Found and Lost

.Lost and found. by Nonnetta on DeviantArt

I've become worse and worse about posting.  Sorry.  Residency has been busy and I've been too tired/lazy in what little free time I have to reflect.  But as I'm on vacation this week (and my original first and second plans fell through), here's Part 1 of several updates.  Without further ado, Part 1: Found and Lost.

So in my last post, I mentioned Pikachu.  We did end up going on a trip to the Big Sur area.  It was an amazing (albeit too short) trip.  I'm always stunned at how gorgeous the coastlines of this state are!  Here are some pics (from just the first day):

Big Sur coastline

Bixby Bridge

Valley View

Pfeiffer Beach (yes, parts of the sand are purple)

More stunning coastline!

And the iconic McWay Falls

We had a great time!  Yes, we did fool around a bit in bed at the hotel.  That was not planned but practically expected.  I won't elaborate much here, but suffice to say he's a passionate kisser and left me with a few hickies (which was a bit of a problem hiding behind my collar in clinic the following Monday, lol).  More than anything sexual though, it was just nice to lie next to someone and cuddle.  It's a wondrous thing, the sensation of touch.

Suffice to say, by the time we parted ways I had fallen for him.  But then an odd thing happened.  His work really picked up speed and he became very stressed out and distant (presumably from all the work he had to do).  We had gone from texting/Skyping almost every other day to just a couple times a week.  I continued to say "Hi" and "Good morning" almost every day for a while with a scarce reply.  I was beginning to wonder what was going on.

When we finally carved out some time to chat on Skype, I confessed that I really liked him in a way that I hadn't felt towards many other people before.  He took it as a compliment but didn't elaborate much more.  Later he would go on to say that long-distance never works out.  He was referencing a friend and her long-distance relationship, but I took it as a sign that we weren't meant to be (at least, not at this time).  The distance between us is about 2.5-3 hours' drive, and he categorically refuses to come to my part of the state.

And so perhaps that was it.  It almost felt like things evaporated away.  We still text and chat from time to time, but it's mostly me doing the initiating.  I feel the gulf of distance and at first it ate away at me.  Yeah, I still have feeling for him and I wonder if I were to match fellowship near him, would we have a chance?  Or would he find someone else in the intervening time?

I let my guard down.  I let a mask fall.  I let myself feel vulnerable.  And things didn't go as I had hoped.  I hate this feeling.  And what's worse is the feeling that I may very well end up alone anyway.  My 20s are quickly fading with each advancing day - is there any hope for this remaining time?  Or will I find what I seek in my early 30s?

Happy Single's Awareness Day

Singles Awareness Day by Ayame-Kenoshi on DeviantArt

Wow, it's been about a month and a half since I last posted!  I suppose a few things have happened in the interim . . .

So I guess the focus of this post will center on this guy.  I'll call him Pikachu because he likes Pokemon.  So I met Pikachu back at the end of December 2014.  We had chatted on/off for months on a dating/hook-up app (no, it's not Grindr) but since we lived about 3 hours away from each other, we never had the opportunity to meet until December.

Since then, we've been texting each other almost every day.  More recently over the past 2 weeks, we've been Skyping about every other day; sometimes it's only for 10-15 minutes but other times it's been over an hour.  I've got a vacation planned for the end of this month, and we're planning on spending 2-3 days together on a mini trip/hike of the Big Sur area.

I think I'm beginning to really like him.  It's been quite a while since I've thought that way about anyone.  I've chatted with both guys and girls on/off via online dating sites/apps for the past 2 years.  A few of them (mostly girls) have made it past that to texting.  But then it fizzles out when my schedule becomes busy.  They don't initiate conversation and I can't sustain it one-sided.  But with Pikachu, he texts me in the morning to say "Hi" or "Good morning."  Simple as that.  But it keeps things going.

I was feeling the Single's Awareness Day tonight, and I texted him if he wanted to Skype.  At some point during our conversation it came up that I was bi.  Although I'm like 95% sure I had mentioned that fact to him when we first messaged on the dating app, he must've forgotten.  But his reaction was predictable, understandable, and . . . unfortunate.  He was taken aback a bit and seemed unsure for a moment.  He explained that he didn't mean it but stated that "biphobia" does exist in the gay community.  He had dated a bi guy within the past several months and it didn't go well (it didn't get very far either).

This brought up all sorts of insecurities for me.  I wasn't expecting that.  I thought I had moved past that.  I guess not.  On a spectrum of 0 to 10, with 0 being 100% straight and 10 being 100% gay, I place myself somewhere between 7 and 8.  In general, I'm more physically/sexually attracted to guys (girls have a narrower range), but I'm more emotionally/intellectually attracted to girls.  Pikachu is the first guy in a long time - possibly ever - who I've felt a romanto-emotional connection to.  And a part of me feels just broken after his reaction to me clarifying that I'm bi.  And honestly, I'm not even sure how well that label applies to me anymore.

