Farewell 2008

I have conflicted feelings about 2008. It was a year of highs and lows for me. Professionally, I finished my Cardiothoracic fellowship, but for reasons I currently question I tacked on an additional year. Socially, I have met some great new friends and moved closer to some great old friends, but have moved too far away from some of my best friends. Financially, I would complain about how poorly surgical trainees are paid, but in light of the current economy it would make me look incredibly petty. Personally, I still haven't figured out the whole guy thing. I was hoping that Northern guys would have less issues with my job, but I guess at the end of the day guys are the same everywhere.

I can't say that 2008 will be a year that I look back on with a lot of fond feelings, but I will count my blessings. I have a job that I enjoy; AMAZING friends; good health (even if it is only "good for my age"), and a wonderful family. All in all not a horrible way to end a year. Here is hoping for a happy, healthy and financially secure 2009 for all of us!

Holiday Hangover

Why is it that following any small amount of time away from work, especially for a holiday, I always struggle getting back into the groove of things? I am at work today where we have a relatively busy day, but I am just not feeling it. I have a cup of coffee and an espresso, but still sluggish. I think there is something about holidays that gets into your system and refuses to let go. I think that I am by nature an incredibly lazy person that struggles motivating whenever I slow down at all. I guess the answer would be to not slow down, but that doesn't sound like fun.

Parents still in town until tomorrow. Good trip so far. We spent the day playing tourists in Philly on Saturday. I finally got around to seeing that broken Bell. It was colder than I would have liked, but not horrible. Yesterday we headed to NYC. Weather was fantastic. It was in the 60's for most of the day with no rain. Couldn't have asked for better in December. LOTS of other people also wanted to take in the Rockefeller tree, but still had a great time. Will post pictures tomorrow once I can reclaim my home office.

Guess I should actually go work now.

White Christmas

It took 35 years and a trip to New Jersey, but I had my first ever white Christmas. It wasn't freshly fallen snow, but there was lots of it; so I am counting it. My friend Beth and her family took pity on the orphan this Christmas and invited me up to their house for the last two days. I had a wonderful time. She has a 15 year old step-daughter and an almost 3 year old. It was exactly what my lagging Christmas spirit needed. Christmas through the eyes of the young is the best way to view Christmas.

We started Christmas Eve with a delicious dinner cooked by Beth's mom. Can I just say she was wasted on the corporate world - she belongs in a kitchen. We spent the rest of the evening opening gifts and talking around the tree. In all honesty, I spent most of the evening playing with Giulia's new doll house - it is AMAZING. I love "old-fashioned" wood toys - they are so much cooler than the plastic crap that is out there these days. It is nice to see that Beth must have similar feelings. They have some seriously cool toys in their house. I would have stolen the doll house if I could have figured out how to get in to my car in the snow and ice.

Christmas morning I had the joy of watching the girls take in their Santa stash. They must have both been very good this year. Calla got more sports equipment this one year than I have accumulated in a lifetime. She also received my idea of heaven - an entire box of books. Giulia can now play a mean game of dress up and is now a budding ballerina.

All in all it helped turn what I had in my head made into a horrible Christmas a most delightful one. I will say it one more time - I have absolutely hands down the best friends in the world.

Parents coming to town today. Excited to see them, but not sure how we are all going to fit into my small apartment. Wish me luck. Hope everyone had a great holiday. Talk to all of you soon.

A Christmas Carol

Since I have been such a Scrooge this Christmas, I thought it fitting to reread the original Dickens version. I have included a portion for you.

"He had no further intercourse with Spirits, but lived upon the Total Abstinence Principle, ever afterwards; and it was always said of him, that he knew how to keep Christmas well, if any many alive possessed the knowledge. May that be truly said of us, and all of us! And so, as Tiny Tim observed, God bless us, Every One!

Merry Christmas everyone!

I need a maid

I am not a messy person - truly I am not. When I say my place is a mess, it usually means that I have been too lazy to unload the dishwasher and there is a dirty plate in the sink. I tend to like order - shocker I know, so I put things back where I got them. Most things in my house have a "place" and it is fairly easy for them to find their way home.

However, some general housekeeping chores I hate. Dusting, mopping and cleaning the bathrooms come quickly to mind. I don't want a maid to wait on me hand and foot - I just want one to clean my bathrooms and dust. I think that is a perfectly reasonable request.

I have a friend who could afford outside cleaning help, but has too many guilt issues about hiring someone (you know who you are). I will be completely honest - I don't get it. Despite the 15 minutes immediately after I walk out of a Wal-mart in disgust, I have no deeply hidden feelings of superiority. It is for me about having someone help with tasks that I find incredibly painful. I have no issues having someone else change the oil in my car although my dad made sure that I know how to do it myself. I refuse to feel guilty about the fact that come July and that real job thing - I will NEVER ever voluntarily clean my bathroom again.

As is probably obvious, I have spent most of the evening getting my apartment ready for parental viewing. It is amazing how things look so incredibly different when you know that your mom is going to see it. Is it just me or does anyone else have that problem? It can look perfectly fine 10 minutes before I find out my mom is coming when all of a sudden it looks like a pigsty. How is it that mom's have this power over their children? Oh well, at least my apartment is tiny.

Goodies Goodies Everywhere

I know that I am not really loving Christmas this year, but if you judge by the number of goodies floating around this hospital - I am in the minority. Anyone who has ever spent much time at a hospital knows that there is always food to be found somewhere. You just have to know where to look. At Christmas, a blind man could find it. I would say that I had never seen so many goodies, but I just have to think back to last year at the hospital. Every counter space is covered with cookies, brownies, fudge, nuts, etc. etc.

I blame my parents - particularly my dad, but I have a hard time saying no when people offer me food. Talking to several of my friends, I think it is a Southern thing. We are just taught to say Yes and Thank you. (I could just unnecessarily be blaming my heritage for a weak will-power - but that's my story.) This year, I was smart. I can simply not afford to gain the requisite "holiday weight". As a matter of fact, I am still trying to lose the "moving weight." Therefore, I went on a diet two weeks ago, and I have told everybody. Therefore, when people offer me such delectable goodies, I can remind them that I am on a diet. So far, I have survived two clinics drowning in goodies - including homemade baklava. I have also successfully managed to avoid the 10 platters of goodies currently sitting in the Thoracic office. I changed my coffee habits to downstairs.

I am not sure that I have actually lost any weight - exercising would probably help. However, I know that I haven't gained any and for this year, I will be happy with that knowledge.

Bah Humbug!

I have no one to blame save myself, but that does not make it any better. I went Christmas shopping today. Today - 5 days before Christmas. I have NEVER shopped this late, and now I understand why. Turns out A LOT of people shop late. I am fairly certain that I met every single person that lives in the greater Delaware valley today. At least half of them were at Macy's.

I LOVE to shop. Truer words have never been said. However, I do not like shopping in the cold shoulder to shoulder with a lot of pushy people desperately looking for that last Christmas gift. It was many things, but fun not one of them. At least I am finished. Now I just have to do some wrapping - I actually like wrapping. It is a great stress reliever for me.

I LOVE Christmas - at least I did until this year. I just haven't been able to truly get into the seasons. I have several theories as to why, but won't bore you with them. I have simply decided to call this year a wash and start planning the biggest Christmas celebration ever for next year. A little Scarlett O'Hara is called for along about now. Tomorrow has to be a better day.

Liking my calendar less . . .

This is not another blog about the fact that Christmas is almost here and I am still ill prepared. Instead, I am blogging about my day calendar. Previously enjoyed a lot. . . less so now. Today's offering:

"I am the modern, intelligent, independent-type woman. In other words, a girl who cannot get a man." - Shelley Winters

Enough said.

More English than I thought

Surnames aside, I have always considered myself to be completely American. Yes, with names like Baxter, Bennett and Barrett, my ancestors were Anglo-Saxons, but quite honestly "came over" so long again - I don't think it counts. I have always been somewhat envious of my first and second generation friends. They sometimes complain about the difficulties of straddling two cultures, but they have a tangible tie with their past. My relatives on the other hand were most likely sent to the "New World" as prisoners in Georgia's penal colony for debtors. I can't honestly say that a lot of the "old ways" have been passed down to me. (Except of course my knack for spending lots of money.)

Or so I thought. I have come to realize over the years that a lot of the "colloquialisms" that I heard growing up are actually British in nature. I actually grew up hearing things such as the boot and bonnet of the car, spot of something to eat, and we actually spoke of fortnights. I am not sure how random phrases made it through the Americanization of my relatives English, but they did. (If only a little less of the Appalachian hills accent could have penetrated.) I have always been an Anglophile when it comes to literature - maybe it is the language that attracts me most.

As I write this, I am enjoying a cup of tea between cases. Although I drink coffee, sometimes by the vats full, I prefer a nice cup of English Breakfast tea to relax. I have also come to realise that my temperament is very English. I am more aware of that here in Philadelphia where there is such a large Italian population. No offense to any of my Italian ancestored friends, but that much emotion must be exhausting. I am not sure I exactly qualify for the "stiff upper lip", but I do tend to keep my emotions pretty tight. I consider myself to be a fairly good listener, but I struggle talking about my problems to a lot of other people (sorry Kris - you lost out here as the one person that has to hear everything).

I am not sure why this is important to me, but maybe I am growing nostalgic as I age or something. I just think it is nice to have some ties - however small - with those ancestors who came before you.

OMG!!!

