2010: Year in Review

Time for my third annual "Year in Review" Post. Get your popcorn and diet soda and settle in for some nostalgia...

For those who like swimming in summaries, here lie 2008's and 2009's reviews. 2010 was indeed a memorable year. I started out in indentured servitude and am ending it in a very different, much more enjoyable place. (Aside from three obvious photos, pictures here are from the eventful month of December.)

Now, on to the very serious business of my annual month by month review, divided into the tidy categories of Uppers and Downers.

January: Rotation: ER, and the usual burden of "back-up". Downers: Slave labor in it's truest form. Scheduled to the max 6-7 days a week with little time to breathe, sleep, eat, care for myself. Uppers: A freak flooding rainstorm in the Southwest led to a canceled flight, a glorious weekend off (the only one for approx 12 weeks) and an engagement! Three cheers for happily ever after!

February: Rotation was NICU with q4 call. A meh rotation with lots of time sitting fully scrubbed and waiting for babies to get sick. Not the best time. Downers: My one golden weekend was a required residency retreat where I ended up getting food poisoning. Uppers: After recovering from said food poisoning my class won the TFM Talent show performing a song I wrote about a lost pager - it was a huge hit and lots of fun! Also, I enjoyed a post-call stuporous Valentine's Day dance with my fiance.

March: Rotation: Cardiology. Supposedly a break from all the call. Supposedly a break from working so many weekends (by March, aside from the freak storm and the work-related retreat, I had worked every weekend in 2010. Yes, I'm still bitter). Downers: due to coverage for other residents, official back-up duty, and my own laboring patients, I was still sleep-deprived and dearly missing my sweetie in Seattle. Uppers: I got to perform the 1812 overture with RCB, complete with [electronic] cannon fire! I managed a short escape to present at the AMSA conference. Passover Seder family reunion in San Fransisco! The Countdown Clock continued...

April: That was my "No Happy Bunnies" post, as you may recall. Rotation was in-patient family medicine. Downers: We were short-staffed and thanks to work, Karin and I missed out on our first anniversary and Honkfest, and I missed out on just about everything that makes Seattle Spring superawesome. I was still horseless and barely able to find time to play my trumpet. However there were Uppers: I groggily made one post-call Renegayde gig for the Roller Derby, and the month eventually ended. But the best upper was that it was the last month like that. Ever! The thrill of my last call was dampened by the fact that I was called in to cover more calls, but at the time I thought it was my last and I celebrated in style: Rounding on roller skates (as above).

May was a breath of fresh air! I finally had less back up and could use that vacation time! Downers: Not much. Just the surprise black weekend call after my much needed vacation, more residents down for the count and more chaos at TFM. Uppers: Band Camp! Vacation in buttery Minnesota! Sleep! Tick tick tick on the countdown calendar...

June was the last month of residency. It flew by. Rotation: Bastyr elective in Seattle. Downers: everything happened at once which was seriously stressful. But, all those things were overall pretty good (moving, the visits from my family, finishing residency). Uppers: Did I mention I finished residency? Moving in with Karin, Pride, Summer solstice festival, family. Oh, yeah, and as of midnight on 6/30 I finished residency! Woot! Countdown clock zero'ed out (I had two countdown clocks, one online and one on my iPod - the zeroed out one from my iPod is pictured at left)!

July: First month without an associated rotation since the month I had off between medschool and residency! Holy moly! Call it my rebound month. Downers: Board exams - ick. Some drama around RCB. Merging two households was way more stressful than I anticipated. At the end of the month the biggest downer was the death of a close family friend, as well. Uppers: OMG I got to do laundry! OMG! I got to do dishes! OMG I got to sleep in! OMG! I got to watch TV! Traveled to Boston for for a week for a GLMA Board Meeting. Rocked some parades with RCB. OMG I finished residency last month!

August: Oy. The biggest Downer occurred Sunday, August 1st: ripped my left gastrocs in two pieces, rolling it up like a window shade and rendering me useless for a large portion of the month. Uppers: Seeing some Aussie pals, Lisa and her mother. Camping with Karin's Neice. Storm games. And BLUE HAIR! Plus, all those rippling upper body muscles from those crutches!

September: It was full of so much adventure that I posted my entry late. Downers: what are those? Oh, right, I was still pretty injured but getting around a lot better and Uppers: No more cane! Seattle Storm Mania. GLMA Conference in San Diego. Another great Lullaby Moon gig.

October: The real recuperation month. As I reflect back, it wasn't until the end of October that I really felt I was starting to heal. I had more energy and dug into life. I looked for horses, barns where I could ride. I did some serious wedding planning and I went through a lot of old boxes and papers and finally finished unpacking. My blog posts were full of nostalgia about medical school and rotations. I was starting to get ready to get back into the workforce. Downers: More band drama. Karin took the Pysch GRE's (ick for her). Uppers: Huge headway made on wedding planning! Plus all the aforementioned healing! Freedom feels so good!

November was eventful. Downers: Snow put Seattle on hold Uppers: Snow put Seattle on hold just before Thanksgiving (making for a loooong weekend!) and Karin and I hosted a Little Gay Thanksgiving at our house. I made some headway on the job and horse search!

Bringing us to this month, December, HanuBirtMas time! Downers: After 34 years I still get bitter that my birthday is lumped with Jesus'. Is that selfish? Uppers: RCB Christmas concert! Birthday sushi (yum at left) with friends and family and ice skating. And, of course, the much anticipated Trip to Minnesota.

In the Tundra of Middle River, MN, among other things, I helped make a traditional Norwegian flatbread called lefse and drove a snowmobile. Ah the snowmobile lesson... it went something like this, "Here's the throttle, here's the brake, here's the emergency shut-off. Follow me." And with snowsuit, helmet and an 11 year old sitting in the seat behind me, I took off in the dark winter night, following faint tail lights and a cloud of snow. That first ride I can't say with total honesty that I had a lot of fun. Terrifying would be more accurate. But the following day was another story. Off we went, in the blazing sunshine across field and dale, through woods and trails. Glorious adventures were had. I smiled so hard my face hurt. And while I missed my family and my usual family traditions, I thoroughly enjoyed my time with the in-laws and actually look forward to another snowy Christmas in northern rural Minnesota - snowsuit and all (see photo above near February's summary)!

