Simple pleasures

I picked up these roses Friday at Trader Joe's. They had them on sale for 7.99, so I couldn't resist. It is funny how such a simple thing can actually bring so much pleasure. They have the most amazing smell especially considering they have to be greenhouse grown. I have them in my living room and every time I see them I smile. I would say that is definitely money well spent. Here is wishing for more simple pleasures.

Selfish Saturday

No huge surprise to anyone - I have been a little stressed lately. As I was coming home late last evening, I decided it was time to quit whining about my life and do something about my attitude. I gave myself permission to make today all about me. I would completely take myself out of the outside world, and make peace with myself.

I started by turning off my cell phones. Don't get me wrong, I love the convenience of cell phones, but occasionally I miss being free. It seems that lately in life we are always accessible. We never have time simply to enjoy our own company without interruption. I am sure when I turn them both back on in the morning there may be hell to pay, but it is a risk I was willing to take. Secondly I slept late. This was harder for me as I have often complained. However, last night I decided to put my medical degree to good use. I medicated myself. Don't worry - it was nothing more that a big dose of benadryl, but it both helped me fall asleep and stay asleep.

When I finally got out of bed this morning, it was almost 9am. This is incredibly decadent for me. I had some breakfast and then ran downstairs to the gym. I then spent a few hours reading before sitting down to lunch. I had lunch with a few West Wing reruns, and then took a nap. This evening, I have watched LOST and played with my iTunes reworking some play lists. I enjoyed a nice relaxing bubble bath, and even spent some time in a few yoga poses. Next up, I am heading back to bed.

I haven't even spoken today - probably only something you can do if you are single, but kind of weird. Don't worry, I haven't gone off the deep end. I simply needed a day that was all about me. I know this sounds incredibly selfish, but for me it was simply about recharging. I will reenter the world tomorrow with more energy than I have had lately. I have also made peace with myself. I won't say that I will still not worry occasionally, but have accepted that what is meant to happen will. It is time to start putting some positive energy back into my universe.

Tomorrow I am making my catch up with friends day. So we'll be in touch.

Lions, Tigers, Migraines - Oh My!

Not unexpectedly I got a migraine today. Perhaps I should explain. My mom suffered from migraines the entire time I was growing up. Her trigger was hormonal. Once she went through menopause, they magically disappeared. I spent most of my twenty's thankful not to have inherited that particular trait.

Then I started my cardiothoracic fellowship. During my first year, I lost peripheral vision one day as I was heading home. In a near panic, I headed back into the ER. One incredibly long work-up later, it was declared that I had an "optic migraine". I have had a few since then. My trigger seems to be stress. I know - you're thinking "Wow you really did pick a bad career." It is not "normal" stress that triggers for me. I can handle stressful cases and patients with relative ease.

The stress that triggers for me is more related to my control issues. It is the stress that comes from having events outside of my control. A big job search for example. The practical part of my brain argues that it is ridiculous to get so worked up about such things. After all, things happen for a reason - what will be will be. However, it turns out that a huge portion of my brain is very impractical, and it actually always seems to win in these situations.

I have tried to relax and let go, but it is much easier to say than for me to actually do. I have a bad feeling that it is going to be a rough few months - (Sorry Kris and mom).

I need a job

Every morning for more years than I care to recall, my first thought when I open my eyes is "crap - it is early". (I am by nature not a morning person. How did I end up a surgeon you might ask - BAD career planning.) For the past week, my question has changed. When my eyes pop open these mornings, the first thought that goes through my head is "oh my god, I need a job." I suspect this thought also has something to do with the fact that I am not sleeping well and having strange dreams when I do sleep.

I have often bragged about the fact that I can fall asleep anytime, anywhere and on a moment's notice. Surgery can take the credit for that one. It also gets the blame for the fact that I have turned into an incredibly light sleeper and can not sleep with anyone snoring or even breathing hard for that matter. Stress has always affected my sleeping. Early in my life and training, sleep was a great anecdote for stress. I fell asleep and planned to think about it tomorrow. As I have gotten older, and my responsibilities have changed, stress now prevents me from sleeping. It is actually kind of spooky. If I wake up on call for no apparent reason, I will go and see all my patients. Almost 100% of the time, something is wrong with one of them. Eerie but true.

The strange dreams are new. I usually don't recall dreams. According to Freud that is a sign of a deeply repressed personality, but I decided years ago to let that go and move on. Lately, not only do I recall them, but they confuse me. I have dreams about weird jobs in strange places. I have dreams of moving to strange places with no job or marrying for money. I am sure these would all be way to easy for Freud, but at least I am remembering a few.

Wishing for the "crap it is early" days.

One of them

Well, it's happening - I am assimilating. When I first moved here, I noticed a couple of things right off the bat about Philadelphians. One, they are not the friendliest sort - don't even try to make eye contact on the street. Two, they all constantly walk around EVERYWHERE with their ipods in place. Once it started getting cold, I realized that they are also crazy. It can be ridiculously COLD here and people are out on the streets everywhere. Often, with no apparent purpose, I think they just stand on the corners and chat.

I was quite smug in my Southern superiority. I smiled to everyone I passed, enjoy the sounds of the city not drowned out by music, and like normal people abhor the cold.

