Friday, May 29, 2009

roller coasters

I LOVED roller coasters growing up. . . the higher, faster, curvier, loopier the better. I knew every ride at Six Flags and Carowinds. I knew the perfect seats and the perfect time of day to ride them (it actually makes a difference - some rides are faster early and some later). I lived for that feeling you get in the pit of your stomach right as you reach the top of the hill, or the beginning of the loop. The feeling that makes your heart race and your breath come a little faster. The feeling that although you have stood there and watched a hundred people come through the ride unscathed your trip might be different. The feeling of satisfaction felt when you completed the ride as if you had conquered Mount Everest - solo without oxygen.

In medical school I learned that all of these feelings are natural, and actually our oldest genetic response. From earliest human days, life was all about survival. We developed responses known as "flight or fight". When faced with uncertainty or danger, our body is hardwired to protect itself - to survive. Our heart rate increases to raise our cardiac output. This allows us to fight off danger or to run from it. All of these responses are triggered by the release of adrenaline from ,of all places, are adrenal glands.

Some people live for this response. They purposefully put themselves into situations that trigger it. These so called "adrenaline junkies" live for the "high" that they feel with all that extra adrenaline circulating around. I have been one of those people all of my life. It is probably one of the reasons that made me a surgeon. Nothing will give you more of an adrenaline surge than being in the operating room during a tricky or dangerous case. It was my own natural high.

Some people hate this response. Their adrenaline brings with it overwhelming nausea. Instead of feeling powerful and ready to take on the world, they develop feelings of impending doom and loss of control. The are incapacitated by the adrenaline. I fear that I am becoming one of these people. This whole job search thing is starting to feel like a roller coaster that never ends. I am beginning to wonder if instead of fighting for my "survival" if it wouldn't be easier to just roll into a ball and admit defeat. I know that there is still a fighter in me - I just need to find her again.

Monday, May 25, 2009

Mirror, Mirror on the Wall

I have often asked if some people looked in a mirror before they leave home. This question gets asked a lot here in Philly. As I wandered around a local outlet mall today, I caught myself again questioning people's "final check" before going out in public. After the 20th such person, I began to question my assumption - surely someone has a mirror. Perhaps they do check, but their mirror is just much kinder than mine.

I am currently at a medically healthy weight for my height and build. Is that what I see when I look in the mirror? Of course not. When I look in the mirror, it is never followed by affirmations. I am 10-15 lbs away from "thin", and 20-25 lbs away from "Hollywood thin". I look in the mirror and immediately catalogue all of my faults. I see too big breasts, big belly, butt that is a mile wide and sagging halfway down my thighs, etc.

I know that I am not a lone in this self defeating behavior. I have a friend who is tall, thin, abs to die for and beautiful. When she looks in the mirror - she only sees her thighs. Another friend who is tiny by any one's definition - she only sees breasts that are "too small" and broad shoulders. Why do we do this to ourselves?

Why can't we be more like these people I see around town. I saw a lady today about my height, but had me beat by at least 150lbs. She was wearing a tight halter and mini - quite frankly she rocked it. She rocked it because she owned it. I meanwhile had spent extra time hiding my "flaws" before leaving the house.

I am not suggesting that we all eat whatever we want and become grossly unhealthy. However, I am beginning to think that we should all give ourselves a break and more importantly a kinder gentler mirror. Will I stop trying to loose those last 15 lbs - probably not, but I will at least give try to give the current body a break from the endless abuse.

Thursday, May 21, 2009

Chicken or the egg??

I have often been perplexed how certain people and things always seem to actually fit into pigeon holes. For example, a certain group of patients that I see with the same diagnosis (which I will leave out on the off chance someone who reads this has it) are all crazy. I don't mean a little different - I mean close to certifiable. It is well know among all in my field. Each field of medicine has a similar group. Does the disease make them crazy or do only crazy people get the disease? I had similar thoughts today when I read an article on MSN about astrology. Do I so perfectly fit my sign because I was born in April? Or have I adapted to fit my sign over the years?

Here is what it said:

Taurus, the second sign of the Zodiac, is all about reward. Unlike the Aries love of the game, Taurus loves the rewards of the game. Think physical pleasures and material goods, for those born under this Sign revel in delicious excess. They are also a tactile lot, enjoying a tender, even sensual, touch. Taureans adore comfort and like being surrounded by pleasing, soothing things. Along these lines, they also favor a good meal and a fine wine. The good life in all its guises, whether it's the arts or art of their own making (yes, these folks are artistic as well), is heaven on Earth to the Taurean-born.