So, dear readers, 2010 was great, but I trust 2011 will be even better! It will be a big year - a real job, a wedding, and a horse! Yes, a horse. I know I keep promising more word on the topic... s0 stay tuned for more word on work and horses...

Happy New Year!

So long Tacoma, smell ya later!

The month of June was rather eventful.

It has totally exhausted me and have as much brain power as a cardboard box right now so bear with the less flowery language herein (the literary part of my brain is resting and waiting for its big binge after my board exams!)

So... June: Let's start from the beginning and try to break it into bite size pieces...

TFM Day
June rushed in with the dreaded "TFM Day" - a full 8 hours of residents (and other notable speakers, but mostly residents) giving dry presentations on evidence-based topics that are on their way to publication via the FPIN Network. I won't bore you with too much detail about the event. Just know that the whole process involves at least a year's worth of work, research and stress. My topic? Anal pap smears. I had hoped to perform a evidence review on transgender primary care but that wasn't approved. So even though I didn't quite get my topic of choice, in the last few years at TFM I have had the opportunity to present transgender medicine topics on my own accord. My TFM Day butt-talk (as I fondly call it) went very well and was actually a pleasure to give. The paper for publication is another story for another time.

Cle Elum
To celebrate the end of TFM Day, and the nearing end of residency, my class head off to Cle Elum, a quaint little rural Washington town, home of yummy Pioneer Coffee, and spectacular views! We recovered a little, bonded a little more, ate a TON (including an awesome Indian dinner made by our Indian classmate). We were there two nights and one full day and at the crack of dawn on Sunday Karin and I head back for our first uniformed marching band gig, a picnic in the park just blocks from her house. Afterward, we waiting in line, in uniform, for nearly 2 hours to get our $1 BBQ fixings (veggie burger included).

The Last Rotation
My last rotation of residency was an elective. I chose to rotate at Bastyr Center for Natural Health, a comprehensive naturopathic, acupuncture and homeopathic clinic in Seattle. In order to do this, however, I had to battle my nemesis, I-5. During the rotation I drove 300-500 miles a week, commuting from clinic to clinic. My previous efforts to coordinate my TFM clinics into full days (freeing me to learn at Bastyr for more than a few hours at a time) was massively unsuccessful - so back and forth and back and forth I went. But the elective was fruitful and I even felt, with my own index fingers on the pulse of a 90 year old woman, the actual palpable changes acupuncture creates in a person. Pretty amazing.

Chaos
Then, the proverbial you-know-what hit the fan and I started hurtling toward graduation at breakneck speed. Moving, packing, vet appointments, address changes, insurance coverage changes, forms to complete, etc etc... And, for extra fun my Mom and step-dad flew into town. We celebrated her birthday at Ray's Cafe, and over the weekend enjoyed in the festivities of the Fremont Solstice Fair and Parade! (us at right - Karin is on the end with the bass drum and I am playing trumpet behind her.) They stayed at my place, on the pullout couch, while I was packing and working, and then, for extra fun, my Dad and step-mom came into town and we had graduation.

Graduation
Graduation was a nice event - good food, good company, ample beverages to soothe savage beasts. However, it was four and a half hours long. For just eight residents. I was the very last to be graduated and by the time it came around for me to say my piece everyone was exhausted and surely sick of being there so I just said a few words of thanks and that was that. Kind of anticlimactic, I think. It didn't help that after all those hours of graduation hoopla I had clinic the following Monday. The best part of graduation for me was giving gifts to my advisor and getting to share with everyone the movie I had been working on for the better part of 4 months! I would love to post it here but am not sure people would appreciate their images up here for the world to see, dancing around and such. I rewrote all the words to Hotel California to reflect life as a resident at TFM and TG and filmed various folks singing and dancing along to the words. It was such a kick to make and I spent way more time on it than I did my FPIN!

Pride
Then came pride, or, "the gay Christmas", as Karin and I call it. With both sets of parents in town, my move a matter of days away, residency finishing, and all my duties with the band I was spread pretty thin. But I managed to enjoy marching in the parade, partaking in some of the street fairs and the festivities at the Seattle Center after the parade was over. One of the highlights of Pride this year was the huge rainbow flag the Seattle Center put on the Space Needle! A historic day! Now if only we can get equal rights like marriage, or at least equal taxation for domestic partners!

Then back to work for me after Pride. It wasn't easy but I managed to work a hellish, soul-sucking clinic on Monday, finish packing, and move my whole life to Seattle on Tuesday. Tuesday night Karin came back to Tacoma with me to finish cleaning the apartment. Wednesday I went to work and closed my charts, tied up loose ends, returned my parking pass, all the usual last day stuff. Hilariously, I got in trouble my last day for not having my badge. Figures some safety big shot would be touring the clinic on June 30th. He was understanding after I told him it was my last day and I had just returned it!

Life as a free woman
Now, here I am, among piles and piles of boxes. Overwhelmed with how much stuff I have to fit into Karin's apartment. We are working hard to make it our place (not just me squeezed in to her place) and it's not going to be easy (33 years of accumulated stuff is a lot!) but we are doing it! The pets have been without incident, Sive lives in the loft with a gate separating the beasts for the time being. I am so happy to be done with residency and ready to start the rest of my life, with my fiance, my family. Karin, me, Sive, Lucy and a houseful of boxes. I couldn't have imagined a happier ending to this story.

Next step? Studying for boards, unpacking, nesting, and continuing my advocacy here in Seattle and through GLMA... now only if I can find where all my advocacy stuff is... and maybe, soon, the feeling of being done with my indentured servitude will hit me.

Like a speeding bullet

Hello readers!

Winding down to the end of residency now. Hard to believe, no? If I keep to my once monthly posts this may be my second to last blog entry of residency. *Gasp!

