Tying up loose ends.

So this entry is just a mish-mash of unrelated commentary. I finished my pediatrics subinternship, and it ended up being an amazing experience. I had great attendings who were super invested in teaching, as well as funny, kind, brilliant residents. All in all awesome. I was on a floor that was part general peds, part pulmonary (kids on ventilators), and part overflow from other services. That was disappointing at times, since I really wanted a general peds experience, but the great team I had was well worth it.

Taking care of neurodevastated kids made me think about some new and challenging things. I had one little patient, a four year old boy, who had no higher cortical function and only partial brainstem function (his heart worked, but the ventilator had to breathe for him). He was there because his kidneys were failing and because his respiratory failure was getting worse. Being his "doctor" was challenging because I could rarely think of any ways to help him...I mostly deferred to the pulmonary attendings, who were really spectacular. The thing that troubled me most is that I kept asking myself, "Who is my patient? Who am I taking care of?" My patient had no awareness, was unresponsive to all external stimuli...and required all sorts of machines to keep his organs working. Should kids in persistent vegetative states be maintained on machines? Is that what is best for them? I don't have the answers to any of these questions...but at least this last month has given me the opportunity to think on them.

Anyway...complete topic change. I think the highlight of my last week was watching the season premiere of The Office, which is my favorite show. Everything I hoped for Pam and Jim-wise happened in a way that was very satisfying and, in my opinion, consistent with their characters. I also found the rest of the show hilarious...I know the reviews have been kind of plus-minus on the episode, but I LOVED it. The Office is back! Yeah!

Now I'm on ambulatory women's health, which is a bit monotonous but with an AMAZING schedule. I worked, oh, about twenty-two hours last week. Pretty sweet. And I'm really good at pelvic exams and Pap smears now...which was my goal in taking the rotation. We don't get a lot of training in that as pediatricians, and it can be really important in adolescent medicine.

The whole interview thing is going great, too. I have five interviews so far and no rejections. I really want to hear from three more programs and then I'll be done. But I'm really excited about the interviews I already have...they're from some of my favorite programs!!! I'll keep my very small readership updated. ;)

Outward appearance vs. the heart.

A bit of a serious entry for once. I am starting this awesome study of 1 and 2 Samuel (books of the Bible) by Beth Moore (she wrote the study; God wrote the Bible). It focuses on the life of David but draws from a bunch of different parts of Scripture. Last week's reading focused on Saul and his disobedience and also sort of the start of David's story. (For those of y'all who aren't Bible reading folks, Saul was first king of Israel...he was not a very good king.)

Anyway, a couple of verses made a big impression on me, so I wanted to discuss them a bit. I hope that I don't take them too out of context.

The following is from 1 Samuel 14. "Now the men of Israel were in distress that day, because Saul had bound the people under an oath, saying, 'Cursed be any man who eats food before evening comes, before I have avenged myself on my enemies!' So none of the troops tasted food....That day, after the Israelites had struck down the Philistines from Micmash to Aijalon, they were exhausted. They pounced on the plunder and, taking sheep, cattle and calves, they butchered them on the ground and ate them, together with the blood. Then someone said to Saul, 'Look, the men are sinning against the LORD by eating meat that has blood in it.' "

Saul had bound his men under an oath to fast that was not from God. The men obviously needed nourishment to do their work (they were fighting a war). As Beth Moore, the author of the Bible study, pointed out, fasting that was not inspired by God led to exhaustion, which caused the men to eat the wrong things. Doing something externally virtuous for the wrong reasons led them to sin.

Does this strike a nerve in anyone else as it does me? There have been times in my life where I have fasted for the totally wrong reasons...to try to be as thin as I could. It led to me being completely focused on myself and my physical hunger...and pushing away my spiritual hunger for God. Most days, I ended up sleeping all afternoon from being weak...or eating the totally wrong things in inappropriate quantities. I did get thinner, but I felt totally ugly on the inside. There are some complicated reasons why I am like that sometimes, which probably are even more "TMI" than what I've just written, but I think the heart of the matter can be summed up in another Bible verse from this week's study that struck my heart.