It's the Bull that serves as the Taurean's mascot, and along with that comes the expectation that these folks are bull-headed and stubborn. Yes they are. Hey, this Sign has a Fixed Quality attached to it after all, so expect that things will occasionally grind to a halt. That said, Taureans don't start out with the intention of getting stuck. They simply want to get things done, and it's that steady, dogged persistence that winds up being viewed as stubbornness. Bulls are actually among the most practical and reliable members of the Zodiac, and they are happy to plod along, as it were, in pursuit of their goals. The good news for Bulls is that once they get to the finish line, they'll swaddle themselves in material goods. A self-indulgent beast? Perhaps, but if you toiled as laboriously as these folks do, you'd need some goodies, too.

Bring on the swaddling.

Tuesday, May 19, 2009

Gremlins

Since Hollywood seems to be in the process of remaking every film from my childhood, I am hoping Gremlins is next. I am fairly certain that I currently am living with at least 3. My friend Jess and her family were up this past weekend. Unfortunately, my place wasn't spic and span, but it was at least reasonably presentable. We enjoyed a nice weekend although I worked way too much of it. I was in house on call Sunday, and they headed back to DC.

When I came home on Monday, my apartment looked still in need of dusting ( I had hoped Micah would have a go at it), but otherwise as it had been on Friday. I threw in some laundry, had breakfast, and curled up on the couch for a nap. At some point, I woke up and threw in a new load of laundry, had lunch and moved my nap to the floor. Next time I regain consciousness it is 2:45 am and I am answering a wrong number call from my work phone.

After politely informing the caller that I had zero interest in his ridiculous consult, I looked around my apartment. I had been ransacked. There were dirty clothes in the hallway. . . clean clothes in the chair . . . dirty dishes in the sink . . . empty Indian food containers on the counter. . . and a full sleeping quarters in the middle of the living room floor. How can I (a fairly neat person at baseline) completely destroy my apartment in less than 12 hours? Appalled as I was, I did not clean up at 2:45 this morning. I crawled back into my comfy floor bed and went back to sleep. I am dreading going home today though, because I am afraid what the Gremlins have been up to while I was gone.

Wednesday, May 13, 2009

I'm It

I was "tagged" by my friend Jessica in her blog, and since my life is so boring I had nothing else to talk about - here goes.

8 Things I am looking forward to . . .
1. A Job
2. A place (state, city, dwelling) to call my own
3. A salary that soothes the pain of my sacrifices
4. Trips to visit friends that I haven't seen in way too long
5. Alex's wedding in Hawaii (I am so going)
6. Tennis lessons
7. Full night's sleep
8. Time

8 Things I did yesterday . . .
1. CPR (patient survived - at least he was still alive when I left)
2. Pulmonary conference (boring)
3. LONG HOT shower
4. Really good work-out
5. nap on my couch (I was post call in case you haven't figured it out)
6. America's Next Top Model marathon
7. "Grilled" a steak for dinner
8. Went to bed embarrassingly early

8 Things I wish I could do . . .
1. Find a job
2. Draw
3. Play tennis
4. Swim
5. Remember more often to be thankful for what I have
6. Eco vacation
7. Adventure vacation
8. Move to Tuscany

8 Things I am currently watching . . . (only the first with any regularity)
1. LOST
2. West Wing
3. Law and Order
4. Closer
5. Oprah
6. My second year resident trying to learn to open a chest
7. CTSNET for new job opportunities
8. my life pass by (kidding)

Okay - I think that is everything. Flying to Syracuse tonight for my job interview. Still hoping to hear back from Miami. New job interview for Univ of Mass - Worcester. I seem destined to live up North (teach me to move here in the first place).

Tuesday, May 12, 2009

Practicing Faith

The Lord is my shepherd; I shall not want.
He makes me to lie down in green pastures;
He leads me beside the still waters.
He restores my soul;
He leads me in the paths of righteousness
for his name's sake.

Yea, though I walk through the valley
of the shadow of death,
I will fear no evil;
For You are with me;
Your rod and Your staff, they comfort me.

You prepare a table before me in the presence
of my enemies;
You anoint my head with oil;
My cup runs over.
Surely goodness and mercy shall follow me
All the days of my life;
And I will dwell in the house of the Lord
Forever.