I'm not sure how to navigate these feelings.  No, that's not accurate - I don't know how to navigate these feelings.  It's easy for me to just box it up and store it away, but that's not what I should do.  It's easy for me to tell myself the same advice I offer my patients, but it doesn't feel easy to follow.  It could be just me, but I feel like the fact/label of being bi has changed the relationship dynamics in ways that can't be undone.

Sigh.  :-/

Where in the World is Aek?

Gosh it's been a long time!  About 3 months since I last blogged!  I would say it's because I've been super busy with residency and all that, but that'd be partly a lie.  Truthfully, I've just been lazy.  Heck, I sat on this post for the better part of a month!  So where in the world have I been?

Well, I've run the gamut from the pediatric intensive care unit (PICU) to outpatient urgent care clinic.  Such a dichotomy in medicine and such different arenas, haha. 

From there I did another rheumatology rotation, but at another institution.  That was an amazing experience!  It was great just being away in a different area, working in a different system, and exploring.  It was also awkward because I felt like I couldn't perform to my full potential because I was learning the system and the hospitals.  It was almost like being a medical student again, almost.

Then I returned and did neonatal intensive care unit (NICU), which sucks as a second year resident, I must say.  You have double the patients to yourself, your patients are way sicker, and you're expected to just know how to manage things.  And on the weekend it can be just you taking care of the entire unit with the attending, which really sucks.

Currently on pediatric emergency department (ED).  It's alright.  I can see why people would want to do it - shift-based hours, sign in/out, lots of potential procedures, patients are in and out rather quick (MUCH quicker compared to adult ED), and you don't have to worry about continuity of care and the frustrations that can sometimes present.  But this is all not quite my cup of tea.  Parents sometimes bring their kids to the ED for really silly reasons.  I mean, if it's not an "emergency" you should really bring your child to his/her primary care pediatrician first . . .  I won't give examples as that may be a HIPAA violation, but if you see and hear the things I have . . .

There's a certain degree of "brain rot" that I feel as a result.  I live for the interesting cases.  The ones that make me think, that make my mind tingle.  On the flip side, as a patient you NEVER want to be "interesting" to a doctor, lol.  And when something could be rheumatic in nature, my mind definitely tingles - like it hungers and salivates for that diagnostic puzzle.

Anyway, to be totally fair, I can honestly understand why some parents bring their kids to the ED even though it's not medically justified.  There are so many factors and when it is YOUR kid, you freak out.  I get that.  I just wished that people utilized primary care as it was intended instead of the ED as their first stop.

Anywho, next post I'll post pics of my adventures.  :-P

The Fastest Longest Year

hospital floors by JESSERZZZ on deviantART

Farewell to intern year, the fastest longest year ever!  It's certainly been a crazy ride full of up and down roller coaster emotions.  And boy did the year finish with a bang!  Time to muse on a few thoughts:

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1.  Doctors incognito

I've noticed an interesting trend among us "newer" physicians: we never let anyone in public know that we're doctors.  At least not initially.  We never introduce ourselves as doctors, we never use our hard-earned titles in public, and when asked what we do for a living, we'll say something along the lines of "I work in the medical field" or "I work in the hospitals," but almost never will we say outright "I'm a resident/doctor."  Why is that?

In a twisted way, it's almost like a sense of shame or being marked.  Open your mouth and say that you're a doctor and people instantly treat you differently.  Either they ask you about your opinions on this or that (I get the "Should I get a flu shot?" question A LOT), or they ask you about homeopathic remedies, or their negative experiences with doctors comes out.  I mean, I don't go to someone who says he/she is a lawyer and say, "Man, I really hate all lawyers.  They're all scum."  Or "Are you the kind of lawyer who stands in a courtroom and all that?"

As such, I'm never offended if someone calls me "Mr." instead of "Dr."  Although, an interesting thing to note that in Britain, "Mr." is a title ascribed to surgeons whereas "Dr." is a title ascribed to physicians.

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2.  The misunderstood adolescent

I may have said this before - I'm one of the few pediatricians who actually enjoys interacting with teens.  Not all teens, mind you, but in general yes.  Anyway, this bodes well especially if I'm really intent on pursuing peds rheumatology (which skews heavily toddlers and teens).

This may be coincidence or it may be intentional, but most of the teens in my continuity clinic are males.  They're such amusing creatures.  I can get most of them to open up at least somewhat (and a handful almost way too much, lol).  I think it helps to understand where many of them are coming from.  And I may be a bit too . . . liberal in my advice to them.

Anyway, there are 3 things I always iterate to every teen guy: 1.) wash under your foreskin (most of them where I am are uncut - good for them, lol), 2.) monthly testicular self-exams, and 3.) ALWAYS USE CONDOMS.

