rotating belize

MAN.  I think mostly my life has been a whirlwind for awhile now, and I have whirled within it to adapt, but coming home from 90 degrees and humid Belize to the chaos of freezing cold family Christmas time in New England has been other worldly!

The chaos, chaos, chaos of just prior to leaving, between commuting to Bangor and switching from night shift to day shift and back again, packing and repacking, giving thanks, breaking (gluten free) bread, squeezing in family and friends and puppies.  I wasn't fully prepared for the entire Belize experience before it happened.  But at which point in my prior overseas travels could I ever really say differently.  I am a master at chaotic lead ups to change.  A type A over-organizer with an international blind spot.

There are often times that I don't realize the real truth of something I have said until a good while after I've said it..  Talking with my mom a few days ago I had one of those experiences.  I often struggle a lot, when I come home from abroad, trying to find the right words or phrases to capture things correctly.  The inevitable inquiries get asked often enough, and every time I feel trapped by trying to fit the enormity of an entire experience into a few short statements.  My brain flashes to a million small moments that, when seen together, seem to perfectly bring the experience together, but I never know how to capture that with just a few adjectives. 

I know that's just me, I like to state things succinctly, hopefully with some tinge of wry humor, and wrap the entire thing up nicely with a bow before deflecting to something else.  Slap hands, case closed.  Relaying travel experiences, though, is often the time where I can't quite sum it up right.  I casually told my mom that during the time I was in Belize, I felt more like myself then I had in years. I'm sure I said that flippantly, and would have moved right on if it hadn't struck me that that was the truth.  And what a sad, strange thing to be a truth!

It seems in life that I've not really felt like myself for awhile, but between all the things, it was an easy thing not to notice.  During PA school I've been this weird, wonked out, anxiously tight wrapped and strapped down version of a compressed Elise, held together with the glue of thousands of studying hours, swaths of tears and thinly veiled fears of complete and utter failure.  I've felt squashed in and cooped up, reining myself in in order to buckle down and learn this craft.  The irony being that even though that sounds like a horrible existence, I have found what I love to do!  I've seriously found it.  I love practicing medicine, it feels absolutely right for me and I wouldn't trade it for anything, but I am now realizing what an unhealthy balance I've been shelving out for myself, and realizing even more how unsustainable that approach is if I hope to retain a semblance of me at the end of this process.  And I very much do!

Our belizean home that existed within the slowest most spotty internet connection, coupled with the lack of space in my pack to accommodate any textbooks, combined forces to create this weird space in time where outside of clinic I didn't feel guilty just lounging around catching up on fun reading, talking late into the night with new found soul mates, playing card games around the dinner table, cooking, reviewing interesting patients from the day in clinic, swimming, swimming, swimming and going for bike rides to town.

And dancing.  Do you know how long it's been since I danced?  Just had fun and cut loose and remembered how much of a necessity it used to be to my entire life and being that I move my body in space every day?  It was like a free pass away from the heaviness that I seem to think is necessary to accurately reflect the seriousness of my education.  What a silly concept for someone who is usually just a sidestep away from a joke at any given moment!  And how nice to have the opportunity to view it from the outside, and to give myself an option for change!

Prior to the start of this trip, I was apprehensive about a lot of things, but one big thing was that I would be practicing medicine in a foreign country with some classmates of mine that, even though we spent almost every single day together, I knew very little about. We each pitted out our own paths last year to get through each section, and for me that meant ample time with my two best studying gals, and the remainders going to time with my family.  I work best in small, likeminded groups, and so that's what I did as I plowed endlessly forward.  But in doing that I excluded so much!

In Belize I found such amazing, individual personalities right in my own group of classmates.  We had a wonderful time getting to know each other after almost two years of being acquainted, and it was just right!  I now count amongst my friends this group of amazing women who will be capable, strong medical providers in less than five short months, and I am so grateful to have met them!