At least until today. As I mentioned previously, I am on call this weekend. I had only four people to see this morning, and no plans to round until 8 am. Therefore, I decided to walk to work. I did this a lot back in the summer and fall. It is about 22 blocks, but a nice walk if you have time. However, aside from last night by necessity, I have avoided walking the 20 minutes in the cold. Did I mention it was 24 degrees this morning in Philadelphia? Did I also mention that Susan bought me a new ipod touch for Christmas, and it seemed the perfect time to try it out?

Off I start, at a slow leisurely pace with ipod in place talking to no one on my stroll to the hospital. I have become one of them. I really need to get out of this town.

P.S. Happy Birthday Giulia - Can't wait to see pirate pictures!

Better days

I will give a little narrative of my day. Not because it was one of those great days that you will remember for years to come with a smile, but simply it is easier to find things to laugh about than to cry.

I am on call this weekend. I am not actually in house on call this weekend; I am just covering Thoracic. Usually this means that I go in each morning, round on my patients and then go about my business for the rest of the day. My life is seldom that simple. I went in this morning to round on my four relatively boring patients, and ended up spending 4 hours. We had 3 consults that had to be seen, and time has a way of escaping at the hospital.

I left work - made a quick run to Target and then headed home. I received LOST 4th season for Christmas and am trying to rewatch the old seasons to remind myself of things that I had missed. Therefore, I was happily camped on my living room floor putting my LOST puzzle together from Season 1. Then it started. A patient that I had just met that morning - NOT on my service - had a syncopal episode. For some reason, they wanted me to evaluate her. I took a trip back to the hospital - stated she did not drop her hemoglobin from anything that I could fix, and suggested a CT scan. I returned home.

Two hours later, I am told that she now has free air in her chest. Free air is a surgical expression that is completely ridiculous. It simply means that air exists somewhere in the body outside of the boundaries of where it belongs. It has escaped "free". It usually portends some form of surgical emergency - bowel perforation, lung collapse, esophageal perforation, etc. It almost always requires some type of intervention that is quite expensive. Regardless, I now have to go back to the hospital a third time to evaluate.

I was muttering quite a bit as I got ready to leave. It is not that I had huge wonderful plans, but it is cold outside and I was comfy on the floor with my new blanket. I got downstairs, dropped off my rent and walked out to the parking deck. This is where I encountered problem one - no car keys. Correct, I had walked out of my apartment without my keys. GREAT! I have to ring the bell to get back into the building - it automatically locks and you need a key fob to get in - and head to the front desk. I am told that the on site maintenance man is currently not on site. It will take at least an hour to get me back into my apartment. Free air waits for no one, so I caught a cab to the hospital.

Once there I head to the ICU where the patient now is living. She looks great, but definite problems exist with her CT scan. It becomes obvious that she at least had an esophageal perforation recently, and I need to see if she still has an opening. I take out my phone to call my attending, and it dies. Not battery low death - electronic black out dead. Usually not a huge problem. I am the nerd with two phones (work and personal). Of course, my other phone is sitting right next to my car keys - at my apartment.

Eventually I am able to contact all the right people and arrange for the study. Even though I have ordered an emergent study, I am not naive enough to think that it will happen in under four hours. Therefore, I decide to head home and pick up my car and my working phone. I only had my hospital ID and my license with me. I spent the only cash I had on the taxi into the hospital. Therefore, I get to walk home in the dark with a dead cell phone. I go out all the time at night here in Center City, but let's just say that the hospital is not in a great neighborhood. I was a little freaked out the first 10 minutes of my walk, and I am not easily freaked.

Needless to say I made it home quite safely if not warmly. I was able to get back into my apartment and have some dinner. Swallow study just finished (3.5 hours after ordered) and no ongoing leak. So at least I don't have to go back in to operate. Some days, it just doesn't pay to get out of bed. Hoping for a better tomorrow.

Resolute!

So about this time every year I get into the "spirit" of the season and make resolutions. About this time tomorrow, I have forgotten said resolutions and gone about my way. This year I have decided to actually put thought into my resolutions and be resolute about keeping them.

Resolution: Regain Optimism - I am by nature an optimist. However, as of late I seem to have misplaced it. Therefore, I am resolving to get it back. I will again believe that people are basically good and things happen for a reason. (On call today, truly putting this resolution to test.)

Resolution: Re find Outer Self - Most of you know me as a fairly girly girl. I like my pedicures, abhor trailer park roots and spend a fortune on clothes. I remember that girl, and I recall that I liked her a lot. I resolve to start dressing for work again, spending time (and money) on hair and grooming. I don't believe that people should be judged on appearance, but I do believe that how we feel about ourselves on the inside is published on the outside. For me I think the outside is a reflection of what is going on inside. Which brings me to my last resolution.

Resolution: Be More Selfish - WHAT? Yes - I said be more selfish. I resolve to actually say no to things that I don't want to do - both professionally and personally. I accept that occasionally I have to disappoint others. I resolve to be selfish about taking care of my inner self. I will give myself weekends with friends, days of complete solitude, trips to the gym, long walks and hot bubble baths. Once these things were a regular part of my life, but somewhere along the way my life got in the way of me. I selfishly want me back.

Hope you guys make conscious resolutions this year, and here is hoping we can all live up to them.