i heart P.E.I.

i recently read through the entire "anne of green gables" series by l.m. montgomery again, after discovering that the first few books were free on google books... luckily i got a chance to swing home recently, and was able to snag the few books that weren't available from our library. and though i do love google books on my phone and ipad, there's just something about the musty smell of my old paperbacks that is so... missed. evocative of earlier times, and an earlier, more innocent me with way fewer bags under my eyes.

reading the "anne" books was like having a reunion with old familiar friends. ms montgomery had this gift of creating these wonderfully fleshed out, awesomely REAL characters whose authenticity stands up even under the scrutiny of my now more-jaundiced psychiatrist's eye. she had a lovely way of describing humanity.

nice to know that some things do stand the test of time. nice to know that though many things have changed tremendously over these past 5 years of residency, 4 years of med school, and 4 years of college... some things haven't.

a letter to my 2011 self/2012 resolutions

dear self...

first, accept that this exercise is purely and embarrassingly self-indulgent, and the irony is that after plunging into the world of social media and in-the-moment self-disclosure, you're even less able to piece together a cohesive narrative of what has happened this past year. but somehow, it does feel important to try to put together a history of sorts because 2012 already feels like we're at the cusp of... something big.

this year was, like every other year, full of notable "firsts". first visits (and hopefully not last!) to greece and paris. first time serving as a matron of honor. first "real" camera. you and the hubs started making the inexorable (inevitable?) transition to the mac universe. first baby strawberries to survive the neglected garden. first trips to random norcal attractions- sonoma, muir woods, food festivals.

you were ambivalent about most of the notable "lasts". last family medicine call. last mommy call. last chance for a continuity delivery as a resident. there's also the looming, currently all-consuming question about whether certain events will have been the last time ever.... e.g. last visit to the state fair. last trip to apple hill.

professionally, it's been really gratifying to finally feel the years of training sink in and settle fairly comfortably. i have faith that we might just turn out ok after graduation. and waddaya know, it turns out that you don't hate teaching! you just hate teaching when you're frazzled and time-crunched and stressed out... but actually even then, it's not the teaching that's painful, it's the consequences of our inefficiency that kill us.

personally, i found it very enlightening that without trying very hard at all (though *ahem* you WERE supposed to be trying quite hard), you were able to drop some pounds. apparently, having most weekends free and bathing in the light at the end of the tunnel seems to agree with your metabolism. i hope to keep up the healthy habits that you tried to implement... and to ride your shiny new bike around more frequently.

so, bravo on getting us through this past year. things to work on in the next year... faith, hope and love. keep the faith even though the decisions that loom large seem completely beyond the ability of two mere humans to make with some measure of wisdom. work on your faith, now that you've been able to peer through the fog of cynicism. hope for good things to come, but work so that they do. and love- you could do a much better job of being a loving wife, daughter, sister... and particularly if there should be a significant move or change in the next 6 months, a loving friend. we've been blessed with wonderful friends, and it's always important to nurture those relationships.

here's to the year of the dragon.

love,

the (early) 2012 me

te amo paris

the hubs and i woke up at 5:30am the morning after we flew back to the states, jet-lagged and missing paris. so of course, i decided to go through our pictures from the trip and start to inarticulately record all that i loved so much. pictured above, two of my most favorite things about paris- walking along the seine at night, and berthillon ice cream/sorbet.

i would beg some consideration for the questionable coherence of this post however, given that along with some tasty souvenirs, i also picked up some kind of virus which is causing fevers and chills. but hey, remembering paris while in a feverish flopsweat is one of the more enjoyable things that i could be doing, all things considered.

we arrived at CDG airport early in the morning last thursday, and embarked on a whirlwind tour of the city of lights. we had 5 full days, but truly i think i would have liked to stay for another 5 weeks... months... years even! some scattered highlights/memory snapshots...

