacked, first shabbos in the new home experienced.  Side note:  shabbos here felt like the promised land: beautiful weather, a nap outside on the back porch, lots of lovely people, having excellent conversations, delicious local food, everything labeled gluten free.  Tomorrow I start work!  Now I just need to figure out how exactly I'm getting there in the morning.  I also need to figure out how not to make myself look like an idiot in front of some of the smartest/best/most accomplished academic OB/GYNs in the country.  So excited to see what this year brings!