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!

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.

Warning: No happy bunnies this April

April hurt this year. Hurt like a month-long flogging. A combination of Chinese Water Torture and a constant spanking with a ventilated paddle. To put it simply, FP-inpatient is rough. Last April, while it was also rough on Pediatrics, I still managed flowers and Honkfest. The April before that, intern year, I made the Daffodil Parade and escaped to Seattle and managed a few adventures. This April was about struggling to stay under the 80-hour work week restrictions (did so-so), trying to eat more than the crap in the doctor's lounge (fail!) and sleeping when I can (also so-so). I would sometimes inadvertently check my countdown calendar twice a day, amazed at how slow it seemed to creep along (me celebrating 80 days, post-call, in picture). The patients were challenging (socially and medically), often manipulative, looking for secondary gain and the schedule was awful (5 weekends in a 30-day month is just plain cruel), all q4 call. Call days go as follows: arrive between 6 and 630 AM (as an intern it was never later than 6 AM so this may be a bit of an improvement), round, admit a patient during rounds, finish rounds, discharge patients, admit more patients, do your floor work, teach the medical students, manage ICU cross-cover, take calls from consulting nurses, etc, etc, so on and so forth until roughly 9 PM. Then back early the next day for more fun. Unless it's a Friday or Saturday, then the call goes on as previously described until 12 or 1 PM the following day (that 30-hour shift I often refer to). This is q4, or in plainspeak, every 4th day. But, these days aren't necessarily the hardest ones, it's all the other days that are starting to suck me dry. The non-call days go as such: Arrive between 6 and 630 AM, round, admit, discharge, admit, teach medical students -- so far similar to call days with the exception it all has to be done before 1:30 PM, a non-stop action-packed stress-filled 7 hours or so. A full day at work, for some people. But that's just the warm-up because after that chaos there's clinic. Twenty-minute visit slots filled with complicated and sick patients, most too poor for the services they need, and many too unmotivated and beaten down by their hard lives to seek out the alternatives that may make them less sick. All looking me to fix it. And, of course, never forget the drug-seekers that so adore residency clinics. After ten of these patients, not surprisingly taking more than the allotted 20 minutes each, I then check on the patients I left in the hospital about 6 hours earlier, my intern sometimes gone home for the day, making sure the discharges went home and the new admits got what they needed. I go home, eat something, call the fiance for a haggard "good-night", manage some sleep, lather, rinse, repeat the next day, and viola! we have burn out.

So, really, call days are quite refreshing in a sense, since my duty is predominately to the patients in the hospital (never mind the labs, studies, results, phone calls and refills from the clinic patients that keep rolling in all the while).

And I forgot to mention that I had the joy of having four OB patients deliver this month plus a surprise set of twins that our clinic assigned to me to round on in the hospital. OB really, truly is joyful. Delivering babies a pleasant part of the job. Even with shoulder dystocias and methamphetamine addiction and teen moms with two possible baby daddies, it's still a real highlight to my practice. But when already being eaten alive by the FP inpatient service it's hard to really revel in the joy of delivering a baby after being awake for 40 hours straight and then adding the moms and babies to the chaos of morning rounds and admissions.

I missed Honkfest thanks to a killer, internless black weekend. I missed the tulips blooming (I did end up driving to the Skagit Valley with Karin to see them but they had all died by the time I had the time off). I missed the Daffodil Parade and (cue sad violins) even had to miss Karin and my anniversary. I did manage a night in a lovely hotel in beautiful Bellingham, WA (a belated anniversary treat) and a post-call, fume-fueled gig at the Jet City Roller Girls (photo of Renegayde above), but despite those small glimmers of the non-work life, I'm burnt. To say I'm in need of a vacation is like saying humans need an atmosphere composed of 21% O2, 78% N2 and a dash of Argon, H2O vapor and CO2. I will suffocate without it.

