Snowed IN Rank list

I have been blog slacking…mostly because I have been living in my car for the last 3 weeks interviewing all over for my peds residency. Its been quite the ride. I loved some programs, hated some programs, had a fender bender, driven over 2500+ miles on my car and been in 10 states.I listened to 2/3rds of my Lord of the Rings on Audiobook unabridged that should indicate how much of my life has been in the car.  sigh. On top of that craziness in the middle I got a call from a top program that I had not heard from saying there was a computer glitch….I canceled an interview to fit them in.  I also bought a plane ticket so I could go from Texas to NC to VA to Ohio in less than 36 hours.

Now I am on Day 3 of being snowed in under two feet of snow at my Parents’ house in the Blue Ridge Mts. The valley roads are ok but for some gosh awful reason no snow plow has come up the mountain.  I missed Hopkins because of the snow.

I can honestly say I am ready to leave Wake Forest after interviewing all over. Its been a great, great home for college and medical school but I am ready for a change. And their peds program is just not global health minded.  Thats the main conclusion I have at this point. I have some favorite programs but not for the same reasons and its hard to shake out a rank list.  But here is my opinions….if you are curious….

I interviewed at the following: Wake, Emory, UVA, Duke, Vanderbilt in TN, Cincinnati Children’s (the late addition), Baylor in TX, Pittsburgh.And yes there are now to be LORD OF THE RINGS analogies mostly because I feel odd publishing my rank list on the internet…but if you try you can figure it out.

The Shire-beautiful facilities, familiar, nice people who mostly want to live in the shire forever.  q 4 call for 5 months. Good electronic medical records (EMR).  home  for me yet not home forever.

Helm’s Deep-Rural, mountains,  horses, close to parents, surprisingly nice global health program, not nice facilities, q4 call for 6 months. Close to wheelchair skiing. Would actually have to eat my ACC liver and be hated by my family to go (just kidding!).  crappy EMR (no notes). nice people.

Isengard-has hospital symbol that looks like Isengard. would seriously have to wear my black/gold tie-dye shirt every day of basketball season to not feel like a traitor and will be hated by all my friends from college (Not actually kidding)..  nice people, close to Rohan (parents’ home), close to the Shire. q3-4,no golden weekends (UGH!!). not nice facilities, hard to navigate on pony (or wheelchair).  Very controlled and structured global health program.  Did I mention I would have to sell my soul?

Minas Morgul: Cold, dark. Not terribly far from Rohan (6hrs) but have to go through the Morgul Vale roads (state just West of Rohan) to get there. People are super nice. Beautiful facilities, best advocacy program of anywhere.  Global health is not really set up but very open and int med program is set up. But would have to live in cold, dark city that I almost died in (fender bender).

Minas Tirth: FUN, FUN, warm city. although all the issues of a city, lots of traffic, expensive, occasional flying monster, etc.  nice people, amazing global health, HQ of the CDC, flexible first year elective, shift work (no call except in community hospital), incredibly diverse patient population.  Direct flight to parents’ city in Rohan. EMR!!!!!!! Big downside: two hospitals 15 mins away in city traffic regularly. Good friends live there!!!

Rivenedale: Close to mountains but fun city.  Cheaper than Minas Tirth.  A couple of friends live here too.  Q4 call for 8 mons BUT early check out system, go home by 2PM. AMAZING EMR!!!!!!!!!! (maybe better than the Shire in some ways).  Was interviewed by health commissioner of the state who is a pediatrician, a christian and really cool lady who told me about all the amazing advoacy opps in the area. Could have a second clinic that focused on refugees and international adoption as a second year.  Flexible not hugely structured but active global health program. CHRISTMAS BREAK!!!!! (unlike Edoras)

Edoras: The Golden Hall, ridiculously highly ranked pediatrics program (always in the top 3 in everything) but sort in the middle of no where. Would also require crossing the Morgul Vale (hard in the winter from the Rohan village my parents live in) and NO CHRISTMAS or NEW YEARS time off.  Global health program is FANTASTIC including 2-3 months of PAID TIME OVERSEAS!!, journal club, really active group. The head of the GH program interviewed me, super nice, worked with people I am working with in Kenya, and told me I could do my contunity clinic in a faith based clinic among the poor in the city.  Plus among the best pediatric training in the country and I think they liked me. Downside: In the airport they sell shirts that say Edoras: our cows are made for tipping and no Christmas/New Years with my family for 3 years.  No direct flights to Rohan.