In any case, what a beautiful life-changing experience I was fortunate enough to be a part of.  I feel changed and stretched, and remarkably also as though I've snapped right back to myself.  I'm going to take care to not lose sight of that.

But guys! I forgot to tell you about the trip! Shhhhhh. Instead I somehow took you on a rambling ramble of the thoughts in my head under the title of another, but there is more to be said and much more to be shown.  For now I think this post is what it needs to be, as random and mismashed as it is.  For later I will bring you with me into some photos that capture a little more of the experience.  I'll try to choose wisely, and hopefully you'll come away with a small piece for yourself.  And dear lord, please dance more. I promise that I will too.

the southerners come north

Back in October, JP's family came for a week long visit to check out this new city we call home.  It was such a great feeling to be able to show off this beautiful place!  The weather complied, and they packed their schedule with lots of the fun things New England has to offer.  Unfortunately, my body didn't comply nearly as well as the weather, and I got food poisoning on the first night of their visit.  That knocked me down for most of the trip, but the last two days I was able to extract myself from my apartment and enjoy their company.

There are six lighthouses within 20 minutes of Portland, and we visited each of them in turn.  Stopping only for lobster rolls of course!

And speaking of lobster, I think Jim was the winner in that arena.  He made it a point to have lobster something every single day he was here.  He had quite the tastings, lobster is everywhere you look around here!  I don't blame him, JP and I were just talking about how we don't eat it enough considering where we are and how cheap it is!  We knew we needed to do it up right for his family though, and we boiled up six jumbo lobsters for dinner one night. They were a hit! 

Jessica was the photographer of the trip, she's been learning all the tips and tricks for her camera.  I haven't seen any of her pictures yet, but I am sure they turned out great.  New England is a gorgeous place for photos in the fall!  We have been searching for a photographer for the wedding, and I have been lamenting the fact that both of our sisters would get great shots, if only they weren't in the wedding party!

And that is the whirlwind sum up of their trip, a month and a half later.  I know you were waiting!  Next time I'm gonna steer clear of the salmonella so I can be assured of more visiting and documenting time, and maybe even a more timely post!

ER

I started a rotation in the emergency department of a level 1 trauma center this week.  In a twist of events that I did not foresee, I feel as though I have ended this week as a completely changed person.  Have you ever felt like you went through an accelerated methaphorical personal growth spurt?  I feel like I found myself far outside anything close to a comfort zone, and instead of panicking, I just put my head down and jumped to the other side.  Well, maybe there was panic, but it was all internal, which for me is leaps and bounds my friends.

Things that have struck me so far about the ER:

1.  Wow some people utilize the healthcare system faaaaar more often than I do.  This actually was a realization I had when I was in my family med rotation, and I would open up a patient's chart to read their last clinical note and BAM there would be like fifteen interactions in their chart between the medical staff and them in the past seven days.  Holy cow, it never even occurred to me that I could even call my doctor and ask them questions, and these people are actively doing that on a multiple-times-per-day basis!  And in the ER, this is no different, which is weirder.  I saw a patient who was there for a viral upper respiratory infection, and who had been seen in the ER every single day for the past three days, and in fact was even there at 1am that morning, but left halfway through because he didn't want to wait any  longer.... Now that's just weird.

2.  Seeing kids in the ER is a whole different ball of wax than seeing them in the outpatient pediatrics.  Kids in the ER are terrifying.  They are crying and inconsolable, or lethargic and blue, and not easily distracted, and probably have bad things wrong with them that I am about to miss because I just spent six weeks seeing a parade of "worried well" children and thus have the mentality that they all probably have a viral illness of no significant consequence.  Case in point, I missed pneumonia in a 9 month old and then felt like a jackass.  I see a baby pop up on the bed board and I immediately wish I could just go see the guy who was here yesterday with a cold.  No thanks. 

