restart

yesterday was my last day in the medical ICU and of course i was on call. i got an admission to rule them all - with everything wrong that could possibly go wrong. it's been a long, grueling month and i've been desperate for a minute to breathe. this month - more than any prior - i've been leaning on my fellow interns. spending 80+ hours a week desperately trying to bring lives back from the downward death spiral of the ICU... grappling with the suddenness of it all with families... finding no time to process what became known only as "the shit show"... despite our meager efforts in the precious few moments to ourselves to pull it together, we all reached our respective breaking points. even so, the shared experience of it all brought us together like nothing else i've experienced before.

last night, after i left the hospital at 10pm, i met up with our whole group of residents/interns and spent 4 glorious hours drinking, laughing, and dancing. i was the last one leaving the unit of our team - and when i arrived, i entered to cheers, hugs, and a drink put in my hand. it was the best time i've had in awhile. i was undoubtedly exhilarated to be finished with my ICU duties, but i found myself truly ecstatic to be alive... something i haven't felt much in the past 6 months. what a reflection of my raw human existence and needs that have gone unidentified - needs that were finally met 100-fold last night.

1st day on new service with massive hangover? worth every minute.

i am done with my graceless heart
so tonight i'm gonna cut it out and then restart
and it's hard to dance with a devil on your back
so shake him off, shake it out

.florence and the machine.

fall

took a therapeutic bike ride today through central park. hey new york: you are ridiculously beautiful in the fall. i would have moved here just for this.







and it talks to me in tiptoes
and sings to me inside
it cries out in the darkest night
and breaks in morning light

but with all my education
i can't seem to commend it
and the words are all escaping
and coming back all damaged
and i would put them back in poetry
if i only knew how

all this and heaven too .florence and the machine.

24

one day soon i'm going to post about something other than my all-consuming job. unfortunately it's just that - nearly all-consuming. and it riddles me with doubt and frustration. there are days i want to quit so badly it hurts. today wasn't one of those days. yesterday was, though.

i'm on night float again - did a week of oncology nights, now i'm on 'variety' which means i'm somewhere different each night. oncology was miserable. cancer can be so terrible. i had to pronounce two people - both of whom i had never met, but still cried with their families. last night i was back in the CCU where i recently rotated, and it was actually sort of fun to have continuity and to have a marginal idea about what i was doing.

i was just riding the train home thinking about how bipolar it feels like my life is right now. a good day/night can make all the difference, where a bad day/night makes me certain i will quit. even so, i keep trucking. it's amazing the endurance, patience, and sheer will-power that is being shaped in me. i don't claim any of it - clearly these are not qualities i've figured out how to acquire on my own.

i hadn't heard this switchfoot song in awhile, but it came up on shuffle just before i hopped off the subway. it's such a powerful song and perfectly expresses the things i can't put into words after a long night at the hospital. i fail - yes - and then try again. every day i find myself as someone different from the day before; everyday life has a new dimension. and all i can sing, over and over, is that i'm not copping out. i'm not. i'm staying the course. sing it for me, switchfoot:

twenty four oceans, twenty four skies
twenty four failures and twenty four tries
twenty four finds me in twenty-fourth place
twenty four drop outs at the end of the day

life is not what i thought it was twenty four hours ago
still i'm singing spirit take me up in arms with you
and i'm not who i thought i was twenty four hours ago
still i'm singing spirit take me up in arms with you

i want to see miracles, see the world change
wrestled the angel, for more than a name
for more than a feeling, for more than a cause
i'm singing spirit take me up in arms with you

and you're raising the dead in me
twenty four voices with twenty four hearts
with all of my symphonies in twenty four parts.
i'm not copping out. not copping out. not copping out.

.switchfoot.

head full of doubt / avett brothers

In the fine print they tell me what’s wrong and what’s right
And it comes in black and it comes in white
And I’m frightened by those that don’t see it

When nothing is owed or deserved or expected
And your life doesn’t change by the man that’s elected
If you’re loved by someone, you’re never rejected
Decide what to be and go be it

There was a dream and one day I could see it
Like a bird in a cage I broke in and demanded that somebody free it
And there was a kid with a head full of doubt
So I’ll scream til I die and the last of those bad thoughts are finally out

hold me now

it's time for an update.

to start: intern year has been an explosion of difficulty. although i've probably had moments here and there for an update prior to today, my mind has been swirling with struggle and i've found it hard to articulate what i'm going through. today, as i transition to another week of nights, i took my bike out for a long, sweet 14mi ride. it's amazing what biking is doing for my soul.

here's an excerpt from my journal from several weeks ago:

so it just hit me... intern year is terrifying. it's like this: the first time i went ice-skating as an adult, i just knew i was going to break my neck. i put one foot on the ice, then two... i could do this, right? i gingerly put one foot in front of the other... and my legs slid completely out from under me. i teetered forward, pulled myself back, and just narrowly escaped a head-first dive onto the ice. clearly, i did not know how to do this yet. i whined and cried: "henry, i can't!" i pulled my shaky legs back together and grabbed the wall. i felt like everyone must be pointing, laughing... what is this girl doing out here? she's terrible! she doesn't even know what she's going! i stayed at the wall and watched people glide by so smoothly, so elegantly... they even looked like they were having fun as i stood there scared senseless. would i ever be able to do that? how am i supposed to learn when there are so many people around me who seem to have forgotten what it was like to take those first wobbly steps out onto the ice? will the pace of the swirling bodies ever slow enough for me, timid newbie, to slide into the mix unscathed?