Part of me (the biggest part) is unbelievably thrilled!
And part of me (that little noodley part) thinks: "ohmygodihavetotakeboards
andrecertifymyACLS
andpackandmoveand
beforeilosehealthinsureance
seeadoctoranddentist
andpreparemyhumongouspowerpoint
andpublishmypaperandholycraphowmanydays?"

But, like I said, most of me is just tickled pink!

So, panic attacks aside, shall we review the month of May?
It began at breakneck speed, starting with a post-call party at Swing Fever, the band charity auction where I stayed up way too late and bought way too many auction items. My wins included interesting items such as an off-peak week-day stay at some resort somewhere on the Washington Coast (exciting, yes?). I also won a gift basket from the Jet City Roller Girls and a few other small items. The coolest item was a drumhead from my own inauguration parade experience. The winning of this was somewhat incestuous as I donated the item with a few of my bandmates. But I wanted it, and wanted it something fierce! Fierce enough to outbid, so there!

Immediately after the event, or more specifically, after 4 hours of sleep, we head off to Minnesota so spend some QT with Karin's family (as I described at the end of April). We flew into Fargo, endured a nearly 4 hour delay, drove about 3 hours to that little place called Middle River and, after I was awake nearly 3 full days, I ate and slept the whole week away. One highlights of the trip was a D.A.R.E. graduation at the local middle school. The end of the ceremony was punctuated by a rousing version of Johnny Cash's "Ring of Fire" but with the lyrics altered to reflect the middle schoolers promise to not drink or do drugs. Then we had cake and fruit punch in the cafeteria. Another highlight was on a literally freezing cold rainy (and in some places, snowy) May day we planted 50 lilac bushes. We stayed in Fargo the last weekend an played in the swimming pool and perused the mall. Mostly, we ate. By the end of the week, we were butter soaked, lard-laden little roly poly's barely able to waddle on the the plane thanks to the Land of Lakes predilection for all things dairy. (Note lovely MN rainbow above!)

I was welcomed back by total TFM chaos. We were still two residents down, and with pores still oozing Minnesota sugar and butter, I took an extra black weekend call, spending my first Saturday night back again on the wards being paged all night with admissions I was admittedly uncharacteristically remiss in admitting. (say that 10 times fast!) It was as if I had never left.



See, my "last call," ending May 1st, was evidently not truly my last. In fact, this coming last weekend in May, the "holiday weekend," will hopefully mark my last weekend at the hospital (note the quotation marks to emphasize annoyance). I already know I will be working both Saturday and Sunday as back up. Regardless, back in the pre-vacation blissful ignorance of May 1st, I treated my (supposed) last call as such and celebrated its end by roller skating around the wards (See above). I'd been fantasizing about this since they installed laminate floors and since I noticed a gently sloping hill from the 5J patient wing to the resident call rooms that just screamed "roller skate on me!" Filming is not allowed in patient care areas so I got some footage of me testing out the skates on this part of the wards, the nice slopey part! Most of my bloggy fans are on Facebook (and may even be reading this blog on FB, even though it is far superior and actually formatted on its original host, Blogger). So, they've probably already seen the video. But... for the three of you who haven't, there you go.

[Insert seamless transition from evils of residency to joys of band camp here. Or not.]

Band Camp! Last experienced in the summers of 1991, 1992, 1993 and 1994 as a high school student, I remembered band camp as a time of sore arms, worn out chops (chops: trumpet-speak for lips) and sun burn. Grown up gay band camp has much the same, but is waaaay more fun! I got to hang out with my 60 closest friends and partake in a talent show, play games, and play my instrument, dance and get some vitamin D and be near the ocean! It was really spectacular. And exhausting. And, did I mention fun?

Coming down off of a weekend like that was hard. Getting back in the swing of things, I took a look at my to do lists and, BAM!, was hit by reality. Not only is residency over and done with in just about 30 days, but I also will be moving, and lose my health insurance and no longer have a salary. But, hey, freedom does come at a price, n'est pas? I have so much to do, I thought about making lists of my lists. Instead, I thought it would be more fun (and debatably less productive) to make a list of reasons I am grateful about moving and finishing residency. E.g.: #8: I won't have to mouth-breathe between exits 134 and 137 anymore on I-5 (the aroma part of Tacoma). #11: less left lane driver rage, etc. I do love Seattle dearly and am excited to officially be a resident. Karin and I, as an homage to our favorite city, wrote a little song we performed last weekend. Left lane drivers are featured in the middle of the song. See below:

So, this brings me to the end of this here blog entry... So much to blog about all of a sudden but so little time. Perhaps June will bring multiple blog entries? That's probably an empty threat however. I would like to tell everyone about the video I'm working on for graduation with my classmates. I would love to vent about all the job offers I'm getting in "random small town only 40 miles from a great golf course in somewhere USA. Call now to sell us your soul and we'll call you every five minutes to harass you until you explode." But for now I must take care of patients, do this pesky big TFM Day presentation and publication thingy (worthy of its own blog entry but annoying enough to avoid the topic altogether), and try to maintain as much of a normal life as possible in the next 30 days while accomplishing the great feats of my endless to do lists. Next on the list: world peace. ...wait... wrong list.... right! Correction: forward my mail.

Lions, Lambs, Four-fingered mice and cannons

As I examined my droopy fender today, I started to wonder if I've been spending too much time on I-5. It rattles quite loudly when I'm driving over 30 mph and I wonder if a big gust of wind might not rip it off entirely. However, like the other droopy side, I am pretty confident I can fix it with some string. My fender dangles because my car has lived a hard Midwestern life of salt and snow and is so rusty it seems just a few years from turning to dust.