Christmas is 8 days away! When did this happen? I haven't finished shopping. I am NOT a last minute shopper. I have not finished shopping for gifts that have to be MAILED. Seriously stressing. I have not addressed the first Christmas card. Last year I did them in October. At this point, they may be Valentine's cards. When did this holiday season get so away from me? I could always blame my job, but I have had the same job for ten years and have never been this far behind.

It also wouldn't kill me to finish cleaning my apartment. My parents are coming next Friday, and my apartment is so NOT in parent viewing readiness. It isn't horrible, but one would guess that I had never been introduced to the concept of a dust or mop. My mom happens to know better.

I would continue freaking out on this blog, but quite frankly I don't have time. I need to get ready for Christmas.

When will I learn?

For a supposedly intelligent girl, I am incredibly stupid sometimes. Take yesterday for example. I just had to tempt fate. I couldn't take a rare slow call day for what it was. I had to complain about it being slow. Well, fate taught me. From 7 pm until this morning, I intubated two patients, coded one and took a ruptured thoracoabdominal aneurysm to the operating room. I am sure I did other things, but those are the ones I can still remember.

I came home took a nap, and then spent the rest of the day cleaning my apartment. Wow, what an exciting life I lead. Oh well, I am going to cap off my wonderful day by going to bed now.

Mazal tov to my friend Jessica on the birth of her beautiful baby boy. I am glad that everything went so well, and I can't wait to see him.

Call Day Blues

Call can be a funny thing. As much as I complain about the fact that I am almost always ridiculously busy on call, it is much better than the alternative. Slow calls are the WORST. It is not just the sitting around doing nothing, although that is pretty bad. Slow call days can be depressing.

I mean seriously depressing. I spend most of my life pretty busy. It does not leave a lot of time for self-reflection. On slow call days, you find too much time to think. . . or at least I seem to. To be honest, I think it is less about self-reflection and more about self-pity. I recognize most of the time that I have a pretty great life. I have a job that I enjoy, family that care for me, and great friends. However, on slow call days - all the things that are not perfect in life seem magnified.

Obviously for me, this is one of those slow call days. (Luckily, they are the exception and not the rule for me.) I have basically done nothing but read while waiting on something to happen. I can never get a lot done on call because I hate to be in the beginning of a project and get called away. At least maybe I will get enough sleep today that I can actually accomplish things tomorrow. In the mean time, I will take this rare slow call opportunity and feel sorry for myself. No worries, it is usually short lived and I should be back to normal tomorrow.

Fit not for man nor beast

Just leaving the hospital. Late of course because I had plans. One would think that I would learn not to make plans since it always seems to jinx me - sorry Jill, I'll try tomorrow. I walked outside of the hospital to dark, cold, windy and pouring down rain. I came very close to walking back inside. Nothing should be outside in this weather. It is cruel and unusual punishment.

It is almost comical to me that I have spent much of the last month complaining about how slow things are here. It is only now that I have other things I would like to work on that work gets out of control. How does the schedule know. It is uncanny. Oh well, Christmas cards may arrive for Valentine's day this year. Hope weather is better wherever you are.

Maybe they are on to something

So as some of you have read and others have experienced, people in medical training now have limits on how many hours they can work a week. The limits have been met with mixed reviews. We all know how much I love being told what to do. For the most part, I have thought they were silly, and besides a little part of me recognizes that I need to be able to function post call.

I was on call last night. I had for me a typical call. Very busy for most of the night with 2 cases and about 2 1/2 hours of sleep. I came home around 9 am this morning. I needed to run several errands, so I took a "quick" nap and headed back out around 1 pm. Grocery store, Target, Mall and oil change were on my agenda. I started at Target. I spent 30 minutes wandering the store picking up the couple items that I needed. I lacked motivation to move quickly. When I got up to pay, it occurred to me that I had left my house and gone shopping with nothing but my car keys. . . no license, no money, no credit card. After a return trip home, I only made it to the grocery store and target today. I decided I am not safe for more than that today. Maybe the powers that be are on to something. Patient care probably not within the realm of my capability today.

Waiting again!

Have I ever mentioned that I am not the most patient person on the planet. No? Well let me do so at this time. I mean - for a surgeon I think I do okay (not as good as Bassam, but we can all admit that he has the patience of Job and the calmness of Gandhi). It is currently almost 8 pm my time, and I am still trying to get through my day's operative schedule. Luckily, I am on call tonight so I am stuck here anyway, but that seems like very poor solace at the moment.

I was stuck here last night until after 10 pm. It is not so much the lateness of the hour because quite honestly - not so bad. Most importantly it was particularly painful because Trader Joe's closes at 10. I have not been to the grocery store in over a month. I traveled for most of the past month, so did not want to be wasteful. Unfortunately that meant when I got home last night starving, my choices were water, frozen broccoli, sun dried tomatoes and instant cheese grits. As only Kris can understand, I skipped the broccoli and had the grits. I like grits as much as the next Southerner, but not as my complete dinner. Oh well, hopefully can go tomorrow when I get off.

Still waiting by the way, I can't believe it has taken us all day to do six cases. Our new attending is so incredibly slow. I am only stuck operating with her because I am on call, but it still does not make me happy. Oh well, enough whining. Life is otherwise good. I spent much of the last month visiting family and friends, and now get to spend Christmas with my friend Beth and her family. Life is nothing to whine about - I'll be better.

Here kitty kitty

All that was old is new again. Hello Kitty, Care Bears, My Little Pony, and Cabbage patch kids have all made a come back. I lived in Georgia - home of the cabbage patch hospital - so it was my biggest obsession. I also had a pony and Susan had a couple of bears. Hello Kitty was extremely popular with my friends, but I was never really into it. I am not sure why exactly - maybe it was the fact that my mom thought it was ridiculously priced for pens and erasers or maybe I have always preferred dogs even as a child. I walked through the stores a lot and enjoyed looking at the merchandise, but never had much of my own.

Matt and Grace gave me a Hello Kitty necklace for Christmas. (I will try to remember to post a picture so that you can really appreciate how cute it is.) I must admit that I am now a convert. I wore it to work today, and every time I caught a glimpse of it in the mirror it made me smile. Considering how crappy my day was and that I am just now getting home - that is a miracle. I dare anyone to see my sparkly kitty smiling and not be in a good mood. I am not sure the hows and whys of the way that it's magic works, but will simply say that it is one impressive cat. Next up for me - a Hello Kitty lunch box.

home cold home

Just arrived back in town from Nashville. When I landed on Thursday, several people blamed me for bringing bad weather. It was in the 30's for a large portion of the weekend. I was as cold as anybody so I took the blame and kept going. However, upon arriving back here tonight, I remembered why it is so much worse here regardless of how "cold" it is back home. I had a fairly uneventful flight and caught the train back in to Center City without much delay.

However, when I popped up on street level at 16th and Market, I remembered why cold here is bad. I honestly thought I was going to lose a hand or an ear on the walk to my apartment. I think the issues are a couple. As I have mentioned before - wind is clearly a player. The other major factor I think is the amount of time spent outside. Back home (be it Tennessee or Georgia) the amount of time spent out in the weather is blessedly short. You are simply bolting from the car to the house or the car to the mall, etc. However, here you walk a lot. Things are considered very close if they are within 6 blocks. I LOVE this fact the rest of the year, but not a fan in the Winter.

Had a fabulous time in Nashville. I got to catch a Christmas show, tree trimming party, and a housewarming party. I spent time with a personal shopper and had great pedicure. I caught up with lots of old friends, and I also got to spend some serious quality time with my favorite under 5 duo. I will admit that I am a little tired, but had an absolutely amazing time. If only Nashville needed a Thoracic surgeon - I could be happy living there.

Christmas Spirit

I had not yet gotten into the whole Christmas spirit thing. I usually do at home with my mom dragging me shopping, but as I mentioned - I spent a lot of Thanksgiving at the hospital. Therefore, I had not given Christmas much thought.

I headed out this evening to the bookstore. I wanted to pick up a copy of A Christmas Carol. I have been hankering to reread it every since I started a Facebook conversation with a friend of mine from second grade. I must admit - although cold - there is something magical about walking down a bustling street at dusk with Christmas lights twinkling everywhere. I am now very much in the Holiday spirit.

Now, I need to get in the spirit to go pack. I am heading to Nashville tomorrow, and a suitcase of belongings would be nice to take with me. It is funny - I never traveled in 6 months - and now I am taking my 3rd trip in 4 weeks. Excited to see everyone. Will hopefully bring back pics.

Predictable

Further proof that I am not anywhere close to normal. . .

I love Christmas - no surprise to anyone. I particularly love decorating for Christmas. Something about the smell of a fresh tree is very soothing to me. However, I have foregone a Christmas tree and any significant decorations for the last two years. My decorations are somewhere in storage, and I was so busy in Nashville it didn't make sense to put much effort into it. (I just spent a lot of time at the Helou's inhaling their Christmas smells.) I had already decided that I wasn't going to do a tree this year either. Decorations still in Georgia, and apartment tiny. I was content with my decision.

That is - until yesterday. When I came home from work yesterday, I had a message on my door informing me of the "Holiday rules". My apartment complex does not allow real trees. This is a perfectly logical decision on their part. In an apartment complex this size, I can see where lots of things can go wrong. However, now that I can't have a real tree - I desperately want one. Why is it that I can't stand to be told no? Reverse psychology works great on me. Guess I will spend a lot of time at the Christmas tree stand smelling the trees.

Thanksgiving at the Hospital?

