Like a Prayer

Me: I have Madonna in my head right now.

B:...Yeah, I tend to assume that's the case. You know...at baseline.


Later, Brandon presents his dinner, complete with cooking show style commentary. Imagine Top Chef/Iron Chef voices. Imagine Brandon performing all of the roles.

B: Tonight we have a trio of frozen veggie burgers, reheated and served with a trio of red sauces. I call this one "American ketchup." This, to add some flare, is sriracha chili sauce. And lastly, Johnny's hot sauce, made popular by the "barbecue chicken wing."
I appreciate the way his sauces bring out the different flavors of the veggie patties. Still, I would have liked to see a different shade of red. These reds are just so....red. And isn't the patty a little overdone? This beef is too...beefy. But it isn't beef!

Yup. It's possible the heat has gone to our heads.

Snapshot

Note: I am not pregnant. Here I sit with my glass of wine - soooo not pregnant. Just thought I'd get that out of the way before sharing the conversation B and I just had.

B: I'm going to get a burrito, and then stop at Juniper on the way home. (Juniper is the name of the frozen yogurt pinkberry style place near us.)

Me: Juniper! That's the baby name I was thinking about today! You know, for a girl. We could call her Juni.

B: ... Yeah. I like it. If we were movie stars.

Me: Hey!

B: Or we could call her Apple.

Me: ...

B: Caperberry?

Scene

Now, real snapshots:

I take pictures of my husband in profile: in Maine and in Chicago.










We see old friends: in New York, Providence, and Chicago.










I pretend to be a New Englander and pose in front of the boats. Also, my intern class - no longer interns.




















But mostly I take pictures of food. And booze.



















*Events celebrated include: trip to NYC, trip to Maine, trip to Chicago, Amy visits Providence, wedding anniversary, residency graduation*

Did you know...?

I am done being an intern. Done, I tells ya. This morning at 6am was my last non-crash primary Cesearan section for a very long time. (Second year residents do repeat sections and crashes; interns do primary sections). As I left the OR, the circulating nurse said, "See ya next time...second year."

Apparently, I am still alive. I made it through. Not sure when I'm going to catch up on my sleep debt (retirement potentially), but I'm breathing.

I've done some really amazing things this year. It's been a privilege. There have been deliveries and urgent cesareans and end-of-life conversations and heroic measures and prevention of unwanted pregnancies and counseling about pregnancies that were desperately wanted but are now over too soon. The learning curve is vertical.

I'm starting to feel a real home in obstetrics, particularly dramatic, high risk obstetrics. Still not sure how that will play out with regards to my career, but it's a thrill to experience.

My marriage is strong. When I woke up at 9pm (got home at 3pm from being awake 23hrs), Brandon was there. "I brought home leftovers from dinner. Salmon and potato latkes. And I bought beer. Oh, and this week's Glee is on the DVR." This is a good man.

I have new friends. It's the whole boot camp mentality: we've been beaten down together, and that makes us inseparable. Who else can truly understand the glory and the shame of being an intern?

And I'm alive. The new interns don't start until 6/24, but for the next 2.5 weeks we're in flux mode: some of us "advance" and some of us stay the same year. Sunday night I go back to work as the second year night float resident.

Trust Women

Yesterday was Blog for Choice day. Thanks to MICU call, I'm a day late. I know that some of the things I'll say will disturb some people who read; some of you are friends and family who I love. If you don't want to know some of my rawer thoughts on the topic, don't read (when has that warning ever stopped anyone?).

This year, the theme is "Trust Women," the George Tiller slogan. Remember when George Tiller was murdered in his church? I sure do. I was a wreck . I was a new doctor, a few weeks away from starting ob/gyn residency, a training program where I planned on performing abortions. This was after doing a Family Planning elective in Pittsburgh with some of the people who get called upon to testify in supreme court cases. Mitch Creinin, Matt Reeves, some of my early mentors in this field.

At Pitt, I saw women come from Baltimore, Philadelphia, Cleveland to get care, and we weren't considered a late term center. We were just a place that the woman with the anencephalic fetus (no brain = 100% mortality) could get a 20 week termination, or the woman with heart failure who was slowly dying from her pregnancy could get a 22 week abortion. We went to the state limit of 23 weeks and 6 days. Was the 23 and 6 week abortion I saw disturbing as hell? Absolutely. But was it necessary? I have to believe so. Because that woman wouldn't have chosen it if it was not necessary. She chose to value her life. I have to trust that. I never actually performed the procedures as I was still a medical student, but I would do the prep on some: speculum, lidocaine injection, dilator placement. I was involved, an active participant in this emotionally and politically wrought procedure.