loved our little modern 1 bedroom apartment in the marais (3rd arrondissement) that we rented for the trip, decked out in IKEA-esque furniture and perfectly suited for our needs with laundry, kitchen, WiFi... we didn't plan on it being so warm (80s all week!) so ended up washing our "coolest" outfits over and over to reuse. cooked a few meals in our apartment, and got a small taste of what it would be like to be a local... which of course just fueled my city-living fantasies... for some reason, this dream of being a city-dweller dies hard.

we hit up the major touristy spots, criss-crossed the town on foot and have the blisters to prove it! next time, will be taking things a bit slower... and also will not be so delusional as to think that i could survive paris on heels of any kind. for some reason, in my head i saw all the women of paris walking around on 3 inch louboutins but i am here to say that about 90% of the women there wear FLATS. sensible women, them. anyhoo, on the hit list- eiffel tower, arc du triomphe, notre dame, place de la concorde, tuileries, luxembourg gardens, pantheon, opera garnier. on the museum list- the louvre, musee d'orsay, musee de l'orangerie, centre georges pompidou. we bought museum passes which were MONEY for bypassing long snaking lines of tourists, though there was no way to avoid the crush of humanity at the louvre for example- can't imagine what it's like to come in high season.

speaking of humanity, i really understood the term "unwashed masses" in paris. there are definitely looser standards of personal hygiene over there. and the bottom of the stairs at any metro station inevitably reeked of urine. no doggy poop around however, to the city's credit- that was one SJP/SATC moment that i did not need to relive ;)

oh the shopping. saw some of the chicest stores anywhere- colette and merci, but felt decidedly dowdy and old and uncool amidst the hipsters. i think i may need to undergo a makeover, post-residency... funded by my post-residency income. marveled at le bon marché, paris' version of neiman marcus and le grande epicerie which is paris' version of eataly. saw the original chanel store and the famous staircase (but was not allowed to take pictures). walked rue saint-honoré, and various other trendy streets for shopping in the marais. such motivation to lose enough weight to fit into couture!!

speaking of losing weight though... i now come to... the food. i'm truly finding myself inadequate to the task of documenting what was an amazing culinary experience. the hubs and i kept saying to each other that this or that was "the best thing we've ever had", and also remarked emphatically that "we can never go back" to "regular" food. as anyone who knows me might have guessed, our food options were the most researched aspect of our itinerary. i put my admittedly weak-sauce excuse for a diet on hold for the trip, and ate guilt-free. had the most amazing croissant, pain au chocolat, and madeleines at blé sucré. scored lunch reservations at chez l'ami jean for an inventive, rich, delicious introduction to basque-style cuisine- wonderfully complex soups, perfectly cooked duck and veal, unique and balanced desserts including a pumpkin concoction that i still think about. had lunch at spring restaurant, and made friends with the chef, a darling of the NYT- eating at the bar by the kitchen was such a cool experience. Chef Daniel Rose himself would describe each of our dishes, actually was very kind about our dietary restrictions, and was overall a perfectly gracious host. We were able to see the effortless ballet that his chefs performed while pumping out exquisitely cooked food... oh man, it really was a foodie's dream. even our unplanned meals turned out to be great experiences as well though- dinner was frequently some store-bought paté or foie gras with cheese and a fresh baguette, or stopping at a local bistro. one thing that i found fascinating though was how apparently most parisians finish their entire plate, because i got multiple worried comments from the waitstaff when i would leave any food on the plate... so apparently portion control when eating out is NOT one of the tools employed by famously slender parisian women.

my quest for the best macarons in paris deserves its own paragraph. i must say, i failed to visit all of the patisseries and bakeries that i intended to visit, for lack of time/planning so i consider my evaluation incomplete. however, i can say this much- i don't think there is such a thing as the BEST macaron, as i found that it is highly flavor dependent. pierre hermé had the best caramel macaron, while the overall best macaron that we had in paris was the orange-ginger at jean-paul hévin. ladurée offered solid, work-horse-like options for tasty macarons. angelina and michel cluizel both had good macarons as well... and i didn't get to try gerard mulot, which is also batted about when talking about the "best" in the city. all the more reason to continue my quest in the future when i come back (not if, WHEN)... also, i have many many flavors left to try from berthillon ice cream/sorbets...