Sorry I didn't get a chance to call everyone on the Holiday. Hopefully everyone had a great Turkey day. I made it home Wednesday without much of a headache, and luckily made it back to Philly yesterday just before the entire east coast got delayed. However, my time at home wasn't exactly peaceful.

As most of you know, I am very close to several of my cousins. We literally saw and played with each other every day growing up. Paul, my cousin who lived next door growing up, now has two beautiful little girls - Serenity and Sidney. They have not had the smoothest year. Early this year, their mom left. She really didn't give much of an explanation, but did say that she didn't want the kids with her. The "kids" are now 8 and 5. Since her departure, she has only been to see them twice and that was with much prompting from my cousin. He understands - mostly because he is living with the girls - how much they miss their mom. Things got worse for Sidney this holiday.

I had just walked into my parent's house when the phone rang. It was Paul asking if I could come take a look at Sidney (he now lives across the street and a couple of houses down). I stated that I am not a pediatrician, but would be happy to see her. She had come home early from school on Tuesday, and had spent most of Wednesday just lying around. If you knew this kid, you would understand how not right that last statement is. As soon as I saw her, I suggested we head to the emergency room. Anyone in the medical profession - be it doctor or nurse that is any good - will tell you that somewhere along the way you develop a sixth sense. Often, even before they "start looking bad" by medical standards, a little buzzer goes off in your head. Sidney had all kinds of alarms going off in my head. This little girl was not well.

We quickly learned why. At the hospital, routine blood tests revealed that she was an undiagnosed diabetic. She is only 5 years old. Her blood sugar had risen to a dangerously high level and she was now in a diabetic coma from the ketoacidosis. She was flown to Egleston Children's Hospital in Atlanta. For much of Wednesday night, we were not given much hope that she would make it through the night alive. She was intubated and her brain started to swell requiring placement of a ventricular drain. Many prayers later, she finally started to improve. She was extubated on Saturday and is slowly waking up. Unfortunately she still has a long road ahead of her. She developed a blood clot in her leg from a groin line and will need treatment for it. She now also has to deal with insulin shots and glucose testing for the rest of our life. I have adult patients who don't like to give themselves shots - I can't imagine that this 5 year old will cope all that well.

We did not get a chance to have the normal Thanksgiving that we would have liked, but we all ended the weekend with so much more for which to be Thankful. For those of you who sent prayers for Sidney - Thanks and keep them going.

Heading Home

Just finished packing for home. It is truly amazing how much one can get into an overnight bag when really trying. This will be my first experience traveling on "the busiest travel day of the year" - so I am trying to keep it simple. I am carrying a small enough bag to fit under my seat - no fighting for overhead space or waiting at baggage claim. I am taking the rail to the airport - no waiting on a cab or "the horror" - parking. I even have alternate plans in place for my parents to pick me up in Atlanta if my connection to SC gets delayed. All that said - I am still prepared for a long journey with its share of hiccups. At least I get to go home for Thanksgiving.

My friend Kris has continued to blog daily from her trip to Chicago - she is such a better person than I am. I will let you know how everything went when I get back on Sunday. To those of you I don't get a chance to talk to - HAPPY THANKSGIVING! Don't eat too much.

More Calendar Wisdom

I really love my Wild Words from Wild Women calendar. It is at times funny, thought provoking and silly. At times, I need a little of all the above. The quote from yesterday struck me in particular. As I spend a lot of my time lately obsessing about reaching the climate of my particular mountain - I am reminded to make sure that I enjoy the climb.

"You never conquer a mountain. You stand on the summit a few moments; then the wind blows your footprints away." Arlene Blum

Priorities?

Okay - I finally caved in today and purchased a winter coat. I resisted for many reasons. I even convinced myself that perhaps I didn't need one and could make do with the myriad of coats that I currently own. Then it got cold. Not that normal low temperature cold, but the wind is blowing and icicles couldn't survive in this weather cold. I headed to the store.

I heard they had a sale at Macy's and as that required only a quick walk downtown I decided to check it out first. The downtown Macy's in Philly is really quite spectacular. It is in a terrific old building with all these hidden nooks and crannies. Love it! They were indeed having a pretty terrific scale and I got a Calvin Klein "puffer" jacket with hood and most importantly sans fake fur trim for 60% off. I was feeling quite proud of myself. It is even red - one of my favorite colors.

On my way out I decided to stop in the Estee Lauder counter. I still hadn't caught a "gift" time, but was really scraping the bottom of the moisturizer container. Therefore, I decided to suck it up and pay full prize without the gift. I initially felt good about being at the counter. The sales lady raved about my skin and its "lack" of wrinkles. (I know that is her job, but it still makes you feel good.) Then I payed the bill.

I payed only five dollars less for my 1.7 ozs of Revitalizing Lift face cream than I did for my heavy winter coat. Perhaps my priorities are a little screwed up? I probably would be feeling less guilty about this if I hadn't had to pass several homeless people as I entered the store. I donate to charity and contribute old clothes to Goodwill, but for the amount of money I just spent on face cream - I could have bought one of those people a new winter coat! My vanity and conscience are currently having a brawl. Will let you know how it turns out.

White Thanksgiving?????

Okay - we all know I grew up well below the Mason-Dixon line. For those of you who didn't, there is this game we all play come Christmas time. We start wishing for a White Christmas. We play the songs, we send letters to Santa Claus, etc etc. We all have this image of snow covered Christmas trees, lights twinkling bright against the white curtain of snow, and enjoying a Christmas dinner while gazing out at the beautiful snow. Even the grown-ups get into the spirit.

Needless to say - it never happens. It is not like it never snows in Georgia. It does - we get at least an inch every 3-5 years. What doesn't happen is life continuing as normal. Christmas would come to a grinding halt should it ever actually snow back home during that time. We would all be confined to our homes with our milk and bread (Southern joke you would have to be there to believe). We love the idea of snow - we just don't do well with the reality. Because we see it so infrequently, we have romanticized it.

Well, all that may be changing for me. I woke up this AM to a light dusting of snow on the ground with more falling from the sky. Back home, schools would have been cancelled and no one would go to work. Here, people barely glance up. The Southerner in me wants to stand on the street corner and enjoy the wander of the beautiful snow falling. The Southerner in me is also a little worried. They are getting our "January snowstorm" in November. If Thanksgiving is dusted with snow, what will Christmas look like? I have got to run to the grocery store - I am out of milk and bread.

Peeved!

Okay - I know that I blogged once already today, but I am extremely irritated and need to blow off steam. I would normally call Kris or my mom. My mom is out currently - see prior blog from today, and Kris has had to listen to a lot of my crying recently. Since I know they will both have to listen to even more as this whole job search thing goes along, I decided to blow off to my computer. Feel free to ignore this blog and check back tomorrow.

As anyone can see from my Facebooking and blogging earlier today, I have spent most of my day doing nothing productive. I did a lobectomy this morning, but was thru by 10:30am. My new attending - we'll call Dr Obnoxious - had a lobectomy followed by a VATS which I am supposed to do. She started the lobe at 11 am and just now finished!!!! I am not sure why it took so long, but thanks to her 8 hour case I have been stuck here all day waiting on my second case to go. It is just now going into the room, and because she never knows when to quit will probably still be going at midnight.

I try to be understanding. In seven short months, I will be her - if I get a job. I can only imagine how scary it must be making the final decisions after all the years of having someone look over your shoulder. I would argue however that since we have 10 years of people looking over our shoulders, we should be the new attendings with the greatest experience. Our decisions should come just a little bit easier. There comes a time where you just have to suck it up, consider your training and go with your gut. We are Cardiothoracic surgeons after all. We are always right - just ask us.

What's so great about NORMAL?

This is the question my mom asked me yesterday. I have spent a lot of time whining to her recently about wanting a normal life. My mom has this great ability to listen to me complain about my "problems", be a little understanding, and then tell me to get over it. This is probably how I survived my surgical training. Whenever I started my woe is me act, she would listen for a little bit, and then remind me that as my friend Bassam likes to say - I checked the box. It may sound somewhat harsh to some of you, but is the perfect way to recenter my reality. [I like to tell my mom that she is lucky I turned out so well, but I become more aware each day how hard she worked to achieve said result.]

My mom's comment made me think - as it was intended to do. When I went to my ten year high school reunion several years back, I was nervous about the fact that I was still in "school" while everyone else had normal lives. I walked out of the reunion thankful that my life was exactly as it was - so many of theirs sounded so boring and foreign to me. I had so little in common with them - I skipped my 15th. Surely that is not what I have been whining about?

Therefore, how do I define normal? I want simple things out of life. I would like to sleep till 5 am. I would like to only be at the hospital for a couple of hours on the weekends. I would love to make plans with my friends and actually be able to keep them. I would like to have dinner before 7 pm occasionally. I would like to read a book that has absolutely nothing to do with medicine and not feel guilty about it. I would like to have a desk completely free of papers to write and even more articles to read. I would like to give good news to patients at least once a week. I want to have complete control over my patients and my schedule.

The more I think about it, the more I realize that my definition of normal - and ultimately what I want in life is so far from what most people consider normal they have different area codes. I guarantee you each of my friends would come up with completely different lists - both from mine and from each others. This is perhaps the ultimate lesson for me. My normal is only normal because it is what is safe and predictable for me. I should neither covet nor judge others normal. We all find our comfort zone in life. It is simply time for me to move into mine.

Do clothes mate?