3.  ER docs are some of the most badass people ever.  We had multiple cardiac arrests and heart attacks occur within minutes of each other, and the providers were so level headed and systematic.  My brain was like "oh no, ______, think things elise! ______remember all of the things!!______" and instantly all of the things I am supposed to know made hasty exits out the back door of my brain.  I was slowly processing I think these are the drugs that we should give, maybe, or is it this drug?, no that's right I think, the first drugs, let me see if they are giving those drugs.  That thought process took me five minutes, and they had already administered two rounds of epi and were five minutes into CPR while I grasped for shards of information in the far recesses of my brain about what they were going to do next.  It was pretty sad on my part, and pretty spectacularly amazing on their part. 

That's all I can think of for now.  I'm gearing up for three night shifts this week, and in thirteen days I will be flying to Belize to finish this rotation out in a clinic in Punta Gorda.  My life is pretty awesome. 

whoa wedding

Remember that time eight months ago when we got engaged?  WELL, although it might not look like it to the naked eye, I have been working like crazy to find us a venue.  It was actually a sad moment when I realized that all the work I had been doing wasn't actually a tangible thing, and in the rest of the world where having something to show for all of your efforts is generally a good measure of the use of your time I was actually probably coming up negative for a while there.  When I arrived in MN and my mom mentioned that extended family was getting a little antsy pants for the date, I calmly invited her to partake in the ever growing joyous experience that was combing through the hundreds of summer camps out here in Maine.  Holy Man.  There are seriously an obscene amount of summer camps out round these parts.  Pretty much they all look like kid heaven too.  Summer camp in Maine seems like one of the best things.  And it's fitting that I have that opinion on the matter, because I finally, finally found THE place and we snapped it right up!  Summer camp weekend wedding time here we come! Well, in like a year.  Here we come, a long time from right now, after all of the seasons have passed over again. Get ready!

Edit: my mom just recently pointed out that perhaps, in the interest of planning, y'all might be interested in knowing what exactly our date is going to be.  September 27th, 2014. Put it in the books.

changing

As my last few days left in Duluth trickle away this week, I thought I should catch you up to present as well as I could.  I always think that I love change, but actually when you microscope up to it, I am not so sure that I do.  I love the part of change that occurs after the chaos and the turbulence of the actual event settles out.  I love the sense of adventure after I have found my comfortable place in the new.  What I don't like is the actual changing, and what I like even less is the lead up.  When something in my life is about to change, I react by either pushing all thought of it from my mind, or pulling it very close to my heart and gripping it tightly in an effort to quickly, quickly, quickly absorb all of the parts that I might forget when it is gone or may have missed while it was here. 

I do that with all sorts of things.  When JP was getting ready to fly back to Maine the day after we arrived in Duluth, it was like there was a stream of giddy anxiety flowing from my brain.  It was as though I had to BOND with him in an important way, but also in an extremely sped up dimension of reality.  QUICKLY, LET US INTELLIGENTLY CEMENT THE FABRIC OF OUR ENTIRE LIFETIME TOGETHER, AND LET US DO THAT IN FIVE MINUTES OR LESS.  I get flighty thoughts and my heart picks up to a faster rate while I try to compensate for the inevitable loss in the balance that had previously existed.

I do the same thing when I am coming to the end of a book that I love.  My brain gets irrational and I feel like I should read each word s.o. v.e.r.y. s.l.o.w.l.y to make the book last longer, and at the same time I let my eyes flit to the bottom of the right hand page so that the fast part of my brain can know glimpses of what will s.l.o.w.l.y. be delivered to it in just a few moments.  It's like wanting to relish in a single moment while experiencing all of the moments. 

I feel like all of those things when I think about changing back to my real life in Maine.  I've been in an alter dimension of my life for the past six weeks, and this dimension has been incredibly great!  I've gotten to see a side of my parents that I have never seen before.  I am old enough now to really appreciate all that they do for me,, and really value having a long interrupted amount of time having them all to myself.  For the first time in my life, returning home meant less about the familiar teenage feelings of perceived stifled autonomy, and more about finding new ways to connect myself to these two individuals that I really don't know as well as I think I do. 