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3.  Rising seniors

As interns we are the lowest person on the totem pole that matters (sorry med students, the hospital functions very well with or without you).  We're often abused - intentionally and unintentionally - by senior residents, attending physicians, nursing staff, etc.  It's a frustrating place to be.  But at the end of every intern year is the promise of becoming senior residents and FINALLY stepping out of the intern role.

And at the end of each intern year, it's an opportunity to reflect on the kind of senior we aspire to become.  I've had the good luck to work with one of the best and by far the most hilarious senior residents I've ever known.  Although the last month was rough, he made every day go by quickly and with enough laughter to sustain us.  I can't say I want to exactly be him, I will aspire to carry on aspects of him.

In less than a week, I'll be considered a "senior resident" and I'll have no idea if I'll be a good one or a bad one.  The best advice I've heard was, "Remember what you liked in your senior residents and do that.  And especially remember what you hated done to you as an intern and don't do that."

The Truth Is . . .

medicine by bloodred on deviantART

I attended the pediatric rheumatology conference earlier this month.  It was like a mini-vacation and I learned so much!  My mind was blown at how much there was out there (and how little I knew).  I ran into a resident who's doing her residency back where we did med school, so that was a pleasant surprise.

I just finished my clinic month, which was mostly urgent care.  It was useful and my Spanish got exponentially better (because I refused to use the translator phones after a while, and like 2/3 of the parents speak Spanish-only).  But it was really bread-and-butter and much of it didn't require much "thinking."  I hate to say it, but an NP or PA could easily do what I did this month without much difficulty.  It doesn't surprise me that NPs are trying to expand their "power" and scope of practice.

But the most brutal truth is: if I could go back in time, I would NOT do med school and residency.  This is not worth it.  As much as I love my patients, as adorable as my toddlers are, as amusing as my teens are; the hours, the hospital politics, the paperwork (oh god the paperwork!) is not worth it.  I daydream of what I've given up to become a doctor.  It's not a career I'd recommend anyone pursuing.  And that's the most brutal truth.  Perhaps I'll elaborate on this more later.

I came across the following coming out video and the way the person spoke, the honesty and anxiety in his voice, really resonated with me.

Apologies that this post is all over the place.  I'm on call tomorrow (again, yay) and have to do yet another 13-hour shift.  At least I'm on with good residents who I admire and respect.  The day should hopefully not be too painful.

Right Place and Time

right place right time by Hitomii on deviantART

There is something to be said for being in the right place and time.

There's a phrase my mom says: 这个是天规定的.  The translation is basically, "This is mandated by heaven."  The concept of a "heavenly mandate" is an ancient one.  Heaven decrees that certain things are meant to be, and certain events happen at certain times for a reason.  How we interpret that and what we do with it is up to us.  It's not exactly fate or destiny, but is along a similar line of thought.

I did my pediatric rheumatology rotation last month and pretty much loved it.  Towards the end of the month, one of the rheumatologists told me that he received an email with an application for a resident to apply for an award to attend this year's peds rheum conferences essentially for free!  How could I pass this opportunity up?  Imagine my joy at receiving the award, and I'm off to Orlando for the conferences next week!

If I didn't do that rotation that month, and if I hadn't heard about the application, I wouldn't have the opportunity to attend these conferences.  Right place and right time.  On a larger scale, matching in California for residency is probably meant to be (though it doesn't always feel like it).  And perhaps dating and finding "the one" (out of many possible "ones") is a matter of time and place as well.

That's not to say that this concept means I should be passive about things, like destiny or fate.  But rather, when the right time and place produce an opportunity, I must not let it slip.  For who knows where it could lead?

Dating: A Hesitant Proposition

Dating: a hesitant proposition.

That's what it seems to be with me.  I've had 2 friends hint as much recently, though they didn't explicitly say so.  I'm the kind of person who, when using dating sites, like to get a decent conversation going before meeting up (or giving out my number).  Perhaps I'm too cautious, or slow, or conservative or something.  Not entirely sure.  Here's a brief history of things:

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Tristan: Half-Asian/half-Mexican guy.  Pretty cute guy, chatted for a while on the app Jack'd.  Finally met in person at a free outdoor play in a nearby park.  He was rather late, the play was like half over.  Afterwards we went to my apartment to watch a movie.  He loved to kiss and we ended up fooling around . . .  We continued to text for a bit afterwards, but then we both got busy and lost contact.  He recently "resurfaced" on Jack'd after having ended a long-distance relationship (some time after we had met), but hasn't been very responsive of late.  Dead end.

Jack: Asian guy.  He kind of annoyed me, was more sexual in his texts than I wanted.  He was very late when we arranged to meet (like, 2-3 hours late).  I was furious as it totally upended my plans that weekend.  I was internally still mad the whole time we hung out.  And he smoked, that's an instant turn-off to me.  We continued to text intermittently for a while, then stopped.  Dead end.