Okay - I am catching up on some laundry tonight. I actually got to wear real clothes this weekend. I miss that sometimes. As I was starting to put things away, I swear that I have more clothes now than I had when I moved here.

Many of you are shaking your heads saying - no surprise there. Girl you like to shop. In my defense the only thing that I have bought since I have been here are a couple of 3/4 length t's from Ann Taylor - honest. Where are they coming from? I glanced thru them - they all seem familiar, but I swear I didn't have that many clothes before I came here.

Maybe they are reacting to the cold and getting closer than normal. I think there has been some unprotected sex in that closet. I could have told Sarah Palin that abstinence doesn't work.

Clarity at last!

I got a chance to head to our nation's capital this past weekend to catch up with an old friend. I had an amazing trip. I caught up with my friend Jessica from college. We spent a lot of time trying to remember when the last time that we actually had a chance to physically see each other and decided that it was more years ago than either of us were willing to admit. However, we were able to catch up and I got to see a lot of the city while I was there.

I had only been to DC once before ten years ago when I was applying for general surgery residency. I had a brief sleet filled layover that allowed me to see basically none of the city. The Washington Monument was under renovation at the time and completely covered in scaffolding. We also got lost and couldn't even find our way past the White House. Jessica made sure that I was able to catch up on all the Monuments and the White House. I should also point out that she is 34 weeks pregnant, suffering from pre-term labor and has issues with a fibroid that she has named frank. Despite all of this she allowed me to drag her all over the city she grew up in seeing things that she has seen her entire life. Now that is what I call a good friend.

I could continue to regale you with the details of my fantastic weekend, and would be happy to at a later date, but the most exciting decision that came out of this weekend involves my future. As I have complained about before, it is time for me to start applying for jobs. The real kind. I have had some issue with deciding first and foremost where I wanted to live. I have been giving serious thought as to where I can see myself in 10 years. I know that you don't have to keep your first job forever, but I want that option.

I had decided already on the East coast - that is my comfort zone and personality. However, it involves a fairly large piece of real estate. As I was touring the DC area this weekend, I realized that I REALLY liked it there. This got me truly soul searching as to what I want in a place to live. Now in a perfect world, I could pick a place and then magically transport all of my friends there to live. Unfortunately, I haven't lived in a perfect world in quite some time. I decided that while proximity to friends and family are important, I need to look beyond to location and type of practice. Friends and family move - mine more than most. I need to make sure that I really like where I live.

So I made a list of things that I want in my future city. The first thing on my list is just that - A City. I grew up in the middle of nowhere. (Literally my street address is Nowhere Road). It was an amazing way to grow up with lots of freedom and safety, but not what I want as an adult. I am a city girl at heart. It doesn't have to be 1 million people, but urban I want. Secondly, I want seasons. I will always be a Georgia girl - that is where I was born and probably where I will retire. I want something else in the middle. As much as I hate winter - I like the things that winter allows - namely fall and spring. Third, access to water. It doesn't have to be outside my back door, but needs to be a relatively short drive away - I prefer salty by the way. Fourth, driving distance from my parents. My parents don't like to fly. I want to be close enough that they can get into the car and come visit me without it being a two day drive.

With the above qualifications, I have now narrowed my job search. I am finally excited about the whole prospect instead of filled with incredible dread. I am still nervous and stressed of course, but I really see no way around that aspect. Oh - guess I should tell you guys what I have decided. I have decided to look for jobs in Washington DC, Maryland, Virginia, North Carolina and Tennessee. I don't want to limit myself more than that right away - thoracic jobs though getting better are still a little hard to come by. I am still trying to make the Private Practice vs Academic decision so have decided to apply for both to see what is out there. The search has begun in earnest - wish me luck and please forgive my stressful grumpy ramblings over the course of the next several months.

The lies we tell ourselves

I think I have an under appreciated talent. I am a very convincing liar to myself. The most interesting thing - I am a horrible liar to everyone else. I have an overdeveloped sense of guilt - and have never been able to lie well. However, it seems when it comes to myself - I will believe anything that I say. This has probably come in very handy as a survival tactic the last 10 years.

The only time that the system starts to fail is when I have a vacation coming or a trip planned. I work between 80-100 hours most weeks. I am not counting the reading that I do outside the hospital or the preparation required for cases. I have convinced myself that this is pretty good. (It is a whole lot better than it used to be before the "80 Hour Work week".) I tell myself that I have become lazy in my old age and should be doing more.

Then I plan a trip. For instance, this weekend I am heading to DC to visit an old friend that I haven't seen in ages. Suddenly, out of nowhere, last week the amount of time I spend at work started to really bug me. I have become grumpy and roll my eyes every time my phone rings. I am on call again tonight - my last one this month - but all I can see is that I am stuck doing a right VAD revision on a sick as crap cardiac patient. Before last week, that would not have bothered me. I would have convinced myself that it makes the night go faster.

My theory - for pure survival - my mind convinces me that life is all rosy when it sees no alternatives in the near future. However, when a chance for fun, rest and a small piece of normalcy presents itself - I become less tolerant of life as I know it. As soon as I get back on Monday, I will go right back to life is good what a lucky girl am I. My only concern - I have both a Thanksgiving vacation and an early December weekend trip to Nashville planned. Maybe since I have this weekend respite coming up - I can sail to the next trip without this grumpy bump in the road.

Christmas Lights !?!?!?!?

So as I was just driving home from work - much later than it should have been - I was silently lamenting my day in my head. I was also audibly grumbling about the slow traffic so late at night. It was then that I noticed that the traffic was backed up because we were down to one lane due to the trucks placing Christmas decorations and lights on the street lights and trees. Correct - I said Christmas decorations. Last I checked - Thanksgiving day was still two weeks away!

My friend Kris brought this topic up the day after Halloween when she first found Christmas decorations in the store. Although I too found this obnoxious, I tried to argue in my head that this is not the best year to argue against retail stores trying to make money. I imagine they are hurting quite a bit at the moment. Therefore, I bravely fought past the Christmas isles and tuned out the Christmas music at the stores and forged ahead. Christmas decorations - this is my line in the sand.

We made fun of people growing up who left their Christmas lights up all year, but maybe they were just ahead of the curve. It seems that Christmas gets earlier and earlier every year. My issue with this is it takes some of the fun out of it for me. Christmas is a season. One, at least for me, filled with anticipation, wonder, joy and hope. By dragging it out longer and longer, it seems to get a watered down. Before long, it will be Christmas all year. What do you look forward to then?

I am jumping on Kris's bandwagon here. As usual she called it from the start.

This can't be good

I grew up a very religious person. As most of you know, Church was and still is a big thing in my parent's house. I am sad to admit that these days I am more spiritual than religious. I unfortunately do not attend services as often as I should. This is from the girl who missed only two Sunday morning services for the first 26 years of her life. My - at the time brand new baby sister - is to blame for one and a freak Atlanta snow storm for the other. I don't necessarily believe that a person has to show up at Church every week to be a believer, but I do think that it helps.

I use my job as the most convenient excuse, but I recognize it is exactly that - an excuse. I showed up every Sunday during medical school. I could certainly find my way to a church pew on my weekend's off from work. My distance from regular church attendance is relatively recent. I attended regular services in Augusta. When I first moved to Nashville, I was angry. Not necessarily at God, but at the turn of events my life had taken. As I have said before, I had lost my Faith. I attended Church with the Helou's occasionally and for the Holidays, but never put enough effort into finding a Church of my own. I have now lived in Philly for several months, and have not yet darkened a Church's door.

I am not proud of this, as a matter of fact it saddens me greatly. It has also been weighing on my mind a lot recently. Maybe that is why I had such a strange dream last night. I somehow mixed the Seven Deadly Sins - biblical version with the movie and I was the star. I don't remember many of the details, but what scares me is how many of them I have given a place in my life. For those of you who don't know, although never listed together in the Bible, the Seven Deadly Sins were developed by the early Church to list the "Mortal sins". The sins that required absolution or penitence.

The first is Pride - I am a surgeon and a cardio-thoracic one at that - enough said. The second is Envy. I struggle with this one. I talk to my friends and think what wonderfully rich and full lives they have, and sometimes wish they were mine. The third is Wrath. I think I may be okay here. Interestingly as I get older, my temper gets less and less. It now takes an incredible amount of incompetence to get me riled up. Fourth is Sloth. Not so good here. I have become so incredibly lazy. I still have grand plans and great ideas, but these days they give way to sitting on my couch or sleeping. Fifth is Greed. I get a pass here. If I were greedy, I would have had a job long before now. Sixth is Gluttony. I stepped on the scales yesterday - we need go no further. Seventh and last is Lust. Too busy being slothful to have much issue here.

For those of you counting - Four out of Seven. I am not saying that regular Church attendance would fix the above, and the list was made somewhat in jest. However, it is telling for me that I could come up with the above list. I need to nourish my soul. My beliefs are a big part of my sense of self and ideas about the world. I have always felt that at heart I am a nice person - I need to make some changes so that I can continue to think so.

Giving my hour back

Okay - I look forward to time change as much as anybody. There is something so delightful about "stealing" an extra hour of sleep. I feel like I am somehow cheating the system. For one day a year, I actually have that extra hour that I so often wish existed. I get almost as upset about being on call for end of daylight's saving time as I do for major holidays. I want to enjoy that hour in the quiet privacy of my home - not in a hospital. All of that being said - despite planning thousands of productive ways to spend my extra free hour each year - I usually sleep for an extra hour. However, it is one of the best hours of sleep on the planet.