Far, far, far away:  HUGE, SCARY, MASSIVE medical center that is bigger than the city the SHIRE is in.  But is home to the pediatric AIDS corp and have a global health residency that allows you to take an extra paid year to work with pediatric AIDS corp. Got to meet the guy who founded the AIDS corp and really enjoyed talking global health. Have dear, dear friends there and family a couple hours a way. But far, far, far from Rohan and the program is a little overwhelming by pony (wheelchair).  Super nice people though wish it was somewhere closer.

SO Current Rank list:

Fighting for 1 and 2-Edoras and Rivendale

3-Minas Tirth

4-6 Shire? Far, Far Away?  Helm’s Deep?

7-8 Isengard,  Minas Morgul

Thoughts?  (other than the fact that I am big nerd with this LOR stuff)

the neverending story….

The first few months of 1994 had an epicenter: March 31, 1994.  I was 9 and on Jan 14  of that year I had undergone bilateral femur, tibia osteomonies (translation: they cut and broke my legs in three places at the hip, knee and ankle and nailed it back together….translation: legal form of human torture in the name of pain relief…).

It snowed a blizzard the night of the 14th the snow drifts were higher than my sister’s head (she was 3). It was so cold that my parents, sisters and a giant Amish family kept been awoken in the night at the Ronaold McDonald House by frequent fire alarms. They would shuffle out in their PJs, coats and hats and wait for the Delaware fire department to arrive and try not to gawk at Amish nightgowns and winter coats.

Meanwhile I was awoken as well…. in the PICU with hives in a body cast. They thought it was my epidural so they took that out in the middle of the night while the blizzard winds whirled outside.  The Anesthesia resident got woken up four times before they did it…poor guy.   My Grandfather (ever the Top Gun) flew in late that evening somehow to Dover AFB and surprised us all.  I have been told it didn’t happen like this but I remember him walking into the ICU room in his US Navy black and gold winter coat (they swear he was in civilian clothes but my morphine drugged mind remembers this)  .    My grandfather and Dad took the night watches so my grandmother and Mom could sleep and take care of the little girls.  (which turned out to be a snow drill with the Amish times three).

My Dad sang Kum-by-ya to me in the wee hours of the morning once the epidural morphine began to fade and six new fractures and numerous nails started to throb…

and that was just the first night of a 14 day hospital stay. and the first night that I counted the days till March 31.

That the day the body cast came off. I counted the days the whole 10 weeks. We drove up there, they took me to the cast room and sawed me out in about an hour.   My legs were scaly, hairy and now dotted with fresh scars. I had not sat up in ten weeks. To transport me to x-ray they needed to transfer to the wheelchair from the high cast table. They picked me up gently but gravity failed me…I screamed as I came to an almost sitting position in mid-air. My body seared with pain at a position it knew no more.

Turned out the bones still had not healed.  i was not ready for freedom. they hollowed out my cast and made it into a splint which I went home in.  I was devastated.  March 31 turned out to be a terrible disappointment.