Dan: White guy.  Rather interesting, as he's like 9 years older than me, and he actually approached me on that app.  Intelligent, sweet, but ADHD (which he legit has as a diagnosis, lol).  Met him at a time when I wasn't really looking for a relationship (other than friends), as I was on a string of super busy rotations.  He was always 15-30 min late (seems like a pattern . . .).  He got into his head that we'd be somewhat friends with benefits, but he took the FWB further than I expected, lol.  He gave great head . . . like, teeth-chatteringly good.  We continued to chat over wine when he's in town.  He's interviewing all over the place and travels a lot, so it's hard to predict where he'll be.  Dead end (of sorts, given the unpredictability of his schedule).

Dean: White guy.  Short (and I'm by no means tall) but really cute.  Is a chef.  Chatted with him via the app, then text and finally had time to meet in person (he has an equally hectic schedule as I do).  Met at a cafe, this time I was about 5 min late because I couldn't find the damn place!  We ended up talking for like 5 hours.  It was really good to connect with something like that.  Alas he smokes, but he's been trying to quit; I guess that helps . . .  Anyway, he seems open to meeting again.  Door cracked open?

Vivi: Asian girl.  Cute, funny, smart.  Is a pharmacist.  Recently got a puppy.  Met at the same cafe as Dean.  I liked how laid-back and funny she was.  We had good conversation until the cafe closed, and then continued for a little while before she had to go home to attend to her puppy.  Probably the best prospect, though her schedule is weird (but at least it's fairly predictable).

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I'm honestly not entirely sure how I feel about any of the people above.  The last 2 people have piqued my interest, but I don't know.  There are people I've met in the past who, in retrospect, consumed a large proportion of my attention (one of whom, as I have blogged about recently, abruptly decided to cease all contact with me).  There are people from my past who I still, from time to time, pine over.

Sigh.  I don't know what I'm looking for.  Yet I feel like time is running out.  This wasn't part of the "plan," lol.  I envy the people who "fall in love at first sight."  I mean, what even IS that?  Maybe my personality is just too guarded.  I need to let things go.  Which reminds me, watch this:

Mental Ativan

Today was a down day. Anxieties are flaring.

One. I take USMLE Step 3 in two days. And it's a two-day exam. Eep! I should be ready. I've been studying for the past two months (when I could and had the motivation and energy after work). I've finished the study question bank, all 1000+ questions. I've been diligently learning on my current rotation, which is a general ED (emergency  department) - so I see more adults than kids. I can't possibly see myself being more ready then now. But I still worry about that remote possibility of not passing . . . shouldn't be a problem as I padded the other two Steps soundly. But still . . .

Two. My chief residents have my on cross-cover call every Sunday for the next three months (that or back up call). I'm basically grounded in this city and can't go anywhere for the weekend. When I emailed my chiefs asking about this (diplomatically, mind you), I get a very bitchy 7-paragraph email reply. In it she basically told me to suck it up, that this hairpins to everyone and now it's my turn, I'm being difficult, and that I should be more  professional about this. Whatever. She can crawl into a hole for all I care. Good riddance when she's gone at the end of this year! I'll need to ask my co-interns for some call switches.

Three. My friend (who I've mentioned several times now) started a Twitter account. I followed him just for the heck of it, not that I'd be commenting on it much or whatever. Today I discovered that he blocked me. That hurt. It opened up the old wound. Why is he going to this length to cut off contact with me, all without ever telling me why? I just want to know why so I can have final peace.

Four. In so far away from ago of my good friends back in the Midwest (though some on the east coast now too). I dearly miss them. Facebook is a sad proxy. The other interns and I are often just too busy to hang out with each other, and they like to do their own thing - often with family if they're from this state or with their significant other. Which leads me to . . .

Five. I found out through a my mutual friend that one of my friends from undergrad is engaged. Everyone is getting married! And what do I have to show? Eternal singleness. Each passing year more and more friend are getting engaged and married, and I feel so left behind.

Like the title, I need a mental Ativan to calm me down and small me or of this funk!!

Janus at the Gate

Janus by ~luka-basyrov-art on deviantART

Janus, the Roman god of Gates, whose two faces look towards the past and the future, and for whom the month of January is named after. An very interesting and apropos Roman god for the new year. 

2013 has been a year of ups and downs. Meeting new friends and saying farewell to close ones. A year that marked the end of one era and the beginning of the next. One filled with pride, accomplishment, and excitement. One full of anxiety, doubt, and frustrations. A year I would do all over again and yet would never wish it repeated. 

I left 2013 and entered 2014 on not the best of notes (what with issues with my student loans servicer and a laptop that's crashing far too often). And least of which I was working on both Christmas and New Year's (actually at work now). What kind of year will 2014 be?  Surely one we make, right?

Lately I've been left feeling so out of balance and it's difficult to find the way back, much less time to look for the way. But 2014 needs to be a year where I can center myself, refocus my energy, find my motivation, and let the wounds of 2013 scar over. Time heals all wounds, but the scars they leave serve as constant reminders of what was. 