i can think of a million analogies for the way intern year feels. the one i feel most often is that of treading water in a choppy sea... pumping as hard as i can and still being washed over the head with waves, gasping for breath. i'm afloat, but just barely. with my arms flailing and my legs pumping i realize: i have the lives of so many in my hands. i write medication orders, do physical exams, order tests... all while drowning. and, in the midst of it all, the fear that i'll mess up paralyzes me and i sink further under the waves. the cure? experience, knowledge, self-confidence. i'm desperate to acquire these in hopes that i will not only take better care of my patients, but that i'll also be less miserable.

as melodramatic as that all sounds, it's true. i was comparing notes with a fellow intern the other night and we surprised each other when we both admitted we were hoping to find a career path after residency that didn't involve patient care. although it's unlikely that we'll both follow-through with that plan, we agreed that the overwhelming feelings of incompetence attached to autonomous patient care at this moment make us want to flee from it altogether. what a crisis to be doing what you have prepared to do your whole life and feel like you suck at it.

i could leave it there, but i won't. there's hope. i mentioned several months ago at the outset that residency is not something i can do alone. i can't and haven't been. the hope i have in Jesus pushes me through another day - he helps me love others despite my self-doubt, gives me patience when my soul is screaming, and comforts me through situations in which i share in the suffering of his children. he reminds me that trials are certain in this world - but that my reaction is critical. what a pampered, sheltered life i've led for residency to rock me to my core like this. even as i suffer, i'm so grateful to have my eyes opened - to become someone more beautiful than who i was.

i am weak
i am poor
i am broken, Lord
but I'm yours
hold me now
hold me now
.jennifer knapp.

putting out fires

i've got one friend
laying across from me
i did not choose him
he did not choose me
we have no chance
of recovering
laying in hospitals
joy and misery
joy and misery
joy and misery

put out the fire boys
don't stop, don't stop
put out the fire on us

.florence + the machine.

(not the sandwich)

i've discovered that there are a number of things that have totally changed my life recently. some for the better, some for the worse. some are directly related to moving to manhattan, others not so much. a post about all of them would be overwhelming and ridiculous, so i'll take it in pieces.

first up: something that frequently smells of urine, crawls with rats, and inspires the use of earplugs, but is incredibly reliable and definitely the "green" option. give up? that's right, i'm talking about the subway, baby.

ah, the subway. something i was incredibly excited about even before we moved to nyc. no car? no problem! i’d been to many cities that have subways (including living in chicago and london), and knew i would love it. and to cut to the punchline: i do! i absolutely love it, although sometimes it annoys me (just like any true relationship, right?) so here’s why:

i adore not having a car. i hate driving -- and not paying for gas/insurance/maintenance is an added bonus. having to carry home all your groceries makes you think twice about what you buy, and also forces you to take frequent small trips (making your food more often fresh!) on the other hand, i realized recently that i actually used my car as a sort of purgatory for questionable belongings – namely my white coat. it worked as a great, accessible storage locker for germy nastiness that didn't belong in the house.

i have regained my voracious appetite for reading. sitting on the train headed for work (~20min) or to run errands has given me lots of undivided attention to devote to one of my favorite (but recently lost) hobbies: pleasure reading! i never made time for it in med school or college. having the time on the train has been life-changing, as my desire to read spills over into my evenings and late nights at home, too.

i sweat off (and replenish) about 10% of my body weight daily. i don't necessarily love this. waiting in the subway station in new york in july is like going to a sauna -- except you’re wearing clothes and weren’t interested in sweating in the first place. henry carries a hand towel with him. i just use the most miserable facial expression i can muster. we've both raided our local duane reade for $1 gatorade. and, honestly, we often don't escape a day without two showers.

my exercise tolerance? well, it exists now! the new york subway in particular is a labyrinth of stairs, corridors, and awkward paths. very few escalators here. just to get to the subway station, i often walk many city blocks. the first week that we lived here, henry and i thought stairs were going to be the death of us. now, we take them two at a time. it’s not always fun, but it’s manageable. and hey - maybe it'll inspire me to truly get in shape! i've already bought a bike.

don’t get me wrong, the subway is not the greatest thing ever invented. i’ve lost count of the rats i’ve spotted on the tracks. people can be jerks about letting you on/off trains and often, even if you make it onto the train, you don’t get a seat. there are mobs of tourists who haven’t a clue where they’re going (and on random occasions, they even ask you to take their picture on the subway. what?!). and then there are those times when you just missed a train or trains are running slow/aren’t running for whatever reason. even so, there are a million more things not mentioned here that i love about it.

it’s far from perfect, but for me, it’s just the right thing. and i love it.