So, I was thinking about I-5 today. While my rusty bumper tick'tick'ticks in the breeze I work hard on I-5 to navigate left lane drivers, mysterious traffic slow-downs and the ever-present construction. Of all of these, it's the left-lane drivers that really get me. Something about Washington State compels people to pick a lane that seems to be the least occupied, pick the speed they feel most comfortable with, hit their cruise control, and hope no one gets in their way. Unfortunately, they pay no heed to anything going on beside them. Or, for that matter, the entire line of traffic behind them, begging for them to move right! It's a WA phenomenon, one that would earn blasted horns, flashing lights, and possible a wielded semi-automatic weapon on I-696 in Detroit!

But, I only have 30 minutes to blog tonight and didn't want to spend it whining about I-5 traffic woes. There are numerous websites devoted to this left lane driving evil. Please explore the links for more info.

This month, maybe even more than others, has really been one worth blogging about.

You may remember that this month was cardiology. Which, you may also recall, that like any outpatient rotation really means lots of back-up duties and continuity deliveries. I worked a few half days with a cardiologist but wound up being called in as back up, covering some of my out residents, and delivering a number of patients and rounding on them in the hospital. Same old FP stuff as usual.

My activism got a much needed jolt of life when I travelled early in the month to Anaheim to present at AMSA's 60th convention on the LGBT history of the org. My co-panelists were two great guys who helped revolutionize LGBT provider visibility and competent patient care even before the DSM was revised in 1973! It was an honor to sit among them. I think that may have been my 6th or 7th attendance and 5th or 6th time presenting. While there were still some national leaders I can still call friends, I definitely felt old and somewhat more disconnected than usual. But, nonetheless, it was an exceptional conference and not only did I get to participate with AMSA, but I got to meet up with a local buddy of mine I haven't seen in ages and see the new Alice in Wonderland Movie (not so great) have yummy creole food (very good) before my flight back to Seattle. Plus, I got to enjoy the total and utter creepitude (yes, new word, you may steal it if you want) of all things Disney (see above for the Bosch-like incarnation of a Tweedle). Am I the only one who sees twisted things in just about everything Disney?

Mid-month I played a killer concert with the Rainbow City Band where I got to play a terrifyingly exposed solo (Pictures at an Exhibition) and hear my sweetie play a wicked concerto AND the cannon for 1812 Overture. The entire performance was amazingly difficult and rewarding featuring Tschaikowsky, Moussorgsky, Rimsky-Korsakow, Shostakovitch, Stravinsky and more! We played two shows and at the end of the weekend I got to celebrate with my 80 closest friends/bandmates at the after party and toast a major milestone: 100 days left of residency!

The weeks around the concert were also colored with a shooting schedule for our class senior video. I have written another song (the last one performed at the TFM's Got Talent Show) and am working with my class in filming a video to go with it to entertain all at graduation and have as a keepsake for the grads and interested staff/faculty. I would tell more but I can't give away the secrets because the contents of the video will be a surprise at Graduation (shhh).

This month wrapped with Passover in San Francisco. Every 3-4 years my family makes an effort for everyone to come to a big family seder. It's a big Jewish Family Reunion. Complete with gefilte fish and bitter herbs. The event this time was particularly fun for me as I had Karin as the newest addition to the family seder. The first full day we had there we spent mostly exploring San Francisco, walking about 10 miles and wearing ourselves out just enough to then spend the next day and a half saturated with loving family.

One of the bigger events of our family passover is the family talent show. This passover, while sadly missing a few of my cousins and their families, was still very well attended. I didn't take a head count but I imagine it was well over 30 folks. The talent portion consisted of sing-a-longs, dances, sneezes, jokes and a reenactment of the RCB Thriller Dance by myself and Karin accompanied by my niece, Zoe on guitar. It was fun and I look forward to the next one. It also reminds me how much more often I would love to see my family. If only we weren't so spread out! They should all move to Seattle and make it easier for me. (at left is a grainy cell phone pic I took in SF)

Amazingly, the adventure didn't end there, the day we flew back from SFO we managed to just squeeze in and make the first marching band rehearsal (which started a mere 30 minutes after our flight touched down). I mention this because the music is really exciting this year! It is quite possible that my band will be adding to its usual marching fare such songs as: Jai Ho from Slumdog Millionaire and Bad Romance by Lady Gaga. Nothings set in stone quite yet, but Magic 8-Ball says "outlook is good"! I can just see Jai Ho now at Solstice and Gaga at Pride!

And, now, I must wake in 7 hours and start my last in-patient rotation of residency. The notorious, "we never cap" Family Medicine Service. The rotation on which I spent my unforgettable intern Thanksgiving and Christmas. It's a rough one and although I'm sad I'll be missing Honkfest, my favorite thing ever, Spring, time with my fiance, sleep, eating well and all those little things... I will surely be happy it's the last month like this.

2185 hours and counting...

Swing, Hula and the Dance of the RRC

February is normally an easy month to hate. Persistently cold, bleak, it's the dregs of winter. However, just when I was prepared to give February its usual due this one pleasantly surprised me.

First off, despite being q4 I managed a wonderful Valentine's Day, post-call but alert and oriented and feeling just dandy to swing the night away to the Mood Swings, an all female swing band out of Seattle in which one of my great friends, JB, plays. Picture at left from the dance.


Additionally, we had our all TFM retreat. This is a required event for all residents, faculty and other staff including their significant others and families. Unfortunately my significant other wasn't able to make it. Another co-resident also was stag so the two of us shared a room and managed to make the most of the weekend. The weekend involved a few required meetings including the "State of the Residency Address" where the hot topic was the recent Residency Review Committee (RRC) review. The RRC is an accreditation committee that, like JCAHO or OSHA, picks apart a system, looks over it from top to bottom, inside and out, and compares it to a check list of requirements. Once its pending arrival is announced, everyone scrambles and runs around in a blind panic like roly poly bugs after their rock has been lifted. At the end (and here I'll change my metaphor) the RRC sits on a big throne while the residency director, supplicated at its feet, accepts a sentence of death or life, or, sometimes, probation. The Director then returns to his or her residency and shares the news. Thus was our Saturday morning. Our program seems to do very well in all aspects except one: Work hour rules. Or, perhaps, we fail by being honest in our work hour reporting. Apparently only 13% or so (a vaguely remember number from one of the meetings) of US residencies report work hour violations. Our level of violations was much, much higher. (The question asked was "in the last three months have you ever violated rule X"). I think our residents answered honestly and other residents have not. And, as a result of this, we may get a little ding for our violations. Or not. Who knows? The RRC has yet to give us their rulings. For those unclear on the hour rules, you can click the above for a Wiki entry, or the ACGME's cache of wordy PDF's. But, in short, the ones we struggle with is 1) no shift longer than 30 hours and 2) 10 hours off between shifts. Raise your hand, residents, if you haven't broken one or both of those in the last three months! ...I thought so.