I don't know when in life people ever get to return back to their parents home for the kind of experience I was able to have, and that's unfortunate, because this visit really felt like more then the hum drum routine of life.  I feel like this was the prefect send off for the next part of my life, as the wife of my best friend.  I won't be gone, or given away, but more like how I picture things happening in an older time frame, nesting at home before I embark on this new path in my new home.

Oh sentiment.  You crazy, crazy.  So, that is all for now. 

Niagara Falls

Ever since we first got wind that we would be living out on the east coast for a few years, JP has wanted to go see Niagara Falls.  When we moved out, we saw the highway exits, but with the giant moving truck and two restless pups crammed into the cab with us, it just wasn't the time.  So, when I got the bright idea that I would need my Oliver with me during my rotation in MN (I of course couched it as easing the pet responsibilities burden on JP, but let's be real, I need my furry pup boy around as much as possible thank you!) his first thought was "we can go see niagara falls on the way!".  So it's no surprise that our first long day of driving ended in just that place.

Now, if you know my family, you know we are suckers for a good deal.  Often at the expense of the actual reality of the situation, so it should come as no surprise that the budget lodging that I had booked was a gigantic flop.  Like the worst flop in the history of flops.  I seriously can't even describe how filthy the place was, the couch, which as far as I could tell used to be a red sort of floral pattern, was literally black in places, sinking in in the middle and reeked, just REEKED of cigarette smoke.  JP tried to stop me from going in to the bathroom because the laminate was peeling off the ground in every corner and the floor itself was really water damaged.  I almost smacked my face on a completely full sticky fly paper hanging from the ceiling.  Oh. my. word.  It was the most disgusting place I have ever seen, and of course we had just paid for it.  We looked at each other and through our eyes said, nope, I would rather lose the money and pay double for some place else rather than stay even one more minute here.  Luckily the guy, after trying to pawn a different room off on us, did refund our money.  How that place even exists is a mystery.  BUT that is the story of why we didn't get to see the falls that night, we were busy frantically calling all the hotels in the area, and then accidentally booking one in canada and having to cancel that, and the finally finding one in the good old u s of a.  We decided that the falls in the morning might suit us just fine.

And suit us just fine it did.  We got there at just the right timing some how.  We found a shady spot to park the car and eventually leave Oliver, but first the three of us tromped to a side overlook away from the crowds for our first glimpse.  We knew Oliver would want to see the magnificence, can you blame him?

Next we dropped O off and headed towards the main gates.  We stopped first to get a closer look at the falls from above to see where the boat would be taking us.  We even wrangled a passer-by to take our photo.

The view was just breathtaking, and the air so full of energy.

We got our boat tickets and just happened to walk up right as the line had dwindled, so our wait time was about ten minutes.  Behind us the line quickly stretched around and around.  We used those ten minutes to goof off in our giant blue tarpcoats of course.

But in all seriousness, the boat ride was very much worth the ridiculousness of participating in a giant tourist trap.  It was so humbling to be up close to the falls and be sprayed by the crushing water.  It was beautiful and scary and thrilling and mesmorizing.  I fully recommend it. 

So then we hit the dusty trail, with wind whipped water in our hair and an exuberant, waiting pup in the back seat. 

road trippin'

I know, dear god do I know, that I haven't blogged in quite some time.  I missed an entire month!  I don't think that has ever happened since I started blogging.  And the worst part is that I actually have things to share!  Lots of road tripping pictures, and visits from both of my brothers, and vacation pictures and first day of work picnic lunch pictures, and wedding dress shopping pictures, and extended family from Iowa visit pictures!  I've been busy, busy, and between you and me, living back at my parents home has made me kind of feel like I am on perpetual vacation.  I get too distracted by how much fun it is to be home with them, and see them bonding so well with my puppy boy, and showing him all these new places to explore, and in general feeling like this isn't my real life.  Thus, I haven't done much in terms of tangible productivity at all! No studying.  No blogging,  No cooking or cleaning.  I guess I have done some laundry, but it kind of doesn't count because I forgot how glorious it is to have a washer and dryer in your own home.  Holy freedom!  Number one top purchase with my first pay check (even though the entire thing will basically be negative money because of loans) should be a washer and dryer.  Even if I don't have a home, cause right now I kind of feel like a queen.