As you can tell - I truly look forward to that first Sunday in November and the extra hour in the day. However, somehow each year, I forget how much I actually hate all the dark winter days that come afterwards. I am used to going to work in the dark. Early on I whined about how much I hate mornings, but in all honesty - I have sort of turned into a morning person. It is not completely my choice - I can barely sleep past 6 anymore, but I can find some beauty in the stillness and promise of a dark winter morning. Don't worry - I haven't turned into one of those annoyingly cheerful morning people, but I can at least now make conversation in the morning.

What I find so incredibly depressing and quite frankly tiring is coming home in the dark. Take today for example. We actually finished work at a decent hour. However, walking out of the hospital at 5 pm it is already dusky. By the time I make a quick run to Target and have a bite of dinner - it is dark. I spend most of the Winter walking by as many windows during the day as I can to help recall what sunshine looks like. I am also discovering that it is incredibly grey here in the City of Brotherly Love.

Even worse is my mind's reaction to the darkness. It is 7 pm and I am falling asleep on the couch. Not because I am getting any less sleep that normal, but because it is dark outside and that seems to flip a switch in my head that says 'must go to sleep'. Therefore, this year I have decided to stay on Daylight's saving time all winter. Sure it may be confusing to be an hour off from everyone else, but since when have I followed the beat of a normal drummer?

Proud American

I will admit that I am a bit bleary eyed this morning and could really benefit from a nap, but I am incredibly proud to call myself an American today. It was an amazing night. Election called relatively early (11 pm on East Coast) without any hanging chads or tampered machines. I had forgotten what one of those election nights felt like. It has been a few years - 8 as a matter of fact.

I will admit that I openly cried during his speech. I truly felt the historical significance of it. This will be one of those 'what were you doing when' moments. We haven't had a lot of those in my generation - and the ones we have had were not great memories. It is not all that fun to sit around and reminisce about what I was doing when the Challenger exploded or the Towers went down. This is a memory I can truly cherish.

He seemed subdued during his speech - understandable given the tragic passing of his grandmother, but I got the impression that part of the issue is that he truly understands the enormity of job he is undertaking. I like that about him. I want a President who understands it is a big deal - not someone trying to pass time during the off season in baseball. We have serious problems we are facing, and it is time for serious solutions.

Luckily, I only have one more case and then call it a day. It has been a tiring couple of days, but time well spent.

ELECTION DAY

I can't believe it is finally here. It seems like this is the longest election cycle ever. I have loved it. It has been particularly interesting living in Philadelphia. The things that I have learned over the last few weeks. For instance, did you know that according to the GOP trust, there is some question about whether or not Obama is even a US Citizen? There was also an interesting ad involving a "failed abortion" who is now a 30 year old woman. Of course, she had issues with Obama also. I know both sides go negative, and it seems to be getting worse every year, but some of these things are getting a little ridiculous. (Godless Americans in NC anyone?)

Regardless, I had a bad call night, but was able to get a quick nap in after I voted this morning. No bad voting story for me. I walked right in to my polling place - literally one block in front of where I live. I waited behind one person to sign in, and behind two people to vote. I was literally in and out in 10 minutes. Of course, 20 years from now when I am telling friends and family the story of voting for President Obama, I may have to make that story more interesting. Poetic license you understand.

The only thing left is a lot of CNN watching. Speaking of, the first polls should be closing soon. Will check back in tomorrow - the first day of our new Democratic government.

Call woes

I am on call again. It seems like a common occurrence. In truth, I don't take a huge amount of call here. I average about 4 calls a month - not bad. I think there are a couple of reasons it seems bad - one call here SUCKS. I don't think I have ever had what I would consider a "good" call night. If I can get out of here without given chest compressions, opening a chest, intubating or running someone to the operating room - I consider it a win. The other reason is that my call always seems to be lumped. For example, for the month of November - I have the 3rd, 8th and 13th - and then I am finished for the month. It is not all that fun for the two weeks that I take all my call, but it is very nice for the other two weeks of the month.

I feel a little guilty complaining. It could be SO MUCH worse. It is just when I am in the middle of the call - it is very hard to see the big picture. All I can see is that I am once again stuck in a smelly call room taking care of an unstable ICU. The good think is that I get to leave early in the morning.

My plans - run to the grocery store, take a shower, VOTE!, go to gym, take a nap - stay up all night watching election returns. I am a little sad to see it coming to a close. I am such a political junkie - what will I watch at night now? I am not really into many TV shows anymore. Lost my one and only show hasn't started their new season yet. CNN is less exciting without all the political pundits. Oh well, I guess I can read more.

Just a quick reminder for those who haven't voted yet - tomorrow is the big day! Don't forget to vote.

Clean bill of health . . .relatively

So, I went to the doctor. Not my favorite thing. I am not sure why exactly. It doesn't make me nervous . . . I understand what they are saying to me . . . I always take a book so I don't mind the wait. . . and although I don't love needles, I don't have a phobia against them. I don't love the poking and proding, but understand the necessity. (Although that whole pap smear thing - there has to be a better way.) I think the biggest issue is that I read to much into every question that I am asked. I mean if they ask me my favorite color, in my head I am trying to decide what the right answer is so they don't decide I have cancer. A little psychotic I understand, but that's me.

I was told that I was in very good shape for my age and profession. Yea that's what I said - for my age and profession. What does that mean? Would I be an unhealthy accountant? Do they grade the age thing on a curve? They didn't teach me that in medical school. What are they thinking - wow she would be a crazy unhealthy 28 year old, but since she is 35 this is the best we can hope for? I use the expression he/she looks great for their age all the time, but I am talking about 70 and 80 year olds! I am choosing to put a positive spin on it and to move on - suprising for me I know, but learning you just have to let some things go.

We did discuss my recent dizzy spells. I am told that they are most likely related to benign paroxysmal positional vertigo. Big fancy term - the only things that I could recall about it were that it involved these really cool little tiny rocks that live deep in your inner ear and it was almost always the cause of dizziness in little old ladies. Turns out I was right on both counts.

The simplest explanation is that there are these cool little rocks in your inner ear that tell your brain the position of your body. As you move, they roll against each other sending new signals about their new position. Outside of the cardio-pulmonary system - coolest part of your body. As one ages, or also happens following head trauma, viral infection and for some unknown reason increased incidence in Urban dwellers, for lack of a better description dust or debris makes it into the area of the little rocks. They can no longer send as clear of a signal, therefore one gets dizzy when changing positions.

Good news is that it is almost always self limiting. Housekeeping eventually comes along and cleans out the dust. There are some exercises that I can try at home to help speed along the process. Of course, they offered to have me see an Otorhinolaryngologist (ENT doc). This is the funny thing about going to the doctor when you are a doctor. Doctors seeing doctors are always afraid they are going to miss something or you will second guess them. Therefore, we are very quick to refer you to a specialist or for a second opinion. Crazy logic, but true anyway. I politely declined and went along my way. Only hurdle left is a fasting lipid panel. I should do it soon since I am currently still off meat and chances are good it may actually be a decent number.

At least I am off the hook for another year.

Slight miscalculation

Okay - I don't love to admit when I am wrong, but like to think that I am a big enough person to admit it on the rare occasions that it actually happens: :) Boy was I wrong. I mean couldn't have been further from correct. I missed it by a mile - as the saying goes. The colossal mistake that I made - thinking that I could survive a Philly winter.

I know you are already laughing. Half of you are saying I told you so - and the other half sneering that it is still October. My concern is the latter. It is only October!!! Today in Philly, it is a balmy 36 degrees, windy with precipitation. The precipitation I might point out has been snow for a good portion of the day. I'm sorry, but where I come from we call this a bad January day. If this is only October weather here - I am seriously afraid to stay and find out what January is like.

I am not completely naive. I expected that it would get cold. I even expected snow. I didn't expect the wind that makes the cold so much less tolerable, and I figured it would at least be December before the snow arrived. I don't have clothes for this weather. I am not sure they make enough clothes for me to handle this weather. The only bright spot I can see is that you have to wear so many clothes in the winter here, that no one could notice an extra few pounds. A bonus yes, but not quite worth the cost. Call me weak, call me spoiled, just call me a taxi to the airport.

Fanatic indeed

Okay - I have lived in a World Series town before. . . I was in Atlanta during the 90's. It was a lot of fun. I saw some great baseball and a lot of good clean fun had by fans. I never felt in danger or that the fun would get out of hand. Of course, maybe part of that was they kept losing the World Series, but I digress.

As most of you probably know, Philadelphia is in the World Series. Even though I do not tend to follow sports, I can't help but also know this fact. You can not sneeze in this town without hitting someone or something with a Phillies logo on it. The whole town is seeing red - literally. I honestly think the election could be tomorrow - Mickey Mouse could win and it would compete for headlines in this town.

They have a chance to win the series tonight, and honestly I am a little worried. The fans here do not strike me as the well behaved good clean fun kind of fans. I am afraid something will burn or a car will turn over. Crowds took over the streets when they clenched the NLCS. I am not sure they can handle more. I am hoping to leave the hospital at a decent hour, put my car in the garage and settle into my apartment tonight. Hopefully, all will be well, but I currently couldn't outrun a two year old much less a crazy fan. Therefore, I will watch from my lofty apartment window.

aches and pains

Okay - I know that very recently I argued that one should only be as old as they feel. I take it back. At least this weekend. I feel VERY old. It started toward the end of last week. I developed back pain. I think it was a combination of a weird case that required me to stand strangely for four hours and the increased amount of studying that I have been doing recently.