"The LORD does not look at the things man looks at. Man looks at the outward appearance, but the LORD looks at the heart." (1 Samuel 16:7b)

Reading this verse last week brought to the forefront of my attention my sinful perspective. I really struggle with hating the way I look. Not just being a bit dissatisfied with a couple of extra pounds or a couple of blemishes on my face...but this deep-seated hatred of my appearance. A couple of days ago I got my residency application photo, and it was NOT good. I hate being on that side of the camera, anyway. Not liking a picture is really normal. But I spent at least thirty minutes stewing over it...how I wasn't going to get into residency because I'm so ugly...how even if I did get into residency, I'm never going to find anyone who is going to marry me because of my huge Amazonian ugliness. I just walked around campus and ruminated. And I had already read (and thought I had taken to heart) the above Bible verse. Eventually, I did laugh at myself over the ERAS photo "crisis." But it still bothers me, I'm not going to lie. And it has been extra hard hanging out with all these pediatrics residents who are super thin and cute.

Having a heart that is so focused on appearance does affect my relationship with God. I know it does. I just don't know how to realign my perspective. Even when I strive after the heart of God and try to focus on the right things, there is still this voice that haunts me with, "You are so ugly and fat and disgusting. No one is ever going to want you." I really believe that is true, and that belief is sinful. I suppose I have to trust God for a "heart makeover." Praying for a heart that is more focused on God would be a good start, I think...I want to WANT to have a beautiful heart more than I want a beautiful face or figure.

Hmmmm...I need to be quiet for awhile. Later, I will post about how stellar my sub-I has been so far. It does pretty much rock.

Leslie is awesome.

The sole purpose of this entry is a shoutout to Leslie Hutchins, who is basically the only person who reads my blog. Leslie, you rock! And you are going to be an awesome neurosurgeon! And now random people on the Internet know it!

OK...I'm post call and in a silly, silly mood. I haven't gotten eight hours of sleep at one time in a long while. But I have Tuesday off.

Subinternship week 2

I'm finishing out my second week of my pediatrics subinternship, and it's so hard. But I think things are going well. I'm more comfortable now with managing my patients and writing orders and all that jazz. Plus, my attending, who I was worried thought I was a total doofus, actually thinks I'm pretty swell. Which is more of a relief than anything. I'm tired, though...and on call tomorrow. Plus I'm on a kind of ICU stepdown service instead of the bread and butter peds service that I wanted.

Well, you can't always get what you want...but, as the wise Rolling Stones pointed out, "if you try sometime you just might find you get what you need." Totally true. I have amazingly supportive residents, and the kids are adorable. And God is somehow blessing me with the knowledge, energy and confidence that I need to get through this...and really enjoy it most of the time! And even though I have a hard time trusting that God will do the same when I have to do this for a whole year next year, I know He will.

For the record, I will go over 90 hours this week at the hospital. Good times. :)

Oh, and I want to clear up something about my experience doing neurology at the VA. A couple of entries ago I ranted about one very frustrating day. As it turns out, I had an awesome time...great team, fantastic attending...tons of fun. One of my teammates read that entry and called me out on it. I promise, I loved my neuro rotation!

new girl crush and sub-I update

OK, this chick is awesome. Her name's Marie Digby, and she's earned a degree of fame especially in SoCal (according to my sis) for these awesome covers of other people's songs on YouTube. They are really fantastic. Plus, she does write her own music. And she's beautiful. I think we'll be hearing a lot more from her in the future.

Some of my favorites:



Her cover of James Morrison's "You Give Me Something"



Her cover of Incubus's "Love Hurts"



The one that made her famous...believe it or not, the cover of Rihanna's "Umbrella"

On a completely different note, I survived my second call on my pediatrics subinternship. Really challenging, but I'm having a good time. My residents are fantastic and really treat me like a member of the team. I almost feel like an intern! And I got to do a lumbar puncture (spinal tap) on a 4 week old baby. It went really well! Now I'm not afraid of doing them...I kind of was before.

I'm tired! Five more calls this month. The kiddos rock, though. Yay, peds!

Post call, I managed to finish and submit my residency application, which was an exciting moment.