Ok, so first up, the road trip seems like an appropriate place to start.  I mean, especially considering that it is the actual start.  We plotted out our route, most important stops included seeing Emily in Massachusetts, going to Niagara Falls and stopping in Cleveland to visit my cousin Eileen.

Quickest visit to North Hampton ever, we drove out after JP finished work for the day, and arrived around 11:00.  We promptly realized we were exhausted, but we powered through amazing nachos that were waiting for our arrival.  Some one had to do it!  I asked Emily to be my Best Woman in the wedding, and she happily agreed.  Morning came quickly and we shoved more delicious food into our bodies.  I love that my family always knows the perfect places to eat in every town they have occupied.  TASTY.

Quick, super duper quick, stop in Cleveland for rice bowls and catch up time with one of my favorite cousins!  She is an RN who works in the NICU and is in NP school, how's that for some acronyms!  We had a lot to commiserate about, and a lot of missed time to catch up on, if only we could have stayed longer!

We actually changed course halfway through our trip and veered sharply north through the Upper Peninsula of Michigan near where my family used to live.  That was a pretty great decision too, the roads were small and not congesty, and there was so much nature to take in!   Plus we had the joy of staying at a beautiful cabin in a remote part of Michigan, my parents drove out so they could get some time with the two of us before JP's early flight out, it was lovely!

Mackinac Bridge connecting the upper and lower peninsulas

 

Oliver chased nine deer across this field, and had the thrill of his young life!

I've got a pile of Niagara Falls pictures, so I shall parse them out of this post and into another.  For now, just know that the road trip was great, and from this vantage point it seems like a long time ago.  Hopefully soon I shall regale you with tales from my current rotation in family medicine, and catch you up to the present day adventure.  I am having a ball!

on explanations

I've recently discovered that it can be quite difficult to explain things to patients.  Or maybe it's just difficult to find the right words quickly to make complex problems easier to understand.  Or perhaps it's that they ask a lot of random questions that never occurred to me before the conversation started and I am no longer good at thinking on my feet while talking and remaining calm.  I didn't think that I would find that intimidating, but I do!

Let me explain it this way.  It's kind of similar to when you just know that your preceptor is about to pimp you on something, and it turns out that it is actually about something that you reviewed recently. Hooray! The start of a thought boldly blurts itself out your mouth with confidence, but about five words in you realize you might not have gathered enough thoughts yet and so you stall out a little and try to gun it to the end, but the end turns out to be a mangled jumble of incoherent thoughts.  At which point I usually semifrownsmile and awkwardly look from side to side as though maybe my brain was accidentally placed on the desk next to me the whole time.  This is the kind of behavior, as you can imagine, that instantly gives your patients a strong sense of confidence in you. 

I think that I may possibly be getting a teeny bit better at this particular challenge.  But really, the bar was pretty low because before my minimal improvements I just fervently prayed that no questions would be asked and my words would just be wholeheartedly accepted as the gospel truth and we could all just go along on our merry ways.  Which was ridiculous, especially since I mostly couched all of my patient discussion in heavy self-doubt and pre-apologies for being just a lowly, meek, baby PA student. and then excusing myself to go find a real person.

In small slices, here are a few of the interactions that have occurred recently that didn't completely fall apart in my novice hands:

I sat with a patient's wife in the waiting room and patiently re-explained the heart catheterization procedure that we had just done on her husband and reviewed what we had found and what the next steps would be even though I was scared that I might say the wrong thing.