I have no particular resolutions. I'd just make the same ones as I do every year. Eat healthier. Work out more. Lose weight. Find love. Explore more. Travel more. Easier said than done when I'm still figuring things out day by day, week by week. 

I do not mean this post to be a depressing one. I am a realist, and reality isn't rose colored. There are some positive things to look forward to this year. In many ways, after the first couple months there is only up. But I must not rest my laurels, vigilance is still needed.

If I am so lucky, so bold, maybe - just maybe - I can achieve some that which I hadn't been able to for several years now. Let the new year begin!

An Inner Peace

Inner Peace by *MistyTang on deviantART

This vacation has been much needed to decompress, de-stress, refocus, and recharge.  It has also been useful to help me re-center myself find an inner peace again.  I've been so off-balance the past 4-5 months it's scary.

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This morning, just before waking up, I had a dream.  Bear with me for a while.  In this dream, I was seeing maybe a 16-year-old black/Latino teen in clinic.  He had a history of cancer, now in remission.  He was complaining of abdominal pain and had a large laparatomy-type scar.  I do my exam and summon my attending.  She brings in another attending, who cuts open the surgical scar to peek underneath (this never happens in real life, btw).  His organs looked good but we were shocked to not find any rectus muscles or even a peritoneal sheathe.  The attending closes him up, wraps his abdomen with bandages, and send him to the procedure room where I would suture/staple his wound close.

He manages to hobble over there, obviously in some pain.  I gather my supplies and head over there.  I enter the room to find him face-down on the ground, barely conscious.  I run over to him, turn him over, and check the ABCs (airway, breathing, and cardiac).  He was breathing and had a pulse, but was in some pain.  The first attending stopped by the door where I call a code.  She goes off to assemble a quick team (this also never happens in real life, an attending won't just up and leave like that).  It being the end of the day, practically no one was around.  It was just me and this teen, barely conscious, in pain, but breathing and heart beating.

A respiratory therapist comes by and gives me a bag and mask, which at that point my patient stops breathing.  I resuscitate him with the bag and mask, while checking his pulse.  A third-year resident comes by and assesses the situation, and by now my patient has regained consciousness.  I was able to give him some pain meds, staple his wound close, and send him out the door (also doesn't happen in real life, you don't send a critical person home).

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Although unrelated, something about that dream triggered a moment of clarity and an inner peace.  I realized that I must have been, in some way and to some degree, in love with my friend (who's been mentioned a few times now).  This was why I dwelt on him for so long, why it felt like a slow painful heartbreak.  What we had shared in the past felt right, and may have been right at that time.  But not now.  Not when we're on opposite coasts and there's an age gap and he has a boyfriend.  Perhaps he too felt this tug, and decided to cut off contact to "rip off the bandage" as it were and get it over with.  I will likely never know.  But I'm at peace with it now.

Why should I cling to something so ephemeral when reality dictates that it wasn't meant to last?  I will always remember the friendship we had shared and that time together.  I'm okay that he's decided to close contact on his end, but I may still intermittently send him a warm text or message.  I'm okay being a friend in the shadows, available if/when he decides to contact me again.

I feel, for the first time since all this started, I can move on yet still hold on to what we had.

P.S. Bonus points to whoever catches the reference in the deviantART pic shown above.

Last Man Standing

Last Man Standing by *Cute-And-Bright on deviantART

Yeah yeah, I know it's been months since I last posted.  In my defense, it's been such a crazy ride I don't even know where to begin!  This residency thing is no joke, with all the days that I just want to break down and punch a wall.  To anyone contemplating medicine, my advice is: do not do it if you can see yourself doing anything else with your life.

Anyway, I've basically been on 5 inpatient rotations back-to-back, starting with NICU, then wards, then 4 weeks of night shift (6:30pm till 8am), then back to wards, then to newborn nursery (which, despite the benign-sounding name, has inpatient hours - 6:30am till 7pm).  That's basically 5 months straight of working 13-14+ hours a day, averaging 6 of 7 days a week.  I've had to work 19 days straight twice already!  Those 19 days are brutal.  And even that's an understatement.

At the end of each day I'm just exhausted.  I barely have time to take care of errands, much less myself!  My chief residents wonder why I don't feel "happy and excited to go to work every day."  Gee, it's not rocket science.  If you basically work twice the "normal" 40 hours/week and have half the number weekend days off in a month, would you be happy and excited even if it's something you love doing?  Likely not, I think.  It's not that I don't love my patients and families - I do.  They're why I haven't quit (well, one of many reasons).  And there are rare moments of joy in my day, but it's so hard to really feel "happy and excited" when it feels like you're just nose to the grindstone every single day.  At least I'm not a surgery resident . . . I'd probably have quit or committed suicide by now.