When I study, I have poor posture. I hunch over the desk. If I am studying regularly, I either strengthen my back muscles or I learn to study with better posture. When I am only studying sporadically - as I am right now - I just end up in pain. I develop mid Thoracic pain just to the right of my spine. Interestingly, this is the same place that I carry stress. I am sure that is probably not a coincidence, but strangely related. I also developed lower back pain from standing in a weird OR position.

In the past, I could shrug it off. It hurt a little, but was easily ignored. This weekend, I struggled getting out of bed. Not because I wanted to sleep or stay in bed like normal, but because physically it hurt to get out of bed. I had sharp pains down my arm and right hip pain. I am old. I am at least up with a lot of Advil, but no longer want to feel my age.

Much to be Thankful for

I know that Halloween hasn't yet arrived, but I find that my thoughts have already turned to Thanksgiving. I loved Thanksgiving when I was growing up. We always ate a late "dinner" ( in the South that is what we call the mid-day meal) at my grandmother's house. My grandmother died on the Tuesday before Thanksgiving my fourth year of medical school. I will be honest - I haven't really enjoyed it much sense.

I have tried. I have planned elaborate dinners that I forced all of my family to attend. I forced friends from work to come to my house for Thanksgiving dinner - all trying to recapture my love for the holiday. I don't hate the holiday - I just don't get that bubble of excitement or anticipation that I used to get.

That finally changed this year. I was looking at my schedule yesterday - trying to make some plans about my Nashville trip when I noticed that I am not on first or second call from the Wednesday before Thanksgiving till Sunday. My first thought was actually oh no - now what am I going to do with all of that time. I decided to check out the price of tickets to fly home on a whim.

Bless our failing economies heart - tickets from Philly to Greenville-Spartanburg weren't only available, but actually had an affordable price. I try to call my mom to sell the idea of flying me home - she was in a meeting. So, I made the phone call that I should have made first. I called my dad. Now we all know that I am a daddy's girl, but even I usually have to hint gently at what I want. I started the conversation by saying - I was looking at my schedule and noticed that I am actually off over Thanksgiving. I didn't have to get any further. My dad says - find a ticket home - we'll pay for it. I love my dad.

So, that was a very long-winded way of telling you guys my news. I not only get to fly to Nashville to see my friends there in December - I also get to fly home for Thanksgiving. Very excited - I think I may need a warm weather break by then.

Wish List

I am not sure why exactly, but lately I have developed a sort of wanderlust. I have been dreaming of traveling to lands far away. Maybe it is the idea that the end of my training really is at hand. Maybe it is that I will finally be able to afford to indulge in a great vacation. Maybe it is just that I haven't had any real vacation in 2 1/2 years. Regardless of the reason, I have been mulling over places to go in my head.

The list is long, and would cost me way more than a Thoracic Surgeon's salary. [Too bad I haven't made much progress on that marrying wealthy and chucking the whole career thing plan.] However, I decided I would narrow it down to 10 and make them places that I truly plan to see and spend some time before I die. [Don't worry I am not sick - although I do have a doctor's appointment next week. I have been having strange dizzy spells. My diagnosis is some inner ear thing, but since I almost fell in the operating room the other day I am being pushed to have it checked.]

The making of this list was quite fun. I would highly encourage you all to do the same. It can't be generic - no I want to go to Greece. Really pick a place that you want to see and imagine what types of things you would do there. I have had so much fun with this that I might make a places to go closer to home list next. I will share my list with you below - if anyone is interested in traveling to these places let me know. I am always looking for travel companions.

Places to See Before I Get Too Old:

(1) - Hiking in Bernese Oberland (Swiss Alps)
(2) - Biking Iverness - Base of the Scottish Highlands
(3) - Art tour - Florence, Italy
(4) - Explore the "Peace lines" in Belfast, Ireland
(5) - Outdoor markets of Tangier, Morocco
(6) - Fishing in Nova Scotia, Canada
(7) - "Roughing" it Australian Outback
(8) - Cruise the Northeastern Aegean Islands, Greek Isles
(9) - Discovering Ruins Athens, Greece
(10) - Shopping Rome, Italy

Now I just need a vacation slush fun.

No more Oprah for me

I like to watch Oprah. Not the Phil Donahue-like ones (showing my age there), but about half of her shows I find entertaining. Oprah comes on at 4 pm here in Philly. No, I am not usually home at that time, but I TiVo them. As an aside - TiVo is the greatest thing EVER. Not only do I get to watch shows that I would otherwise never get to see, but it is much easier than setting a VCR and I can fast forward through all the commercials.

Saturday morning is my catch up on Oprah time. If I am not working, I get up - walk down the street for coffee and a bagel or scone and curl up on my couch to watch a little Oprah. This past Saturday I had to round in the morning, but I curled up on my couch around noon. A lot of recent shows have been about the economy and how to be more frugal. I know she is incredibly smart, but Suzy Orman bugs be for some reason. Again I digress.

There was an episode on last week, I am not sure which day, with Lucy Liu. The episode was about the raising of farm animals. Now, most of you know that I grew up on a pseudo farm. We had the occasional cow, pig, chicken, duck, or goat. I by no means romanticize farming, but I do have a certain world view about it. Most of you also know that I refuse to eat veal. It all started MANY years ago when I read that veal calves are raised in a small box so that they reach a certain size. The idea bothered me. The Oprah show was about some new proposition that is on the California ballot this year talking about increasing the mandatory size of cages for chickens, hogs and calves.

Lucy went to a compare and contrast farm with each animal. There was a free range cow farm vs a "factory farm", etc. etc. I had difficulty watching the pictures of 700 pregnant sows in small cages that didn't even permit them to lie down. I am not sure why I can't stand to see animal suffering - especially since I see human suffering every day, but it has always bothered me. I refuse to watch Animal Planet because it always makes me cry. I finished the episode, and moved on to Live Friday on Oprah. Where strangely Halle Berry spent a huge amount of time talking about orgasms. I tried not to give much thought to the "farm" episode.

Saturday night I decided that I would walk downtown for dinner. I headed off down the street and could find nothing I wanted. The hamburger place made me recall the cows in boxes, the bar-b-cue place (yes they have them here, but they are bad) flashed me to the sows, etc etc. I finally settled on a vegetarian salad. No big deal, but now it is Tuesday and I still can't bring myself to eat meat. Luckily for me I have bought cage free eggs for a couple years - mostly because they have extra Omega-3 fat which Gail and Martindale drilled into me was good.

I don't think I want to be a vegetarian, and I don't think I could be vegan. I truly love a good juicy cheeseburger. I would just like to enjoy it again. I already had to worry whether or not the cow had received antibiotics, steroids or growth hormones. Now I also have to worry whether or not he got to walk around or was forced to stand it one place inside a box for his entire life. I am not sure I like being an educated consumer. Naive consumerism was much less stressful. I think I need to swear off Oprah for awhile.

I HATE computers

Computers make my life more difficult. I seem to spend more time trying to figure out why the computer program didn't do what it was supposed to do, than it would have taken to do a lot of the tasks by hand. I know McCain says that putting medical records on the computer will save money, maybe - but it just makes me pull my hair out. And don't even get me started on "computerized order entry systems". My handwriting is quite neat thank you - so get off my back and give me an order form.

My current issues with computers probably stems from my home computer being on the fritz. On Friday night, I downloaded the new "adobe flash player" that my computer recommended that I download, and now it doesn't recognize half of it's own old programs. Nor does it recognize the fact that it has internal speakers. I always like to listen to Itunes when I play on the computer, and currently it is incredibly silent. I spent most of the weekend trying to fix it. By that I mean that I would try something for about five minutes - get incredibly frustrated - and move on to something else. Currently my home computer and I are taking a break from each other. I feel we both need some space to figure out if our relationship is really worth saving.

It is FREEZING up here by the way. I pulled out the Southern card last night and turned my heat on low. I know Kris has claim to the "windy city", but the breeze here is fairly biting. I am starting to have a bad feeling about this winter thing.

What Oprah knows for sure

Post call so I am stealing from Oprah. In this month's mag, she summarizes her top 20 "things I know for sure." Pretty good words to live by.

1. What you put out comes back all the time, no matter what.
2. You define your own life. Don't let other people write your script.
3. Whatever someone did to you in the past has no power over the present. Only you give it power.
4. When people show you how they are, believe them the first time.
5. Worrying is wasted time. Use the same energy for doing something about whatever worries you.
6. What you believe has more power than what you dream or wish or hope for. You become what you believe.
7. If the only prayer you ever say is thank you, that will be enough.
8. The happiness you feel is in direct proportion to the love you give.
9. Failure is a signpost to turn you in another direction.
10. If you make a choice that goes against what everyone else thinks, the world will not fall apart.
11. Trust your instincts. Intuition doesn't lie.
12. Love yourself and then learn to extend that love to others in every encounter.
13. Let passion drive your profession.
14. Find a way to get paid for doing what you love. Then every paycheck will be a bonus.
15. Love doesn't hurt. It feels really good.
16. Every day brings a chance to start over.
17. Being a mother is the hardest job on earth. Women everywhere must declare it so.
18. Doubt means don't. Don't move. Don't answer. Don't rush forward.
19. When you don't know what to do, get still. The answer will come.
20. "Trouble don't last always." This, too, shall pass.