another thing i loved about paris.... people just LOUNGE there. we took the bateaux mouche boat ride on the seine at night, and saw scores of young people just chilling on the banks with their friends. ditto for any gardens- luxembourg, tuileries, in front of the louvre... people just sitting and talking, lovers canoodling, families spending time together. it was lovely, and i can't really think of an equivalent here in the states... but there should be, i think. like, the big plan for friday or saturday night is... just to hang out and talk, in a lovely outdoor environment. i like it.

so, i took a year of french in 3rd grade which has left me with the ability to count to 10, and parrot a memorized "conversation" consisting of questions and answers to "what is your name?" and "how are you?"- essentially, totally useless. the hubs took french in high school, but his retention of any such skills is self-admittedly abysmal. luckily most people in paris speak english, which is good because any attempts i made at making simple conversation invariably led to some spanish sneaking in there. for example, water "sans gas" became "sin gas". "ouí" became "sí". i was reminded of one of my high school spanish teachers who also taught french, and frequently had this problem... i don't know that my brain is able to retain working knowledge of more than 3 languages, but i'm eager to try... whenever i can afford that darn rosetta stone software.

suffice it to say, i'm hungry for more paris. i loved it, and i want to go back in a way that is wholly atypical of how i've felt about my other travels. i hope this is the start of a beautiful friendship...

a day in this life...

i find that my memory fails me too often... certainly more often than i'd like for someone under 30. and i'm starting to realize that as my residency draws to a close, i really probably won't remember very much about what it was like apart from vague nostalgic fuzzy bittersweet feelings. so, i'm going to make an effort to document this year in mental snapshots. today, for example...

8:05am- walk in (late) to huddle in clinic where i catch the tail end of a discussion about a recent article documenting anemia due to blood draws in the hospital.

8:15am- am told by my MA that a mien interpreter is not available until noon (while my mien-speaking patient has just been roomed). luckily, i grab another MA to serve as my interpreter to avoid yet another appointment carried out largely with awkward gestures (e.g. how does one ask about hemorrhoids?) and slow, loud talking in an attempt to somehow make myself more understood (which reminds me of an appointment i had with a deaf patient and his sister, who claimed to be an interpreter and whose claims i gradually started to doubt as she basically used the same rudimentary/universal body language/signs that i might have used while again talking loudly and slowly)

9:00am- get an inbox message saying that my nursing home patient, whom i saw last week after she was discharged from the hospital, has been readmitted with a stroke. she's now nonverbal and on comfort care. i'm never going to have a conversation with this lady again.

9:10am- carry out extensive discussion about contraceptive options with a new patient, whom i'll follow for all of 10 months before passing her off to a colleague as i leave. she seems nice, i'm sad that we probably won't see each other very much before i graduate.

9:30am- go out to mollify a patient of mine in the waiting room because she's been waiting 30+ minutes while her insurance status gets sorted out, and at this point i need to reschedule her. she says, "I need meds!" and i oblige.

... and so on, and so forth- i use my breaks in between patients to check emails, send yet another reminder email to my combined residents to RSVP to some event, switch a call, drop off a triplicate, call patients back, write notes, etc... though before lunch one highlight was that i did get to freeze an actinic keratosis off an attending.

12:15pm- i rush out to the cafeteria to grab a sandwich and travel over to the county psych clinic where i'm finishing up a 2 month stint. along the way, i tweak my ankle while navigating a tricky patch of soggy grass in my wedge heels.