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On another depressing note, I think I may have lost a friend.  Even back in June I hadn't chatted with him in like a month or so.  Now it feels like all communication has been cut off.  He doesn't respond to Facebook messages, texts, IM's (actually, he doesn't even show up on IM or Skype anymore, leading me to think he has either deleted or blocked me), Tumblr messages, etc.  A couple weeks ago I noticed that he unfollowed me on Tumblr and blocked me, such that none of his posts showed up on my dashboard.

I'm at a loss for words and thoughts.  I don't know what I did.  I know he has a boyfriend who he's quite involved with, is busy with school and work, but it just doesn't explain why he doesn't respond to any mode of communication.  I even called him once or twice and left a voicemail.  I don't know what to do.  I haven't really tried to communicate with him much over the past several weeks, to give him some space.  I'm just at a loss as to why he cut me off like this in the first place.  Maybe it's partly cuz of what we did when we met in person, and given he has a boyfriend now?  Idk.

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On a happier note, I was lucky to have Thanksgiving off so I could go visit my family (I work both Christmas and New Year's).  It's always nice to see my grandparents and my little cousin.  It's such a world removed from work.

And now I'm on vacation visiting my brother in Texas for a few days.  Huzzah!  It's nice to sleep in.  :-)  I'll try to find time to post some pics later this week when I return to my apartment.  After 5 blocks of inpatient rotations back-to-back, these 2 weeks of vacation are sooooo well-deserved.  And I fear it'll fly by quicker than I can blink . . .

All the Babies!

Sorry for the lack of posting, it's been quite hectic (but manageable, sorta).

I just finished a block of genetics subspecialty outpatient clinic.  Genetics is a fascinating subject as always, and I must say, this block reignited some of my former interest in the field.  I'm not sure if it's enough to make me want to pursue it as a fellowship and career, but it's back on the radar, lol.

In the middle there I did a week of nights.  I got pretty good at assessing normal healthy newborns, haha.  But man there's such a learning curve when you haven't done it in like 2 years!!  I was lucky enough to get some sleep most nights, but the schedule of nights (6:30pm to 7am) is still rough.  Takes a while to adjust and adjust back.

Now I'm in the NICU (neonatal intensive care unit).  I was terrified of it at the start, but it actually turned out to be a really nice rotation.  I'm definitely learning a lot about taking care of premature babies, often with other health problems too.  After a while they mostly become "feeders and growers," that is they're just eating to gain enough weight to go home.

Anyway, up until now, the majority of my experience has been with babies.  All the babies!  Haha.  They're pretty cute, I must say.  One just has to get on the good side of their territorial and protective nurses, lol.

I've had the privilege to see some weird and rare things, which is really cool.  I mean things that we should not be seeing because current routine medical care should have picked up these things earlier, but there are always babies that slip through the cracks.  It's quite unfortunate when a baby could be otherwise perfectly normal and healthy sees us and by then it's too late to stop the worst of it.

Anywho, enough rambling.  Must sleep.  6:30am to 7pm schedule is pretty rough too.  Unfortunately that's my schedule for the next several months . . .  As one of my senior residents said to me, "Oh wow, I'm sorry.  But the Lord doesn't give us more than what we can take."  I hope she's right.  Still, I'm soooo glad I'm not a surgical resident.

The Next Stage

Wow.  Graduation is in less than a week.  In less than a week I'll have my MD.  And in a month from yesterday I'll start orientation for residency in a state across the country (at least it's not as far away as Alaska or Hawaii? lol).

The last 3 months have flown by.  It's like I blinked and I'm here.  Doesn't help that it's still a bit cold outside even now in May, haha.  I'm not sure I'm mentally ready for this next stage - for financial independence, for having a real job, for being responsible for the life (and death) of patients.  It's only in retrospect that I can appreciate how far I've come, but I've still got a ways to go in so many respects.

I was never one of those people who hurried to grow up.  In fact, just the opposite.  I did NOT want to grow up.  Childhood is so short, adulthood is so long and fraught with issues that no one else can solve but you.  Maybe this is part of the reason why I'm doing pediatrics, who knows.

At these critical junctions I find myself reflecting in nostalgia - what would and could have been if my life had taken a different path.  What if I decided to take a year off and complete my MPH?  What if I decided not to pursue medicine?  What if, instead of being paralyzed in fear and confusion, I had decided to date her in undergrad?  What if I had decided to come out to my parents?

I have little regret in the things I have done.  I only regret the things I haven't done or haven't been able to do.  They say that medicine is one of the ultimate delayed gratifications.  You spend the majority of your 20s studying your ass off, working long hours, often putting life and health on hold.  This continues (or perhaps worsens) in residency, and in the blink of an eye, you're in your 30s.

It's okay though.  There's still some of my 20s left.  Sure I may not have much time off each year, but that just makes each day off that much more precious.  With my salary, with my own money, I will have the ability to do many of the things I want without having to consider the debt looming over my head (which will get paid off in time).  And with the new duty hour limits of 80 hours/week, I may even have time to develop a social life if I'm efficient.