Are you REALLY only as old as you feel?

Okay - although I complain a lot about my age, in actual fact - most days I feel like I am still pretty young. I don't think of myself as "middle age". I know that I have been out of college for a while and that I was 14 when my mom was my age, but all that aside - i still feels young and relevant. [I mean let's be honest - I have been flirting with twenty year old lately.] Oh, how much a single day can change your perspective.

The day started innocently enough. I was doing an anterior mediastinal mass resection, and as the case was going really well and I was sans staff - we were all laughing and telling stories. I was telling some tale about when I was in medical school. At some point in the story, I mentioned that the parents of the two year old who could not afford $3.00 for antibiotics had no difficulty buying him a pair of Air Jordan's. This is where my story takes a frightful turn.

My medical student innocently asks "what are Air Jordan's." I pause for a minute and look around. I have an anesthesia resident, medical student, two scrub techs, one circulating nurse and two nurses observing in the room - a full house. All who look barely old enough to drive. I then ask the unthinkable question - "Who in this room was born after 1980?"

EVERYONE IN THE ROOM RAISED THEIR HAND!!!!!! I almost walked out right then and there. When did this happen? When did I become one of them? I, like Peter Pan, didn't want to grow up. I guess it had to happen some time - and for me today seemed to be the day. Well, I am going to rub on some BenGay and sit and yell at the television during the debate. Does this mean I have to start identifying with McCain?

Screeching halt

Surgery is a funny thing. It is a profession of unbelievable highs and unfathomable lows, but it also is incredibly cyclical. For anyone that spends anytime around surgery or surgeons, they know exactly what I mean. Instead of having a constantly busy but steady stream of work, surgery tends more toward the all or nothing variety. I am either working my now sizable backside off or sitting on it twiddling my thumbs. There really is no in between.

Even more ironic is how shocked all surgeons are by this incredibly predictable occurrence. We complain when we have too much to do, but are even more vocal when things slow down. We start pacing the floors worrying that we have nothing to do, and let me tell you surgeons with time on their hands can be dangerous.

I say all of that to offer the following complaint. I have worked ridiculous hours for the past week and lived on very little sleep and today --- I did absolutely nothing. I went to work, but our one and only case was cancelled. I sat around all day reading and playing on the Internet. Unfortunately tomorrow looks about the same. We have only two cases, and one of them is looking kind of iffy. I don't mean to complain about a much needed rest, but is there no in between? Why can't the fates combine to produce a steady stream instead of flooding or drought conditions? Oh well - there are many things that I don't understand about the fates.

Still alive

Despite what my mom and Kris currently believe - I am still alive. Let me explain. Whenever I get busy and don't stay appropriately in contact I can always count on both of them leaving me - "just want to make sure you are a live messages". They have an uncanny ability to usually call within a couple of hours of each other and both evoke the same guilt. I feel incredibly chagrined and make the appropriate time to "call home." Unfortunately for me, not only have I been busy and sick, but my cell phone is currently on the fritz.

In all honesty, I sometimes get so wrapped up in the speed and craziness of my life at a particular moment in time that I forget that I haven't spoken to any of my friends or family in a few days. I actually count on the above mentioned phone calls to remind me that I haven't spoken to anyone outside of the hospital for a week or more. It is perhaps not the best system, but it has worked for several years now. At least it did until my phone decided to stop telling me I had messages or missed calls.

My first clue - Kris called Saturday evening and gently hinted that I should have called Matt back to congratulate him on his goal. (Scored his first soccer goal on Saturday - WAY TO GO MATT). When I protested that I did not get the message, I find out it was not the first. With a sinking feeling in my gut I proceed to call my mother. Turns out I missed a lot of calls there - and the fact that my mom threw her back out and required a trip to the ER. She will probably eventually forgive me, but I'm guessing no time soon.

I took my phone to the local Sprint store this afternoon, and they think they have the problem solved. The phone problem that is - I still have some ticked off friends and family. Therefore, I am offering a HUGE I'm sorry. Last week was crazy, and I was somewhat felled by the "common" cold, but neither is an excuse for being completely out of touch. I will try much harder in the future to do better. (I will even send you some dates Jessica so that we can plan my trip to DC.) I continue to be thankful for all of your great patience and understanding. I will get better some day - PROMISE.

Whew!

I am still at work. A place that I have spent an overwhelming majority of the last 160 hours. I don't think I worked this hard as an intern. I know I wasn't responsible for such sick patients. It didn't help that I was the only Thoracic resident in town this weekend and four of our patients got sick enough to need an ICU, reoperation or both. Thought things would slow down today, but so far I am wrong. We still have one more case to go.

It does not help that I am also getting sick. I woke up this morning with a sore throat and a fever. Not the end of the world - right?. Well, I was rubbing my neck this am before my first case and found a lymph node. Everyone in the world - medical or not - would say : sore throat, swollen gland - most likely connected. Not me. I have decided that I must have lymphoma. (Yes, Bassam and Jill, not exactly what we learned in medical school, but I think I may need a biopsy.) Oh well, I will continue to obsessively rub my neck to monitor it's size.

I am quite jealous of those of you back in Nashville. You have a Debate buzz going on tonight. Hoping I get home in time to watch it. I completely slept thru the Vice Presidential debate. I had been up the entire night before playing like a doctor on ER and didn't get home in time for an adequate nap. It doesn't sound like I missed much more than a few winks. The SNL - Tina Fey debate was HILARIOUS.

Rain Rain Go Away

So everything comes at a price. The cost for my gorgeous weekend a couple weeks ago - rain. It started raining here last Friday and continued to rain until Monday morning. Now I have really enjoyed the convenience of living in a pedestrian city, but it is A LOT less fun in the pouring down rain. Rumor has that it briefly stopped raining during the day on Monday, but I worked all day so I missed it. Rain started back Monday night and most of the day Tuesday. I had Tuesday off (2 of my 3 staff were observing the Holiday so we had no cases). I had the great joy of running errands in the rain. Another rumor circulated today that the sun actually came out and it was gorgeous. I am on call and haven't left the hospital. Tomorrow - my post call day - it is supposed to start raining again. Oh well - that's life.

Because it just randomly crossed my mind - I need a favor. I am sad to report that I no longer am a frequent visitor to Macy's. My move to Philly has turned me into a Fiscal conservative (personally - not politically and hopefully only for 9 more months). Therefore, I try to avoid temptation. However, I need new moisturizer. I refuse to pay $60 dollars for my Estee Lauder moisturizer unless I get a free gift out of it. {Yes dad - I know that is a ridiculous amount to pay for lotion, but think of the money I am saving by putting off my first face lift.} So, I need someone who still gets to walk thru Macy's and look at the pretty things to tell me when Estee Lauder is having their gift time. Thanks.

You really are what you eat

I have a confession. This past June, I was a little stressed out about this whole move to a new city - start a new job thing. Therefore, as I am oft to due in a time of emotional turmoil, I turned to french fries. I am not going to lie and say that I have eaten perfect for the last four years, but I will say that my strays from the straight and narrow road have been minimal - and usually involve french fries. I had gained about 10 lbs back from the original 60 that I lost, but overall, I was doing okay. I always had plans to lose another 20 (I never got to my "perfect" weight the first time), but overall I was comfortable with my body.

This particular stray was different from the rest. It set off an emotional trigger somewhere in my head. I didn't stop with my one trip to McDonald's. I began a three and a half month tribute to eating crap, and believe me in a city known for less than healthy food, I had plenty of opportunity. I am not sure why I didn't stop. The light bulb moment finally came when I needed "real" clothes two weeks ago to wear to clinic, and struggled to find something that fit. I stepped on a scale - something that I had steadfastly avoided since moving here - and was appalled.

Needless to say, I am back on the straight and narrow. This is where my frustration comes into play. Now I am a little frustrated that the weight comes off at my age a lot less slowly that it goes on. (I know metabolisms slow down, but I am starting to think that mine is on permanent sabbatical. ) I am also a little frustrated that I let things get to this stage - 5-10 lbs is one thing - 20 lbs is quite different - particularly at 5'2".

However, my biggest frustration is my memory loss. I so easily forget how normal feels. When I eat as if I actually went to medical school and took a nutrition class, I don't just feel "healthier" - I feel better. It is easier to get out of bed in the morning. It is easier to go to the gym. I take the stairs at work on purpose. I have better skin. I sleep better. I all around have more energy, and with my schedule that truly makes a difference. How could I forget this feeling and settle for feeling like the crap that I was eating? I am supposed to be smarter than that right? Well, I am feeling good again and have lost 5 lbs - slower than I would like, but I'll take it. I still have a ways to go, but am confident that I will get there. I have even run twice this week. Stay tuned for updates.

P.S. Blessed and Happy New Year for my friends to which that statement makes since.

Explanation please

Okay - I really don't understand guys. I mean quite honestly they make no sense. The source of my latest confusion - guys flirting. I have complained to most of you in the past about how I seem to attract the most male attention when I am post call. There seems to be something about my the purple bags under my eyes, unwashed hair and day old scrubs that really turn guys on. It has never failed in all my years of surgery that I get way more male attention post call than not. I have explained this in my head as guys like the vulnerable look. I have seen myself post call - the kindest thing than can be said for me is that I look in need of help.