Aside from the State of the Residency Address we also had unstructured fun time which included this year a Talent Show! Each class performed an act. Each was a surprise. The first year class (interns) dressed up in their concert best and played Ode to Joy on recorders. The second year class performed a sock puppet show to the yodeling song from The Sound of Music (and did all their own singing!). Our class performed a song I wrote called "The Pager Song" - I played ukulele and kazoo and two of my classmates danced the Hula while a fourth played percussion and manipulated props. The rest of our class made their pagers go off at certain points of the song. The acts were judged a la American Idol with four judges each picking us apart ruthlessly. And... we won! But the competition was stiff. There were some musical numbers from faculty and an impressive Gilbert and Sullivan performance as well. Hopefully, I will have video to share on here soon! At left is a picture of me preparing the song on call.

Lastly, this has been a gorgeous February in Seattle. Spring has Sprung! There are daffodils and tulips, cherry blossoms and so much more! So while the East has been slammed with snow we are getting showered in sunshine and flower petals. No bones about it, the Pacific Northwest is the most beautiful place on earth. (My photos of the blooms aren't uploaded from my camera yet so I took this one from the CHS blog's haiku comparing the flower petals to snow. Jealous, NY-ers?).

Tomorrow I start Cardiology. Hopefully a lighter month, however I do have several patients ready to deliver soon so I imagine sleep may not be something I will get much of. The month does end with a mini vacation to San Fran for Passover where Karin will finally get to meet my wonderful and somewhat crazy (but in that good way, of course) mother's side of the family.

And count this! As of today 122 days left: One more inpatient month, 8 more calls, three more back-up stints, probably 60 or so continuity clinics, a pesky board exam and I can call myself done with indentured servitude! Happy Dance with me tonight!: Swing or Hula - your choice!

2009 in Review

Now for the traditional Year in Review Post!
2009 was really a year of changes for me.

Click here for last year's entry, if you are feeling extra nostalgic.

Most photos are from my recent trip to Detroit for Christmas.

January: Rotation was Night Float and Geriatrics, emphasis on the Night Float. Uppers: The fabulous inauguration of the new President Obama. Marching in his parade. The world-wide sigh of relief at the end the "W" years. Downer: The start of the Dental Saga of 2009. Inauguration and a wedding not included, I had all of 2 days actually off the entire month, yet somehow managed to cram in 4 dentist appointments and a two-part root canal.

February: Night float and geriatrics continue. Upper: Vegas, baby! Downer: That night float crap was getting really old, the dentist crap even older. My only weekend off was spent at an all-TFM retreat. I was so dizzy and sleep deprived I think I may have hallucinated once or twice.

March: My "Away" Rotation with Puyallup Tribal Health. Uppers: Shilo turned 20, Sive turned 10. I ran a 5K, started in on Honk Fest excitement and spent a ton of time on horseback. I got back in shape, I took care of myself, and finally wrapped up the Dental Insanity. I also completed my USMLE Board Exams. Downer: My friend's wife died. My community, Rainbow City Band filled an entire section of the funeral home. So, the silver lining: It made me realize how lucky I am to be a part of a community like RCB.

April: Ah April, the best and worst of times. Rotation: Inpatient Pediatrics. Downer: Peds just about killed me. The hours were insane, the patients sick as hell, and the attendings, ruthless. But the uppers! The Uppers! I played at HonkFest West which magically fell on my one weekend off that month! And, most amazingly (include all superlatives here), I fell in love. And while residency tried its damnedest to crush me with my peds rotation, I was like one of those trick candles and sparkled despite it all!

May: More blasted Peds and the start of clinical GYN. Upper: Swing Fever with RCB. Vacation in Boston (the only thing I managed to blog about). Downer: Yeah, peds was still killer, and just when I thought it was over I was back rounding on the service my first weekend after vacation, covering for another resident. But despite the peds interjections, GYN heralded my last rotation of R2 year. And any free time I had was spent with my girlfriend, Shilo, and my band. In that order.

June: GYN continued. Upper: Realized I was almost done with R2 year! Woo! Started my Countdown Calendar. I played some awesome gigs including ones for the Majestics, Solstice Parade and Pride. It was a very RCB-heavy month for me. Downer: Getting the swine flu sucked.

July: Internal Medicine. Uppers: Played for the Rat City Rollergirls, Mom came to visit, got to see my friends Suhani and Rachel even if it was just for a few hours. Downers (this wasn't my best month): q4 call, new interns, and most insane month for the hospital ever. My one weekend off that month spent over-caffeineated, sleep-deprived at a board meeting in Chicago. Missing playing in the Seafair parade. And did I mention getting totally and mercilessly spanked by Tacoma General Hospital. How much left on that countdown? I was so brutalized that month by work I didn't even have time for one little blog entry! I did highlight a bit of the month in my first of two August entries under the subtitle: Red, white, blue and burned out.

August: First two weeks the flogging continued as Night Float. But, at least this time I didn't have a dozen dentist appointments keeping me up during the day while I should have been sleeping. Instead I had elevator construction and a record-breaking heat wave! Uppers: Dad and Julie visit from Michigan. Mount Rainier! Downers: Said goodbye to Shilo, the horse that kept me sane and human. One of the hardest things I've ever done. Here it is almost 5 months later and I still feel heartbroken. And to add to it all, my dear, sweet dog, Kiki, passed on. It was indeed a month of loss.