So it's alright, I can't stop the flow of time just as much as I can't reverse it.  I have just begun creating a bucket list and I'll be damned if I'm unable to do every one of those items!  This wasn't the post I originally meant to write, but here you have it.  Sorry for the scattered thoughts.

First Time

The First Time by ~ChadtheFab on deviantART

Welp, no longer a virgin anymore I suppose.  It was meh.  But perhaps I should backtrack.

Yesterday, a (gay) friend visited me who I haven't seen in almost a year.  I've known him for probably 4-5 years or so.  He's in the process of moving out of his town to literally halfway across the globe, so I insisted that he visit me before he left the country.  We had also flirted/bantered online back and forth about all this (sex), so none of it is any surprise.

So anyway, long story short, we had brunch, we hung out a bit, we went back to my apartment where I eventually coaxed him.  We wanked each other a bit before I ask if he was up for "something more."  I handed him a condom and lube and asked what he wanted to do - he would top, and I would bottom.

He asked, "Don't you want your first time to be special?"

To which I replied, "Meh, I'm over special.  Plus this is special in its own way."  I've been holding off and waiting for so long, I don't really care anymore.  I'd much rather it be him than some one night stand whose sexual history I know nothing about and will never see/talk to again.

So he put on the condom and lubed up . . . it wasn't enough lube.  It hurt when he tried and I told him to stop.  He applied some more lube and then slowly entered.  It was alright.  He's about 7 inches and somewhat thick.  He slowly ramped the speed of his pounding - I didn't like that too much.  He never hit the good spots (aka, the prostate) for very long back he was going faster; it felt much better when he slowed down.  Eventually I actually kinda got bored and told him to stop, and we'd just wank each other to finish.

He then did this thing to me that he discovered accidentally a while back with some other (uncut) guys.  He just rubbed the bare head with his lubed hand and I was soooo sensitive - he had me squirming and twitching.  It felt tortuously good, but it wasn't the kind of good that gets me to orgasm.  At one point I'm pretty sure I shot out pre-cum, as I felt a spray of something up to my chest and shoulder; it definitely wasn't cum.

After he finished me off, I returned the favor.  I basically tried the same thing he did, but he wasn't anywhere as sensitive (he's cut).  However, when he came and squirted all over he chest - if he hadn't sat up slightly he would've probably shot over his head - I continued to rub his penis.  He suddenly got that post-orgasm sensitivity and I thought I'd repay him for basically doing what he did to me, lol.  He actually grabbed my hand to stop me - too bad he grabbed the wrong hand, muahaha.

So there you have it, my first time.  It was meh.  I suppose it's something to get used to, an "acquired taste" if you will?  Hmm . . . I imagine first-time sex with a woman may be more enjoyable, haha.

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My time with the last guy (post here) was way more enjoyable.  I think it was because of all the kissing and cuddling, it just felt way more affectionate.  Oh well, experiences.

I Matched!!

Wow.  What a day.  The Ides of March.  Match Day.

It's been a crazy ride.  I'm SO glad that my med school doesn't make students read where they matched out loud to the entire class.  So many people would've completely broke down crying (in joy or sadness).  Instead, my med school puts all the match envelops in a bin and chooses out names at random.

As each of my friends go up to get their results, I see their faces downcast as they matched their 6th or 8th place.  Finally one of my friends matched her #1 and I was called shortly after.  I was SO nervous - like nauseated and heart palpitations.  Imagine my (shock and) surprise when I matched at my NUMBER TWO rank!!  :-D

It's not my #1, but it's (obviously) the next best.  I had psyched myself up for my #1 so much in my head that really almost all of my other ranks paled in comparison, which is unfair.  It's unreal.  Even now I can't quite believe it.

Actually I'm starting to have irrational doubts now.  Will I be okay with the culture shock of moving so far away?  Did I make the right choice in the order of ranking my programs?  Did I lower myself as a candidate for not ranking more "prestigious" programs higher?  Will I have the time and energy to have a social life outside the hospital?

Like I said, irrational.  In retrospect, this may be the perfect match for me, even though it's #2.  It's a smaller (but not "small") program without fellows, and so more attention can be paid towards teaching me and mentoring me.  It still has all the sub-specialties represented and is a free-standing children's hospital - so my training is automatically solid.  And it's still in the state I want to be in (albeit not quite in the area of the state I'd prefer to be in, but that's okay).

It was a tough match this year.  Lots of disappointed people who applied to a surgical programs, or even medicine programs.  The number of American med school graduates keep growing, but the residency slots are static (some programs may even have shrunk a little as a consequence of the crap going on at the federal government level).  It's only going to get tougher but at the end of the day, most people match, which means most of us will become the clinical doctors that we went to med school to be.