12:30pm- utter panic. my computer has been replaced with a shiny new one. which would be otherwise very good news as my old computer operated at the speed of dial-up, however this is NOT good news because i had not backed up my patient files that are sitting in a folder on the desktop of said old computer. a flurry of desperate phone calls to IT ensues. meanwhile, i listen to several messages on my phone from this morning- a typical example: "uh, dr park, i really need to talk to you about my depakote, ok? because i think i might have a seizure and i'm almost out of the medication and the pharmacist told me not to take the medication that you gave me, so i don't know what to do! call me back, ok? please call me back!!?" (note, i am not practicing neurology).

1pm- time to see a new patient!

2pm- new patient out the door, and i'm frantically limping as i haul (haulping?) computer towers that look like the one that was in my office back and forth from where they sit in anticipation of exile to my office. dangit, the new monitor doesn't work with the old towers! i bring back another monitor as well... dangit, it doesn't have the power cord attached! i bring back yet another monitor... and try a tower... and another one... and another one... [life lesson learned- BACK UP FILES]

2:45pm- sweaty, covered in dust, but triumphant. i think i might survive the last few days here in this clinic. next few hours until 5:30pm spent seeing a few patients, writing notes, printing notes, sticking patient labels on notes, fielding telephone calls, faxing refill requests, reviewing labs, punching holes in all papers to put into paper charts, checking my OTHER inbox to make sure it's clear, etc.

... and now, here i sit at midnight, unable to sleep because like an insane person, i never learn that caffeine post-5pm results in insomnia, and the aforementioned gimpy ankle is protesting with the slightest positional change. and that, is another day.

hello, goodbye

who decided that may/june would be a time for graduations and weddings? and whoever decided on making the start date for residency around july 1st? it makes for a really busy, bittersweet season. hello to new interns, celebrations for new married lives together, but goodbye to friends who are moving on. above, a brief pictorial spread of the graduations from this season- so this year, we hit up our family medicine and psychiatry graduations, as well as the hub's old residency graduation, in addition to our "combined" graduation/BBQ. congrats to all the new grads!!!

all of this graduating makes me really antsy to do the same. *sigh* one more year to go.

γειά σας! (hello!)

independently, and long before we met each other, the hubs and i put a trip to greece on our bucket lists. last week, as part of our efforts to "enjoy life before babies", we crossed that item off our lists. now, any vacation is in my book a GOOD vacation, but this... was really a GOOD vacation.

we spent the first few days in athens, trekking over the entire city on foot and using the metro. our hotel was in plaka, a fairly touristy neighborhood with souvenir shops and restaurants crowding the narrow streets... and, oh by the way, THE ACROPOLIS smack dab in the middle. we were struck by the juxtaposition of classical, ancient architecture and ruins amidst modern fixtures. every so often we'd turn a corner and find a little square with an impossibly old looking stone arch... i suppose that's how athenians know who's a tourist- the one taking pictures of that old heap of rocks. we also ran into a little class of maybe 2nd graders, having a field trip and learning about history while sitting in the shade of the parthenon. how cool is that??! we of course hiked the Acropolis, visited museums (New Acropolis Museum and the National Archeological Museum were must-sees), the National Gardens, sipped coffee in Syntagma square, watched the changing of the guards in front of Parliament, shopped along Ermou Street, and ate ridiculously well. Gelato nearly every day (it really does taste better in Europe! must be the cows), refined and rustic preparations of moussaka + souvlaki, gallons of olive oil with freshly baked bread, baklava and marzipan goodies... *sigh* i like to think that the hours of trekking made up for the way we ate, though the pounds that we both gained over the week would beg to differ.

then we flew to santorini. when we explore an island, we EXPLORE. we probably drove through all the major roads of the island in our little smart car convertible. we walked basically ALL of the streets of oia and thira (the major cities on santorini), most of them multiple times. we saw ancient thira, the ruins of akrotiri, ancient monasteries (one right next to an apparently radioactive military base), museums with artifacts from 17th century BC, and all sorts of beaches (red, white, black). but, lest one think that this family doesn't know how to relax, we also spent an entire afternoon lounging by the pool. we watched the sunset every single night, usually whilst lingering over a delicious dinner. and oh, the food. santorini is known for their cherry tomatoes, fava beans, white aubergine (eggplant), and we ate copious amounts of all of the above.