So when George Tiller was shot, it was personal. I immediately thought of the next George Tiller. The next murder in the name of a false justice. There are the obvious names that were immediately introduced in the media: Carhart and Hern immediately came to mind. But I thought of other people, people I knew: Mitch, Matt, Bea, Lisa. And then, Karen. Because now, as a resident, I too have become an abortion provider. And so I have the fear, the fear of being gunned down or watching my professional colleagues be gunned down for providing reproductive rights.

Recently, a new George Tiller quote was discovered:

"It is not for you, if it is not an inner calling, it just isn't. It doesn't work that way. It's not the technical component, it's not the intellectual stimulation, abortion services are a heart issue. It's a heart issue, and if you have a willing heart to help women in catastrophic situations, you can be an abortion provider. You can qualify and have a satisfactory life. There are probably more physicians who get shot working in an emergency room than are abortion clinics. There are all sorts of dangers - postal workers, firemen, police officers. Everything has a risk to it."

I try to remember that. I try to remember that this is important. I trust my patients, and I trust myself. If I'm going to be brave enough to do this, I have to trust in my passion, my heart, for this field. There are 1787 abortion providers in this country, according to Guttmacher data. If not me, who? Trust women.

Knitterly husband

The following conversation just happened:

Background: a pregnant friend sent me a pattern for a "baby cocoon" that she would like for her fetus, you know, in two months when it is external. It is knit with chunky yarn on size 15 needles, so I was all, yeah, no problem.

Me: Arrrrgh! I can't believe T paid money for this pattern! It's a tube! It's essentially a long hat! If she wanted a tube for her baby, she could have just asked me. I can make up that pattern as I knit! I mean, I guess a totally new knitter might want a pattern, but I don't need one. Grrrr...

B: ....?

Me: See, here's the picture. It doesn't even make room for the head. I'm gonna change it. I'm gonna add short-rows and make head space. It will be better. Everything is better with short-rows. I can't believe how stupid this pattern is.

Note: B gets subjected to these knitting rants a lot. I'm never sure how much attention he's paying. Until now.

B: (as he looks at the pattern notes) Well, it does call for Lion Homespun acrylic, so what do you expect?

Yup. My husband is a yarn snob.

Win.

2009

As is the way of things, time for a summary statement:

2009 was apparently a big year of change, if the internets tell the truth. It certainly was for me. It was the year I became a wife, a doctor, and a (cough) New Englander, in chronological order. In 2 months we had the most amazing wedding with so much love from friends and family, quickly drove back to Cleveland for graduation, flew to Milan, honeymooned in Tuscany where we practically drank the olive oil straight (and maybe some wine too), flew back to a Cleveland now empty of our med school compatriots, finished packing, and drove the Penske truck to Rhode Island with the help of my father-in-law. 2 weeks later, I was introducing myself as Dr. G, checking cervixes, cutting into abdomens, and trying to project confidence.

While here in Providence, I have changed. I'm learning to act fast and trust that I actually do know how to manage sick people. I've learned what it's like to bond with oncology patients over time, only to hear that she died over the weekend or two days after you discharged her to home hospice or on Christmas morning. I'm learning about marriage. About relying on your partner enough but not too much. About trying to feel like a human partner after working and worrying about your patients all day. And I've developed my relationship with my sister. We're both on the east coast now, within a short driving distance. More things are possible. Work has provided new friends, including Cat, my "Work Wife," my partner in foodie crime. We go to Boston for Ethiopian food, New Haven for restaurant week, and La Laiterie all too often for cheese. We discuss the changes that our jobs demand of us.

Transition: it's the part of labor where things truly get going, where the pain becomes truly intense. It looks awful, overwhelming, impossible. But it is necessary for birth.

Love my job

Monday, as I performed my first perineoplasty, I had this conversation with my attending:

Attending (A): I would go here...then here...Make it work!

Me (K): Um...The Tim Gunn method of surgery?

A: Hahaha! Yes! It's Project Runway: Vulva Edition! Less is more!

We both were quite amused with ourselves. (Also, I made it work and improved this patient's quality of life, which is the important - but less amusing - part.)

We're currently in the process of interviewing next year's group of interns. This is amazing. It is amazing because it means that I will not be an intern forever! Yay! Also, it is amazing because I get to talk about this program to people who really, really want to hear about it (or at least have to pretend as much). In the process of talking, I realize over and over again how great this place really is. Obviously, it's a great hospital with Ivy League affiliations and wonderful volume, but it's really so much more than that. It's a chosen community of people dedicated to providing top notch, comprehensive health care for women. It's people who are self-driven to great heights and who will support everyone else in reaching their own goals, in good times and bad.

At every applicant lunch we play a slideshow of us working and playing together. I get a little teary every time.