Nov 23, 2009.  10 weeks after  total hip replacement (translation: they cut out the top of my thigh bone and jammed a large piece of plastic into the rest of my thigh bone and into my hip socket…translation: more human torture in the name of pain relief).  10 weeks ago I discovered Nov 23 was the end of  the dreaded  hip precautions.  disappointing yet again. I can’t touch my toes…heck I can barely touch my knees. My hips are tight and resistant to the idea that they should now go back to doing what they did 10 weeks ago and more.  My therapist doubled my stretching in honor of the occasion. I came home soaked in a tub for an hour and still feel like my hip flexors are made of cement.

you would think i would learn to expect less…to expect no miracles but rather that all freedom especially orthopedic freedom is not free.  (if only the surgeons understood this).

yet again disappointing. really these surgeons  for all their confidence are more trouble than they are worth at times.

the uglies

everyone seems to like listening to my life stories. the little gimpy kid with the disease no one has ever heard of growing up and becoming a doctor has a nice ring to it.  the stuff on my resume makes me look smart, sane, mature.

but in reality most of it is a facade. none of it is untrue but putting it all in bullet points on a sheet of paper cuts out all the details.  no body likes the details.

the details are ugly. everyone wants to know how my surgery went. but everyone wants me to say it went great. everyone wants to know what being a disable medical student is like but everyone wants me to say its been swell.

I just had a surgery that was basically palliative care. it didn’t cure my disease it kept me from pulling my hair out because I can’t sit still because of the the pain. but the truth is yeah the actual four hours of the surgery went well but physical therapy is a bit of a disaster.  i have what appears to be a three to five year old flexion contracture that is not only tough as nails but if it doesn’t get better is going to wear the prosthesis down much faster than usual (which basically knocks off years of walking).  No one diagnosed this crucial fact…one has to wonder what role it played in the hip pain the first place. no one wants to hear from the little medical student that her transition from pediatric to adult medicine has been fraught with peril, that the adult orthopods are not only ignorant about her pediatric disease but too arrogant to admit it.  I suffer for it not them.

I am getting up at 5 AM, rounding on patients I do not know half the time, writing notes either observing (as in not touching) in the OR or occasionally interacting in clinic till 5PM when I go to PT and get pushed on till I finally get to go home by 6:30 and then repeat. today i repeated plus SWINE FLU.

then I try to prepare for things like my interview on Friday, fall asleep on my computer and then wake up in the middle of the night and worry about the flexion contracture that gives me muscle spasm cramps randomly and frequently that leave me begging for tramdol and has not moved a single degree in the last three weeks.

no one wants to hear that some times I come home and I cry with frustration and pain. no one wants to hear about how some days I absolutely hate my chosen profession not just because it has so few answers for me but because  no one have the balls to admit they have no answers.  Good gosh people just tell it like it is. do you think I somehow don’t know that it sucks?

no see that doesn’t sound all that inspirational now does it…

H1N1-Swine Flu is Overrated

2000 deaths a day nearly all children.

853,000 pediatric deaths a year.

this is not swine flu.

this is a disease that is completely curable.  it also doesn’t exist in the developed world.

Malaria.

lets compare shall we…

Swine flu has caused 6250 deaths since April ‘09.

3,900 Americans. **

thats the kicker.

80-90% of the malaria deaths are in Africa.

so the next time you see one of those glossy articles about swine flu or five minutes spots about just how bad swine flu is..think about the value of a life.

Every three days the same number of children die as all the swine flu deaths combined.

Does the life of an American child mean more than the life of an African child?

You know the answer to that question and you also know that CNN is never going to report about in a glossy five minute media spot.  Because no one likes to know about dying children

It so much easier to forget they exist.

I too am guilty of this. For the last six months I have taken notes in lectures, carefully masked and gowned and prayed that my little patients would not end up in the ICU.

I took the h1n1 vaccine along with my other classmates three weeks ago.***  We have been chosen, our young age, our knowledge, the investment the state of NC and the federal government has made in us and our daily exposure makes us first in the line at our hospital even over residents and attendings.

Yesterday I was all in a tizzy because I woke up with a fever, body aches, cough, sore throat and my roommate is recovering from swine flu. Student Health was all in a tizzy too as they listened to my history and promptly wrote me a script a 120 dollar script (20 dollars with insurance) for tamiflu.  I am faithfully taking the drug.