Sunday, May 10, 2009

Running hungry

I have lots of friends who are runners. I have often blogged about how envious I am of these friends. They actually enjoy running. They run for fun, friendship, and that mythical runners high. Not me as I have previously stated, I run for what it does for my body. (The only high I feel during running comes from hypoxia.) Or I should qualify what it used to do for my body.

When I "got in shape" 4 years ago, I sensibly combined exercise and a healthy diet. It worked quite well for me and allowed me to continue at a "wouldn't kill me to drop 10lbs, but I look okay" weight for 3 years. As mentioned, I gained weight when I moved to Philly. I have gotten most of it off. However there's a catch.

Instead of my previously used method, I just changed my diet. I didn't starve myself - I just dropped my calories with smarter choices. I was happy that I could wear my clothes again, but not thrilled with the way I looked in them. My arms had lost all definition, my legs (once my best asset) now begged for cover, my butt headed in all directions but North, and we won't even discuss my abs. Therefore last week, I decided to recommit to an exercise plan - specifically running and weights.

I was actually quite excited. I had stalled on my weight loss and figured a little cardio on my previous diet would get things started again. Boy was I wrong. I have actually gained weight since I started exercising. The reason: I can't quit eating. I run in the mornings. Not because I am a morning person (as we all know) or because the books tell you that morning is the best time to exercise. I run in the morning because it is the most consistent time that I can count on being mine. I do best with schedules. I need someone to physically drag my butt into the gym evenings (where are you Jill?), but I seem to be able to get there on my own at 4am (ironic huh?).

However, the fall out of that early morning work-out seems to be a ravenous appetite for the rest of the day. I have tried everything - protein, starch, even fat for breakfast - all to no avail. I refuse to quit exercising because the sane person in my head knows that it is the right thing to do. I just need to quiet the insane person in my head that thinks - wow I ran this morning - "Let's have a cupcake." I am at least choosing to believe that I am building a very toned body under these layers of adipose. Just need to keep chipping away.

Saturday, May 9, 2009

Comfort Food

When most people think of comfort food, they dream of mac & cheese, roast beef, mom's apple pie. Not me - I think french fries. I don't know why, but as long as I can remember, french fries were my go to food. I can pass up potato chips, baked potatoes, and mashed potatoes, but I have never met a french fry I didn't love. They quite simply make me feel better.

I needed feeling better this weekend. I was on call Thursday night. It wasn't a horrible call, but I can think of much better ways to spend the night. However, it left me feeling vulnerable on Friday. I couldn't keep up my sunny front. The reality of my situation overwhelmed me all of a sudden. I spent the car drive to my apartment crying on the phone to my mother. Once home I showered and took a nap hoping to sleep it off. It didn't work. I woke up in the same funk. I settled on the couch with a bag of Pita chips and hours of mindless television.

I decided today that my funk needed sunshine. It was actually a sunny day here in Philly. It has been cold and rainy all week so everyone was out. I started at the bookstore. Thanks to my mom, bookstores always have the ability to make me feel at least marginally better. I picked up a few books and then headed to the retail stores. I actually bought a shirt at Anthropologie. I am not sure that I will ever have the nerve to wear it, but at least it felt like a step outside my box. I hit all my faves - Ann Taylor, Loft, Talbots, J Crew, Gap. I didn't buy much beyond my books and shirt, but started feeling better.

Funny aside. . . I was looking at a ridiculously priced shirt at J Crew when I overheard a lady ask the salesman if they had anything smaller than the 00. It was a little big at the waist for her. I mean seriously. Double Zero!!! Should they even make a zero? Doesn't that by definition mean that you don't exist as a size?

I still was feeling a little overwhelmed by the jobless thing so I decided to stop for some french fries on the way home. I haven't found any great fries here. At home - Zaxby's are probably my favorite, but here I had to settle for regular old fries. Don't get me wrong, all fries seem to work, but I like to expend my wasted calories well. I don't know that I am feeling at the top of my game, but I at least no longer feel like jumping off a bridge. Maybe I will try the movies tomorrow.

Thursday, May 7, 2009

Call Again

On call yet again - enough said.

Wednesday, May 6, 2009

Learning Challenges

My entire life, I have been told that I was smart. My parents, teachers, professors, attendings and friends all propagated this idea. It started very early when I was told that I was too smart to go to kindergarten. (My mom sent me anyway - supposedly for "socialization", but I think it was mainly to get rid of me during the day.) In first grade I was tagged as "advanced", and by second grade I was in a "Challenge" program. My biology advisor at Emory would argue that I was wasting my intelligence taking all those pesky liberal arts classes (ironically this professor worked at my liberal arts university). Deep down inside I knew it didn't feel "right", but can everyone be wrong? The answer - YES!