September: Rotation? Keep reading. Summed some of the month here. Upper: LGBA in New Orleans - very, very awesome. GLMA in DC, also pretty fabulous. Lullaby Moon - surreal. A good month for recovery from the losses of the month prior. Downer: I spent so much time working in the hospital as back-up I completely have forgotten was rotation I was on. Had to look it up. It was ophthalmology, urology and ENT (OUE). Go figure.

October: Away rotation on the East Coast, LGBT Medicine. Adventures aplenty. Uppers: I completed my GLMA conference. My talks were huge hits. I loved, loved Mazzoni Center. My RCB "TV Land" Concert was sold out and fantabulous. I only wish I had video of our awesomeness to share! Our pep band played at Macy's in a mall which was a really fun experience. I celebrated Karin's birthday for about 2 weeks straight! I dressed up as Daddy Warbucks this Halloween and had tons of fun with my friends in Seattle. Downers: The month had to end. And I missed the long-time coming, awesome, big, gay Connecticut wedding of my old friends Stevie and Jill.

November: Rotation was HIV Medicine. Uppers: A low key Thanksgiving on the Oregon Coast. The rotation rocked. Educating my program about transgender health and making TFM officially a trans-friendly place for patients! Downer: My 99 year old grandpa died. Half my program was struck down with the flu and, as above, I had to struggle for my balance.

December: And here we are. Rotation: Pediatric ER and sports medicine. Upper: my first week vacation since R2 year! Christmas with family and Karin and Lucy. Christmas caroling with Renegayde. Adventures in Detroit. Another sold out concert with RCB (left). Downer: Good-bye weekends, I'll see you in March.

Oh, the weather outside is frightful

Get this straight. I'm not complaining. I love it here. It's far preferable to being in the Midwest right now. Or the blustering, snow-covered Northeast. Really. But, for this week, it's bitterly, bitingly, abnormally cold. My friends are taking pictures of their temperature gauges because single digits awe them. I imagine them craning their heads, looking for the preceding "3" before the "8" sitting solo like a headless snowman on their digital dashboard reading.

But, like I said, I'm not complaining. See, we also are having blazingly beautiful, bright, sunny days with the mountains all snow-capped and glistening, and the usual slate blue of the Puget Sound looking brighter and more cerulean than it has a right to be this time of year.

It's the interview season for residencies. Which is interesting because it helps me look at TFM from a fresh angle. Last year I got to interview people I hoped to work with! None of who ended up here, as far as I can remember. Now, at the time I write this, I have 202 days left of residency. So, interviewing is more like interviewing my replacement. I'm hoping to get a queer-friendly, pro-choice extrovert to come here. Wish me luck!

This weekend I am caroling with my band in downtown Seattle. I did this last year and it was great fun! Next week we get to have a fun Holiday Concert. I say "holiday" instead of Christmas because interjected into all the X-mas classics is a little klezmer medley ending with a dizzying rendition of the hava nagila. Jews even got a little cookie parity at rehearsal last week (see left)! My favorite song we perform this year, however, is not the usual Sleigh Ride (because I'm a sucker for the horse whinny) but a kazoo rendition of Jingle Bells, to be performed concert night with local school children. See video below for a short preview from rehearsal!



Now, I hate to kill the mood, but I have to wrap up with a bit more somber news. Tacoma has been rife with tragedy and crime lately. The economy has hit everyone hard but for some reason gun-related crimes seem abnormally high. Most have already heard about the four police officers who were gunned down the day after Thanksgiving. Their memorial was this week. Also, my neighborhood bank was robbed and my favorite breakfast place was held up at gunpoint and the elderly owner assaulted by one of the robbers. My bank was robbed! Two blocks from my house. Seriously?

In hard times people are supposed to band together. It seems some haven't been getting the message. For Christmas this year I want a Kevlar vest and all the weapons in Tacoma and Seattle to turn into gumdrops.

November's not for sissies

How to cram the last 5 weeks in one blog post? Halloween weekend was a celebration of the last weekend of freedom before my return to being a slave to my pager, to TFM and to the needs of patients, colleagues and administration. I enjoyed it fully with a weekend in Seattle, playing a remarkable concert with RCB to a sold out house. Our concert theme was TV Land, complete with a LGBT and Ally friendly Brady Bunch video and sing along (below!!).

I dressed as a mad scientist last year. This year I was daddy Warbucks, complete with a bald head, three piece tux and pocket watch. I also had with me a pretty convincing Orphan Annie!

November rolled in like a steam truck and plowed pretty quickly over the peace and balance I had spent most of October carefully cultivating. My grandfather, not a month after his 99^th birthday, died. It feels like one minute he’s doing his morning calisthenics, shoving 5-dollar bills in my hand, telling the same jokes he told me last time I visited. Then, the next minute, my mother calls to tell me he’s dying. In a way, it was a good way to go, relatively quickly with people you love by your side. His funeral was in Ft. Lauderdale, Florida in a plot adjacent to my Grandmother, Minna. My mother and her sister, their two children, and the five of us cousins were able to make it. A pretty amazing event. I can’t even recall the last time all five cousins were in one place. I think it would have made Grandpa very happy to see us all.

The most riotous part of the funeral (yes, we put the fun in funeral) is hard to pick out. Getting lost in a minivan with family had its charms. Mother’s quirks were particularly funny – in that van adventure she must’ve called her sister 2 dozen times announcing each intersection as we passed it to make sure she knew we were finally going the right way. Self-depreciating humor was rampant and the men poked fun at the suggestion of their submission to the powerful Jewish women in my family. We Detroiters had stories of being held up at gunpoint, Black Panther and police evasion, and mayoral corruption (circa 1970’s and 80’s – how retro! Funny how little things have changed). Somehow, even the darkest jokes coaxed everyone into laugher at one point or another. The resident Catholic even managed to get a few colorful nun jokes in there.