Now, it is starting to happen to me when I am not post call, but SO not trying to look cute. Take this morning for example. I was up late last night watching the debate and post debate spin, so at 7:30 this morning when I woke up and could not go back to sleep - I decided to head to Starbuck's for a nice pumpkin latte. I threw on sweatpants, long sleeve shirt and a baseball cap. I think I ran a brush thru my hair, but would not swear to it in a court of law. I was not dressing to impress - I wanted a cup of coffee and a scone. As I leave my building two different men I pass on the street say hello. Not uncommon back home, but no one here in Philly speaks on the street. No one is that friendly. When I get to one of the four Starbuck's within two blocks of my house I order my drink and scone and then become engaged in a 5 minute conversation with the cute barista while he is warming my scone. I sit at a table by the window with a newspaper when another customer asks to see my sports page. This ended up turning into another flirting session.

Don't get me wrong - I am not complaining that cute and in 3 of the 4 situations younger guys flirted with me today. I am not that stupid. What I don't understand is why no guys ever flirt with me when I make an effort. Until recently, I would have argued that I have relatively cute taste in clothes and can pull a look together that looks fairly presentable, but maybe not. Maybe I am one of those women who belong on What Not to Wear and just don't know it. There has to be some reason that when I look horrible guys want to talk to me, but I can't attract any man under 70 when I try. Am I missing something????

Maybe I do have a problem

So we all know that I LOVE to shop. I shop for many reasons. I think first and foremost it is a stress reliever for me. When I am in a store looking at pretty things, I can forget whatever is wrong in my world for that amount of time. I shop for companionship. Some of the best times I have ever spent with my girlfriends involved shopping. It is not all about the shopping itself, but it is the fun of spending time with your friends. I shop for sport. I get a thrill with putting a really cute outfit together at a bargain. Regardless of the reasons I shop, I at least recall what I buy - or at least I thought I did.

This morning as I was getting ready for work, I walked into my closet for shoes. Clinic day - so I had to actually wear real clothes. I was looking for black heels and clearly saw in my head my black heels. I flew past two boxes labeled open toe black heels, several pair of black heel sandals, and saw the box labeled black heels. Imagine my surprise when I opened the box and saw a pair of shoes that I would have sworn that I had never seen. I am not kidding. Not only do I not remember wearing these shoes, I have no idea where or when I might have bought them. They were wickedly cute, and look like shoes that I would buy, but I honestly can not recall buying them.

I have never fogotten shoes - I can vividly describe my shoes at a moments notice. I have forgotten clothes before - but usually when I see them I have the "oh yeah" moment. I remember where or when I bought it. (Usually involves some great sale and my friends Kris or Jackie.) This is the first time that I can not conjure any memories. Maybe I have reached the point of my addiction where I am having black outs. I wonder what else I may have bought that trip? I guess rehab is next for me. Oh well, I will be like Britney and avoid it for now. I have a Presidential debate to watch.

Post Call

I am just getting home - post call and last night sucked. So, here is as good as I have - although my Wild Words from Wild Women calendar is incredibly situation appropriate at times.

"There are no shortcuts to anyplace worth going." Beverly Sills

Move over Gracie - I need a nap

I have never been a napper. I started sleeping through the night at an early age according to my mom, but even as a baby I didn't like sleeping during the day. I was the kid that always got in trouble during nap time in school. I didn't want to miss anything by going to sleep, and if I was awake why couldn't I talk to everyone else right? My teachers failed to see the logic in this, but I think I was just ahead of my time.

In college, most of my friends would take naps in the afternoon. Jackie could sleep 18 our of 24 hours and still complain about her schedule. I didn't get it. I always had other stuff I wanted to do, and didn't want to waste any of my precious time sleeping. Even during my surgical residency I wasn't a big napper. When I would get home post call I would force myself to stay awake until 7 or 8 and then just have an early night. I always felt that sleeping during the day just throw off my schedule.

Well, my body seems to have decided it has some nap catching up to do. During the past year, and particularly the past 6 months, I get incredibly and sometimes inexplicably sleepy in the middle of the afternoon. It seems to have nothing to do with how much or little sleep I get. When 1 or 2 o'clock rolls around, I start yawning and looking for a blankie. I can indulge these strange cravings on the weekend, but it is a little hard to take a nap in the middle of my work day. They frown upon snoring in the operating room. Aging is weird. Hopefully, like the terrible two's this is just a faze that I will outgrown. In the meantime - scoot over Gracie, Aunt Tammy needs a nap too.

Perfect Fall Day

Fall has come to Philly, and let me tell you it is fabulous. I decided yesterday to turn off my air conditioner and open my windows. Therefore, I was awakened this morning to the sounds of the city waking up with a crisp and cold bite to the air. I snuggled into my covers and listened for a while. It is amazing what you can hear in a city if you really listen. Once up, I had a quick breakfast and then headed out. I dropped off some dry cleaning and decided to walk around downtown. The weather was perfection defined. It was cold enough for long sleeves, but not uncomfortable.

I was wearing my Obama t-shirt and ended up having quite a few interesting conversations. I may have finally hit on how to get people in this town to be friendly on the street. I picked up some coffee and heated to Rittenhouse square (Central park Philly style) near my apartment. They were having a fine arts festival and I was able to spend some time walking around looking at some truly amazing paintings. If only it were a year from now and I had a house - I would have spent some serious dough on wall art.

After finishing the festival, I walked across the street to Barnes and Noble. I truly LOVE book stores. I may have my mother to blame for my bad eyesight, inability for a truly flat stomach, and big ankles, but she made it all better by giving me a true love of reading. I smile just walking up and down the aisles looking at the books. I ended up buying the latest book on Oprah's book club - The Story of Edgar Sawtelle.

Now, I end up reading a lot of Oprah's book club books. She likes slightly more depressing books than my personal taste, but many of them have been quite good. I have never actually bought the book that was currently on the list. It just seems so drone like - you know I never want to be like everyone else. However, she made this book sound so amazing I couldn't wait to see for myself. It is only available in hardback, and I never buy books in hardback - mostly because I read so much that it would be cost prohibitive, but also because I actually like the ease and portability of paperback. None the less, I bought it and several other books that will probably take me years to actually get around to reading, but I am living for the life I wish I had not the one I am living.

After the bookstore, I picked up a bagel from my favorite shop for lunch and headed home. I had lunch did a load of laundry and then headed to the gym. After a workout, I took a quick shower and inadvertently a short nap. Once I woke up, I grabbed a blanket and headed back to the Square. I spent the rest of the afternoon reading and people watching. Once dusk set in I headed back home and had a nice dinner. I am going to catch a movie on TV and call it a night. All in all this was pretty close to a perfect day for me. Many more days like this, and you may not be able to get me out of the City come July.

My mom was right again

On many occasions during the last several years, my mom has pointed out to me that I have great friends. (Most recently when Bassam and Kris helped my parents move my stuff while I was safely ensconced here in Philly). She feels that often I forget how lucky I am or probably more accurately take for granted what a great group of friends. I disagree, respectively of course, that I forget. However, I may take it for granted.

Therefore, I am making a conscious effort to try to be better. You guys have never let me down. My recent hair debacle is the perfect example. Really great friends will tell you that a horrible cut is really cute when they know that is what you desperately need to hear. Thank You. Really great friends make your crappy job seem more interesting and beneficial. Thank You. Really great friends remind you that there is a light at the end of the tunnel, and they even convince you that it is not the train that you secretly know is coming. Thank You. Really great friends will convince you that Mr Right is still out there, and that you didn't miss him one night on call. Thank You.

I am very blessed to have such wonderful friends in my life. I just want you all to know that I do realize how lucky I really am to have all of you to keep me sane.

I have been scalped!

So, my roots had gotten pretty bad - you know trailer-park bad. I had the weekend off, so I decided girl grooming should ensue. I am a slow learner. I ended up blond because I went to have my haircut and colored post call. Yet off I went to the "teaching" salon for my post call hair cut. In my defense - the "different" looks that I got in the past were somewhat agreed upon by me. I would at least in my sleep deprived haze say something along the lines of "do whatever you like". I did not say that this time. In fact, I distinctly recall telling the butcher that hacked at my hair that I was mainly there to get my roots touched up. I really liked the hair cut that I had gotten the time before and only wanted a trim. I asked if she could just take the dead ends off the back, and shorten my bangs.

Needless to say, that is not what happened. I have NO hair left. It is horribly short and I did not want short hair. My issues with short hair are many. First, I have had long hair my ENTIRE life. Shoulder length was a walk on the wild side for me. I only went that short because of Oprah saying women my age should not have long hair. Secondly, I have a very round face. Skinny or overweight, my face is a perfect circle. Circle faces do not do short cuts. A fact touted in every fashion magazine. Third, short hair actually requires a lot of work. I can't wake up late and throw this hair into a pony tail. It isn't long enough to pull back. Also, as an ironic aside, my stick straight hair now has an annoying tendency to curl up on the ends. Without help, my hair does a Jackie-O thing in the back, and curls under in the front. This is not a simple easy to care for cut.

I have considered extensions, but I shutter at the idea of "fake Britney hair". I have already added extra protein to my diet to try to make it grow faster. To be completely fair, I do like the color. It is less gold and shiny which is good for the fall. If I ever get enough nerve to go back for a hair cut - many months from now - I will be finding a real hairstylist. Enough school for me. You should all be thankful that you live far away and do not have to see this atrocity everyday. I have covered my mirrors. I will check back in a couple of weeks.

Happy Birthday to my friend Bree :). She turns 30 today. Welcome to the best decade of your life. (Not sure I believe it yet, but it is what I am supposed to say). All honesty, hope you had a great day.