at the very end of our trip, we saw a brief glimpse of the rumblings that have been going through the country in the form of a very laid-back "demo" in front of a sleepy government building in thira. otherwise, we would hardly have known that the country was on the brink of insolvency, though the long periods of inaccessibility to shops/restaurants in the afternoon (from about 2pm-5 or sometimes 7pm) hinted at the "work ethic" which may have led to austerity measures. the country is primarily dependent on tourism for the economy, so i suspect we were mostly spared from whatever ugliness may be the reality for greek people... but selfishly, i was grateful. i got my greek adventure, and am having trouble adjusting to the fact that i'm not there anymore. *sigh* perhaps someday, when the as-of-yet theoretical "kids" are learning about greek mythology, we'll be able to go back... God willing.

This is our 2011 team for the CAFP Battle of the Residents.. and for two years running we have come in second. Third time's the charm?
We drowned our disappointment in Asian fusion food at Betelnut as arranged by Serena, so at least we got a pleasant evening in the city (and a travel mug) for our efforts.

(tim, me, char)

spring has sprung!

so after the hibernation of night float, I've been happily adjusting to a regular schedule and the ability to enjoy gorgeous spring days... though my nose/sinuses object to the blooming greenery that so delights my eyes. the hubs and i have kept busy, finding hidden tennis courts in the pocket (very secret garden-esque), hiking, planting, exploring napa/st helena/sonoma, all of which i will be very glad to demonstrate through our new and improved pictures (from our new and improved camera) as soon as i find a way to edit down the size of these monstrous files...

june 2012 doesn't seem so far away now that i'm able to enjoy our family's half-attending status and mostly-free weekends. and now i can say that i am DONE with inpatient rotations, forever. so fitting that easter is around the corner- i feel renewed! :)

snippets from the ED

thank you, oh ER schedulers, for scheduling me for 4 full weekends in a row. really appreciated that. especially for making me come in on sunday morning, after spring forward. that was a treat.

....

to the lady complaining loudly about me after i leave the room... just because i close the curtain on your narcotic-seeking, symptom-faking self doesn't mean i can't hear you. it's a CURTAIN. and moreover, what you're saying doesn't make me any more likely to give you what you want. might wanna take that into consideration next time you call 911 claiming to have fallen. oh and by the way, the paramedics actually remember that they took to you another ER last week, for the same exact complaint. the psych side of me acknowledges that this is why it's called a personality/substance-use DISORDER, the human side of me is still ridiculously frustrated and disgusted.

....

i am more determined now than ever to discuss end of life care with my family and patients. coded an 86 year old Asian grandma yesterday who collapsed in the hallway before even being roomed in the ER. as i stood on a stool over her, pounding her chest as her horrified family sobbed in the hallway, i thought... why? and, this is really not the way life should end.

....

on a happier note, i think that the ER folks are kinda like brothers/sisters from another mother to FP folks. but also like siblings who wonder how they could have come from the same parents sometimes.

....

as happy as i will be to be done with calls and night shifts FOREVER, i must say that my absence has inspired the hubs to great culinary heights. there really is nothing like coming back after a 12+ hour shift to a home-cooked meal.

....

i've been very impressed by the ER staff's growing familiarity and expertise with dealing with psychiatric emergencies. am the opposite of impressed by what this says about the state of mental health care in our county.

....

2 weeks of jeopardy, and 2 weeks of night float then i'm done with inpatient rotations foreva. BRING IT ON!

you mean money doesn't grow on trees?

the hubs is working hard for his attending salary... i'm a kaiser widow tonight. here's hoping that this doesn't become a habit. i think i'd much rather be a golf widow.