And that said... my last day on this rotation is also my last call. Friday night. A 30 hour shift. Last call ever of residency! And after it's over (and I take a brief nap) I head to Swing Fever, our RCB Fundraiser/Auction! There, I'll party with my 80 closest friends, blow some money for a good cause, and, if I can stand upright, dance! But Wait! There's more! After Swing Fever, I hop on a plane for rural Minnesota, Middle River to be exact, population 319, to meet the in-laws (eek!), get some much needed R&R, and recover from this mad, mad April. Sixty-five days and counting...

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.

June's post - just under the wire

Last day of June. Tomorrow I officially start my last year of residency.

June was a pleasant month overall. The only really bad part would have to be the terrible bronchitis I had for four weeks. In all, I had several weekends off. It was filled with many wonderful band gigs. Renegayde played for the Seattle Majestics (the women's full tackle football league). We played for Bat n' Rouge, the fundraiser for the LGBT Alano Group (12-steppers) which was a blast. One of my favorite Renegayde favorite pieces is our rendition of the hip-hop song, Low, by Flo Rida - we toss in little dances, and shout out a "hey!" or two and the piccolo's rock. We'll be playing it again, surely, at our Rat City Roller Girls gig next month.

The marching group marched in Solstice and for Pride the last two weekends. I missed a few other parades and will be missing a few more but feel lucky to at least make those two events since they are freaking awesome! and being a part of them was filled with unspeakable amazingness (so cool, I make up words!). The best part easily was when the band would put down our horns for the the Thriller dance in, obviously, Thriller, by the recently departed Michael Jackson. The roar over the crowd (even before his departure) was so deafening it gave me chills and kicked my adrenal medulla into high gear! I have a video of it a band-aide got for us that I'll try to post later. Some random folks have posted pics up us doing the dance on the web so if you google Rainbow City Band and Thriller you may get a few hits like this one!

The rotation I've been on is GYN/FPO. Which basically means a hodgepodge of gynecology stuffs and touchy-feely stuffs the residency makes us do so they can make sure at the tender age of 32, and after 6 years of back-breaking medical training, we still know how to write an essay about feelings. No, really, it's potentially a very good opportunity for making sure we stay in touch with understanding our patients and, probably most importantly, coming to terms with things we can't understand. Since, as doc's, admitting we "don't know" sometimes feels comparable to showing up to work without any pants on.

I feel I've gotten the most out of the gynecology component, however. I do really enjoy working at Planned Parenthood and I particularly enjoyed learning to do colposcopy and treating cervical cancers with excision techniques. I feel pretty good about my colposcopic skills and wonder if I'll want to do them in practice. I also put in enough IUD's this month to put the Mirena manufacturer's kids (and their kids' kids) through college, I'm sure.

Next up: 4 weeks of in-patient Medicine (q4 call of course, first call tomorrow), followed by 2 weeks of the back-breaking Nightfloat. I have to reluctantly admit that I'm kinda sorta maybe looking forward to the next four weeks of in-patient. Don't get me wrong, I am NOT excited about the hours, the lack of time off, the sleep deprivation, the lack of time to see my girlfriend, or any of those terrible things. But I am looking forward to a routine - in the mornings at least, because as a 3rd year resident my afternoons will be spent in the unpredictable no-man's land known as clinic as opposed to the more structured wards. Additionally, I will be the senior to a fresh out of medical school intern in his first week of work as an MD! It's a little exciting to help him be a part of that. It's especially great because it's too soon for them to be bitter or burned out, maybe I can soak up some of that fresh perspective and get to see my job through new eyes again! Remember my first month of internship?

Additionally this month, I travel to Chicago for 30 hours or so (on my Golden weekend, getting there by plane, train and automobile). Which hopefully will be productive for myself and GLMA. My mother also visits which should be fun and we have that Roller Derby gig I'm thrilled about! On a sad note, Shilo will be leaving. For the next year at least, so there's a possiblity that this may be the last month I will get to spend time with her. I try not to think about it however and have been out to see her as much as possible in the month of June. That horse saved me when residency was about to break me. I owe her a lot (and of course her owner, who recognized a horseless rider when she saw one).

(photo credits: Michael Clark for the first, official Bat n' Rouge photographer for the second, and me for the third!)