I talked with a motorcycle man about risk factor modification for the prevention of future cardiac events, and I told him I always wear my helmet whilst scooting and that I fully expected him to as well.

I explained the different ideas we had on the etiology of a heart attack my patient had had the night before, and what we had found when were paged to come in to the lab late at night to open up her coronary arteries, even though I had to explain that we weren't exactly sure what had occurred.

I listened to a patient struggle to describe his understanding of what had just happened to him, and I worked to help him find a better hold of that information, even when it took me a long time to find the right combination of words.

I held my patients hand and reassured her while the anesthesiologist administered IV sedatives when she told me she was afraid she wouldn't wake up, even though I couldn't one hundred percent tell her that she would. 

I'm not sure those tiny interactions describe it, but very slowly I think I am moving in the right direction.  Some days it feels like all I can do is stand still to not move backwards, and I try to accept that as progress.  But on other days, I know I'll be fine. 

realizing long dormant dreams

HA.  That title is way too solemn for what this actual post is about, which of course is nintendo.  I stumbled upon a picture on the internet a while ago of a person playing Mario Kart 64 out in the beauty of nature, projected against a blank wall.  What more could a girl with a super nerd fiance ask for?!  And, more importantly, what more could a super nerdy fiance give a girl who would ask for such things?!

Well we planned and plotted, and packed up a giant haul of things to bring up the street to Joe's house where it had been decided that the shenanigans would go down.  I brought the meat and cheese, and JP hoofed the heavy suitcase.  It was not lost on us that we both had extremely light weight and powerful wireless machines in our pockets that had far more power then all the heavy stuff we were shleping about, but nostalgia knows no weight my friends, so up that hill we did walk.

After the food had been consumed and the sun was just setting, we slung some extension cords out Joe's bedroom window (brown to match the brick work all sneaky style), and let the magic begin.

After a few rounds we realized a fan would be necessary to blow away all the mosquitoes that we couldn't swat away while in the throws of karting.  I'm sure you understand how these things can be.

And in the end, it was everything I ever thought it could be, I wish you could have been there to experience it for yourself because it was glorious.

house on an island

Is there anything more glorious that staying in a house on an island for a week?  That laid back, serene, salty aired goodness to soak up.  Bicycling to the market in the morning (and afternoon, and evening, it's a Walsh vacation, we need copious nacho supplies, come on!), barbequing on the grill or making fresh lobster, reading in a rocking chair on a screened in porch safe from all those ravenous mosquitoes.  Delighting in the exhaustion of a pup who ran all his energy out in the nearby woods and ocean.  Playing cards by candlelight.  Swimming in the frigid water and skipping rocks on the shore.  It was bliss.  We all came and went between work and friends and other obligations. and it was just the perfect gathering spot for relaxation with some of the loveliest people I know. 

My pops and I on the ferry 

Yin likes to travel in style.

 

 Haircuts were had.

 

Rocks were skipped.

Pups were refreshed.

 

Bicycles were biked.

Lobsters were tastily steamed by one brave Emma.

 

 

Naps were attempted.

Sunsets were enjoyed.

fourth!

This time last year I was cramming a ridiculous amount of immunology into what felt like a pea-sized brain.  In stead of that mess, I got to spend this year's festivities with JP, Joe, Emma and our pups.  Next to a lake!  Grilling foods!  Playing bocce ball!

My favorite part may have been introducing Oliver to fireworks though.  He was terrified and army crawled from me to JP to Joe, and dove head first into Joe's armpit to hide.  Joe wrapped himself around O like a protective straight jacket and together they rolled over to the wall and Joe let Oliver squish between him and the wall, covering his eyes with his arm, and letting him peak out occasionally.  It was the most adorable thing ever.  After the fireworks finished Oliver popped out as if to say, ain't no thing guys, I was just pretending. What a loon.