Why am I now certain that I am not very bright? Well, I could point out that I still don't have a job after 13 years of primary school, 4 years of college, 4 years of medical school, and 10 years of post graduate training. However, in my head I am still blaming that on the economy so we won't go there. My stupidity involves having to learn the same lessons over and over again. When will it sink into my head that the fastest way to get me to do something is to tell me I can't? Likewise the best way to get me to crave something is to tell myself that I can't have it.

Albert Einstein once said: The definition of insanity is doing the same thing over and over again expecting different results. Can I have my straight jacket in green? Obviously I am struggling with my diet again. I recognize that part of my frustration with my diet is probably related to my job stresses, but part of my diet frustration is my stupidity. When will it occur to me that regardless of how much I work out, if I eat like the boys I work with - I will weigh as much as the boys?

Monday, May 4, 2009

I miss sugar

It started innocently enough - it was my birthday, and I had a slice of birthday cake. One slice only - I promise. However, it started me back on a vicious spiral. I then decided a brownie for dessert with my family was okay. Surely no one can argue with chocolate covered strawberries. Well I do like the peanut M&M's - they have protein in them right? It seems that in my head, my diet is either all or nothing. I either make good choices all the time or I start eating crap and can't stop.

That one piece of cake turned the switch in my head. Fortunately, this time I was able to recognize that the sluggishness and malaise that I felt this weekend probably had as much to do with my diet as my sinus infection. Therefore, I decided to give up sugar in its entirety. Yep I said it, I gave up sugar. I am only one day into this latest folly, and can I just say IT IS HARD. I never realized all the places that sugar exists. They sneak it into my protein bars, my "no sugar" cereal, and my yogurt. We won't even discuss the "sugar substitute" (which I am also giving up) in my diet coke and chocolate - OOOH I miss chocolate.

I don't expect to give up sugar forever - let's be honest is a life without chocolate really worth living? However, I thought this would be a good detox for my recent sugar binge, and perhaps re kick start my healthier living plan. At least it got me to the gym and running today so it can't be all bad.

Sunday, May 3, 2009

Diagnosis

Sinus infection. Not excited about it, but will take it over the H1N1 virus. I have been spared from allergies most of my life. Secretly, I have felt somewhat superior to my mom, sister and many friends who have bad seasonal allergies. I always thought that I had a better immune system that could recognize friend (seasonal allergens) from foe (viruses, bacteria). I guess this year is my karma catch-up. It started a couple of weeks ago. Late for spring some of you might argue, but you have to recall that my spring didn't start until a couple of weeks ago.

Strange that I spent all of my life in the pollen covered South, and it wasn't until I moved North that I developed allergies. I am crossing my fingers that this is a aberration year (on so many levels). In the mean time, I will just go on record as saying that sinus infections suck. I am sure that all the flying isn't helping, but still need to find a job so that can't be helped.

Saturday, May 2, 2009

Paranoia

I don't usually tend toward paranoia, but here is hoping that I am today. As most of you know, I went to Miami on Thursday for a job interview. (I have no news in regards to the job, and honestly no gut feeling one way or the other. I have truly decided that what will be will be.) I flew back home yesterday, or I guess technically early this morning. The plan was simple enough. . . Leave MIA at 5:15 pm with an 1 1/2 hour layover in ATL to arrive in PHL at 10:25 pm.

The ATL screwed me yet again. I guess it sprinkled or something so they wouldn't let us leave Miami on time. We actually left the exact time we had been scheduled to land in Atlanta. Needless to say, I did not make my connecting flight time, but luckily it was delayed also. Long story short - I got back to Philly rather late last night/this morning. I unpacked necessities and went to bed.

Here is where hopefully my paranoia kicks in to place. I woke up this morning with a headache and malaise. I initially shrugged it off as a long couple of days and too much time on planes. I am still trying to sell that argument although I now have muscle aches and chills. I am sure this all goes back to my karma argument. I was laughing in my head at all the people on the planes in mask (in my defense none of them were wearing them correctly). Hopefully this is just tiredness, but I am quarantining myself just in case. I cancelled my plans for a nice dinner in NJ with my friend Beth and her family. I don't need the notoriety of being the local index case. Will keep you posted if I start to oink.