From the funeral I basically went right back to work, where I found my fellow residents falling out here and there, felled by the flu or other family emergency. I worked twice as hard as I had anticipated, filling in on extra clinics, working as back up on the weekends, working on my elective at an HIV clinic in Tacoma. Not to mention a number of presentations I’ve done over the month: formal, informal, at meetings, teaching sessions and the like. In fact, instead of writing this blog post, I should be preparing a presentation on the culturally competent care of transgender patients and a quick overview on hormone therapy and standards of care. But, I’m not! Or, rather I should be working on my research for my 3^rd year project. But, obviously, I’m not.

Thanksgiving 2 years ago I was on call at the hospital, getting pimped in the morning by ruthless (er, invested) teachers and feeding my sorrows in the afternoon with 12-hour-old, 3,000-calorie cinnamon rolls listening to cheerful voicemails from my family’s respective celebrations. Last year was a huge improvement. While I still had to work too much to travel, I did find some time to enjoy Thanksgiving Seattle-style with sushi and salmon at my cousin’s place surrounded by a number of relatives from around Washington State. I also had the immense joy of busting my chops Christmas Caroling with Renegayde.

This year traveling far was out of the question as the time off was not guaranteed, and the two days of traveling it would take to get to anything in the Central or Eastern time zone would make the trip essentially futile (and maybe more stress than its worth). So, Karin and I opted to hit up a beach on the Oregon coast. We were pleased to have some sunlight and enjoyed the hotel hot tub and in-room fireplace. Always non-conformists, we walked the beaches on the windy day and flew a kite on the calm and sunny day (pic at left). We visited bookstores and toy stores and tried to whale watch, however, as I lifted the binoculars to my face to try and spot a spouting behemoth the woman working at the whale watching center mentioned to another employee that "there's nothing out there this time of year". No whales. Maybe in a few weeks. Alas, before I could even focus the binoculars, I put them back on the table. They were probably teeming with bacteria anyway, and we were much better off eating bagfuls of salt-water taffy driving up Highway 101 admiring the view.

The nightstalker

Nothing like showing up as the sun sets to a full bay of ambulances, their engines pumping diesel fumes, smokers sneaking puffs below the “This is a Smoke Free Campus!” sign, certifiably insane patients of mine yelling to their cell phones with central lines flopping around their necks. This is how my nights will start (although, admittedly, the insane patients of mine don't always greet me at the entrance). Then, about 12 hours later (plus or minus), I will drag myself back through the same ER doors, past that wet sound of people vomiting into blue condom-shaped emesis bags, past another line-up of rigs, not nearly as plentiful as the night before, sometimes EMS personnel joining the patients and families in creating that silver cloud of stank under those “no smoking” signs.

Such is the life of a night float resident.

I’m plodding through the night as I type most of this post. Admitting patients to Pediatrics, Internal Medicine and our own, beloved, family practice service which includes not only our bottomless barrel of sick TFM patients but additionally the Indian Health Service patients who happen choose Tacoma General over the multitude of neighboring hospitals and ER's. I cross-cover the same panels of patients and am the back up for the labor and delivery deck, in case things get a little crazy in their neck of the woods, too. It has the potential to be eerily quiet or insanely mad.

When not on the wards or in various ER's or delivery rooms I will camp out in our call room (me being insanely mad in the call room at left). This call room is located in the "M wing". The patients reside in L, K and J wings. The call room is flanked by volunteer services and the learning and development offices. Neither which are staffed after 5 PM. Thus, at night, the lights are off, the hallways are dark, and this part of the hospital feels completely abandoned, in a Stephen King kinda way.

One night in the winter, last time I was night float, I was walking back to the call room in the dead of night when out of the corner of my eye I spotted what I thought was a man down at the end of the dark hallway. The eyes play tricks on you that time of night so my first instinct was to ignore it. Then the man-shaped blob moved and I looked again. "Oh hi! You scared me!" Or some such generic statement miraculously came out instead of a yelp. He reported he was lost and looking for the elevator. How one would end up in the abandoned wing down a dead-end dark hallway looking for the elevators is beyond me. "They are over there," I pointed and discreetly entered the code to get into the room and closed the door behind me.

Not much later I get called to standby for a delivery on obstetrics. On my way down the yellowed stairwell of the M-wing I find the same man sleeping on a landing between stairs. I call security: "Does he have a red baseball hat on?" They ask. I recall that he did. "Thanks," they offer, "we have been looking all over for that guy!" I tell them his location and later find out they have evicted him from the building with the promise of arrest should he come back. I spend the rest of the night safely nestled in the bustle of a nurse's station.

But I digress. I wasn't talking about creepy night stalkers! I was talking about my current rotation: Night Float! Brought to you by the letter W! W: Withdrawal, the act or process of ceasing to use an addictive drug. Seems to be the flavor of the week for me and my adult admissions. And before I get called to admit another patient brought to TG by the letter W I will also present to you a superfast ubershort summary of July.

July 2009: Red, white, blue and burned out

Hold on tight, here we go.... July 1st I get the pleasure of starting on call. In the deep end from the start. On my first day a patient expires, my second day I get threatened with a lawsuit (by a crazy patient, go figure), and my third day we get 14 admissions. I get a day off on July 4th - march in a Parade, get this amazing photo taken (left) by the Adventure School photographers. Then back to work on the 5th for more insanity. Things persisted to be totally and inexplicably crazy until my "golden weekend" where I take a red eye flight and a train to Chicago and proceed to engage in a weekend long board meeting before coming back just in time to be on call the following day. By this time I am exhausted and worn out and amazed I'm still upright. Post call on the following Saturday I manage to stay awake well into the night, hell, into the next morning and finally crash after being awake for nearly 48 hours straight, a gig with my band at the Roller Derby and Bite of Seattle squeezed in for kicks. And did I mention my mom was visiting that weekend? Finally, I get a day off, it's spent perusing a farmer's market in the sun and before I know it I'm back at work and don't have a day off until August 1st - when I change rotations and now find myself immersed in the life nocturnal.

So there you have it. I won't even begin to go into the week-long heat wave with temperatures topping 104, the joy of having only one working elevator, the horror when that one decides to break, and how hot the stairwell can feel after 15 flights in 100 degree heat!