Its not what I am doing is wrong. I just can’t help but wonder what kind of difference we could make in saving the lives of children if we had the backing that swine flu has.

What if for every dollar we spent on swine flu, we sent a penny to Africa for malaria cures?  How many lives would we change? save?

Does a death require less grief if no one knows it happens? Or can we be held accountable for the lives we could save and don’t?

I shudder to think of God’s justice and how much it pales our own man made justice.

Somehow I doubt he is going to buy the whole tree falls in a forest with no one to hear the sound excuse….

**(right NOW swine flu is spreading to the developing world more and more, Ukraine and Mongolia are facing huge numbers with the disease. In Mongolia the WHO fears it could overwhelm their health care system but for the last six months while all the money has been spent, all the decisions have been made its been a developed nation disease…I wonder how many vaccines are being sent to Mongolia???)

***(there is a 2-5wk window period for the vaccine to give you full immunity, my roomie got sick at the end of week 2 so I was not fully immune yet)

Desperate housewives….

Biblical WOMANHOOD????????????????

Correct me if I am wrong but could someone please tell me about a woman in the bible who looked like an American, fundamentalist housewife sterotype?  I can think of perhaps of two Mary the mother of Jesus and Martha.  Mary had a child out of wed lock in a culture that would stone her for it.  (um ok so maybe not like an American house wife) Jesus came to visit Martha’s family and he praised her sister Mary for not cooking dinner but sitting and talking theology with Jesus and scolded Mary for doing housework rather than learning…(not exactly a role model…)

The women that bible speaks most highly of look NOTHING like American housewives: Tamar fought domestic violence, Sarah became the mother of an entire nation/people group, Deborah was a judge and a warrior, Esther was a shrewd politician and a queen, Ruth was a caregiver and the sole  breadwinner (no pun intended) for an elderly relative (she also went and lay in a man’s bed who she was in love with to tell him her feelings for him..),  Rahab was a prostitute who descendant was Jesus,  Elizabeth proved the impossible, Mary gave birth to a child outside of marriage in a culture that would stone her for it, Joanna and Susanna ministered to Jesus, Mary (sister of Martha) listened and discussed theology with Jesus,  Mary Magdalene was a prostitute whose enduring story teaches us about grace and who also was among the only followers who were fearless enough to go to Christ’s tomb after his death, Aquila  made tents and may have been one of the first missionaries, Lydia was a wealthy, successful businesswoman who was the first European known to accept Christ she along with Phoebe were leaders in the early church….

Come to think of it maybe Paige Patterson is on to something.  The women today have indeed lost sense of biblical womanhood.  Could you imagine what the world would be like if every woman who follows Christ actually lived like these women did? (OR a if a few good men did too?)

Could you imagine a woman would shrewdly crush the head of a foreign general (either figuratively or literally, diplomatically)? Or could you imagine a woman so strong and wise that a general refuses to go to battle without her? Could you imagine if there was a woman like Esther who would go before the governments of nations where genocides, other hate crimes or gross human rights violations are happening and convince them to stop? Could you imagine if women would support their elderly, widowed family members like Ruth rather than sending them to nursing homes or griping about them?  Could you imagine if women of the world fought back against violence toward women and children like Tamar? Could you imagine if the women of the world embraced the children born unplanned or unwanted? Could you imagine if women in nations where there is no freedom of religion quietly yet openly worshiped and ministered like the women at the tomb?  Could you imagine if women stepped up as leaders yes pastors, ministers, teachers in places where there is no faith or where faith has died?

How different would our churches be?

How different would our families be?

How different would our world be?

…if every woman got up from the mud of our world that exploits women and their bodies and brushed off the  dirt of centuries of fear and ignorance  hidden in church tradition but lacking biblical substance and embraced her calling…whatever that calling may be from motherhood (yes even the stay at home kind…love ya MOM!) to ministry to beyond.

how desperate our world is for biblical womanhood….how desperate…