Ahead: another week of nights and then, holy crap, I have a full entire normal weekend off! The first real weekend off since the last weekend in June! Plans? I'm going camping and and plan to eat, nap, sleep and spend some QT with my cutie! (first photo is from my apartment window, of course)

2008 Year in review (complete with links)

This year has been up and down. I made it through intern year by the skin of my teeth. I won’t lie, I battled both burnout and cat pee. The spring brought me some great surprises. I stumbled forward and ended up right here.

Since those yearly letter summaries have been so popular from my friends and fam this year I thought I'd spit out one of my own. So, here it is, my year in review. (Photos from my wintry vacation in Michigan: Kiki, Christmas cake, punch, Hanukkah cake, latkes.)

Jan: My second month of OB as an intern. Upper: Hawaii. Downer: my first whiff of burnout.

Feb: My away rotation in San Diego. Upper: pretty much the entire month. Downer: shortest month of the year

March: Surgery rotation. Upper: National Physician’s Alliance conference – reconnecting with my fellow activist doctors. Downer: surgery

April: Orthopedic surgery. Uppers: Daffodil parade, carrot soup, sun comes back to the PacNW!

May: In-patient pediatrics most the month. Upper: Vacation the first week! Meeting my friends’ twin baby boys! Meeting Shilo’s mom. Downer: q4 call and gastroenteritis.

June: Still in-patient peds. Uppers: Last month of intern year! Q4 but squeeze in… Solstice parade, Pride parade, horse time. Downer: Violating work hours this month and that stink of burnout creeps back. It’s not the Tacoma aroma, either. Only month without a posting.

July: No longer an intern. But, launched into 9 weeks of OB and continued q4 call (solo! Ack!) thus wasn’t feeling very celebratory. Uppers: Learned a ton. X-Files movie with an old friend. Downers: that not sleeping every fourth night thing.

August: Still OB. Uppers: Mom visits. Shilo time when I can. Downer: Became grumpy and not particularly pleasant to be around most the time. Are you sure I’m not still an intern?

September: Life smacks me with a big wet kiss! Rotations: In-patient family practice and behavioral pediatrics. Uppers: Vaycay in Colorado. Join the Rainbow City band! Become officially a board member of GLMA. Downer: Sive won’t pee in her litterbox – might smell worse than burnout.

October: Surgery. Again. Uppers: Dad visits (escape to Whidbey!), GLMA national (gay docs take over Seattle!), My first RCB concert! Downer: New computer system hell in the hospital.

November: In-patient medicine followed by ER. Uppers: Election. Thanksgiving with a million cousins. Caroling in Seattle. Downers: My health: Gastroenteritis (again). URI. Chemical pneumonitis.

December: Here we are. ER rotation. Uppers: Three amazing concerts. Get into the inauguration parade with LGBA! My program is supportive! I realize, I heart Seattle and I, gosh durn it, I kinda heart TFM. Christmas with family in Michigan. Snow in Seattle. Start riding at a jumper barn. Sive starts peeing in her litterbox again! Downers? What are those?

Weekend on Whidby

The weekend I spent on Whidbey Island with my father was fabulous. I was thankfully able to swap out my weekend of back-up to have the freedom to roam off of TFM boundaries. I even turned my pager off. Our ferry landed in Clinton, we stayed both nights in Langley and also visited Useless Bay and Coupeville.

As my Dad put it, we "ate our way though Whibey Island". The highlights of the weekend were:
1. The Food - Penn Cove Mussels in Penn Cove, the most incredible chocolate mousse in a a chocolate tulip (pictured), the most amazing caramelized kettle corn from the farmers market and a tasty salmon omelet breakfast are just a few highlights.

2. The Digs - A gorgeous two story beachside residence with a to-die-for panoramic view of the water. Warm, cozy, with a gas fireplace and flat screen TV. Luxurious down comforters and a pile of pillows I could get lost in.

3. The sunrises. See picture, taken from our window.

4. The beaches. Each with their own smooth volcanic skipping stones, bleached driftwood, washed up jelly fish, views of cliffs, mountains.

And there was so much more... It was peaceful and restful. The weather was cooperative all day Saturday (though certainly brisk - great hot chocolate weather). The place we stayed in Langley was called the Boatyard Inn. Check it out.

We rounded off the weekend with a nice dinner with the Seattle cousins and then it was back to work on Monday for me. Amazingly I was able to have some breakfast with Dad before he head off on Tuesday morning and we had the BEST Tacoma breakfast ever at Southern Kitchen. Definitely a place I'll have to return to. The fried catfish breakfast looked incredible but I had to have the cornmeal pancakes. I won't even get started on their famous beverages. Click on the link above for a great review.

As when family usually visits I had a bit of a low afterwards. Thankfully I had band practice and Shilo planned Tuesday and Wednesday respectively. A difficult call on Thursday (thanks to our new live in-patient electronic medical records) and a busy workday today rounded up the week and here I am back in action. I have my concert tomorrow with the Rainbow City Band. I'm a little nervous. The woman sitting next to me in the trumpet section said that she thinks we sound the worst we have ever sounded at a dress rehearsal... but you know what they say about bad dress rehearsals, right? Of course I have invited everyone and their mother. A couple of my resident friends, Shilo's mom and my faculty advisor plan to be there if they can make it. Hopefully we won't suck too badly.

On a side note, today a clinic patient about 10 years older than me exclaimed as I was introduced: "A doctor! But she's a kid!" I'm flattered that to some people I look half my age, but it gets tiresome. Maybe I should spend more time in the sun and get more wrinkles, of course skin cancer isn't fun either. I actually had one patient say to me "You don't look old enough to be qualified to be a doctor!" Qualified? Even Doogie was qualified. Hm. I should start thinking of ways this may work to my advantage... maybe people will sue me less than other doctors because they think I'm so young?

So I'll leave this lengthy post with that last reflection and this hilarious pictures of cat "costumes" Pet Smart tried to market to me.