In about 2 months, I will have an MD and have a spot as a pediatric resident.  :-)

Lonely Thoughts

First of all, thanks to those who read my last post.  Alas, said guy in that post has been accepted to a 4-year university in another state (one I didn't apply to for residency) and has a crush on another guy for a while now.  The chances of something physical between us are vanishingly small.  But I'm okay with that, I seriously wish him all the best - I'd rather have him as "just" a friend than not at all.

I'm glad that I'm done with surgery - forever.  It's almost surreal.  It's been such a privilege to be a part of surgery.  I think that's the main reason why I don't hate the OR (operating room).  At no other time can you say you've been hands deep in another person's abdomen, or held a person's bowels out of the way, or cut off a person's leg.  It is a privilege - as is all of medicine - to help someone in such an intimate way.  But whereas I willingly relinquish my privilege to ever do surgery, I acquire the privilege of being the first doctor a child sees in life and helping kids and families through good times and bad.  And that's exactly what I signed up for.
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So the real purpose of this post is to vent my annoyance.  Over the past year, most of my friends have paired up and a number have/will be getting engaged.  And much of our conversations involve them talking (either positively or venting) about their significant others.  And it irritates me.

I know they don't mean to, but I can't bring it up.  I can't ask them to not be with their other half especially when I'm friends with all of them too.  I've apparently been described by some friends as a "bitch" lately for being annoyed and snapping heads off at particular things.  Maybe I have but I'm not going to apologize for it.  I know I'm treated (unconsciously) as a secondary friend by now.  People will bend over for their significant others but make excuses to not hang out when I ask.  I expect no less.

I'm at such a stagnant time-point in my life.  It's frustrating.  I hesitate to act until I know where I'll end up for residency (Match is next Friday! oh my!!).  But here everyone is on the way to getting married and I'm not much further than I was since I started this blog . . .

Maybe I should just focus on me, my career, and accept that I'll be alone forever.

Happy Chinese New Year!

Take Care little Sister 2012 leaves 2013 by =ShadowSaber on deviantART

新年快乐!  恭喜发财!  身体健康!!

Happy Chinese New Years everyone.  The Year of the Dragon now gives way to the Year of the Snake.

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Apologies for the lack of posts of late.  Transitioning from interviewing and vacation back to rotations is tough, and to a surgical sub-internship no less!  My hatred for surgery is nowhere near as intense as it was last year, though my . . . displeasure for surgery is 90% in the hours (specifically how early I have to wake up).

That said, this surgery site is pretty chill all things considered.  I love taking the surgeries that don't have a resident in them because I get to be first assist and do more (and see more).  The attending surgeons here let me do a fair bit more than I was allowed to as an M3 last year.  I can see how one would love doing surgery; however, I still hate waking up before 5am and standing for hours on end putting strain on my lower back.  I should start doing some yoga . . .

More posts coming up soon (hopefully).  I have an unfinished one drafted.

Let The Journey Begin

And so it soon begins, the traveling across the country to visit and interview at residency programs.  And then to create a rank list from my most preferred to least preferred programs.  And finally, letting the Match dictate where I'll end up for the next 3 years of my life.

One interview down, nine more to go.  First to southern California, then to Michigan, then to Philadelphia, then Delaware, and then Chicago.  I didn't get interview invites at several programs I really wanted to have the opportunity to interview at (i.e. Kaiser North in Oakland, CA, UCSF, U of MI, UW-Madison, DC programs), but no matter; 10 interviews is plenty to match.  According to NRMP statistics, I only "need" to rank about 8 programs to virtually guarantee myself matching somewhere.

You may wonder what "matching" means.  Basically, I get interview invitations from residency programs that I send my application to.  Of the programs I interview, I create a rank list of which programs I most to least want to end up at.  Meanwhile, the programs create a similar rank list of which med students they want as residents from most to least desirable.  Then each party submits their list to NRMP and through some computer alchemy, it matches applicant and program.  This is a binding contract, so wherever the match dictates, the applicant must go for residency.  I've heard that the process favors the applicants, insofar as most applicants get one of their top 3 choices or so.

Still, it's a daunting thing.  I've come to accept that I'm almost a second-tier applicant and hence am out of the running for many of the more competitive residency programs.  And that's unfortunate but whatever.  I'm hoping to fall in love with a few programs, as people keep saying will happen.  We shall see.

Let the journey begin!  But first to finish packing . . .

Redefining the Republicans?

As we all know, President Obama won re-election and Democrats solidified their majority in the Senate, with the House of Representatives still Republican dominant.  And as much as I dislike politics, I couldn't help but read some post-election commentaries, such as this, "Christian Right Fails to Sway Voters on Issues."

The current Republican party is so far to their end of the extreme it's no wonder that they failed to win the election.  This got me thinking.  What is meant by "conservative" and what is meant by "traditional?"  These in and of themselves aren't sinister terms that should be tabooed.  Indeed, many people may consider themselves conservative or traditional but still be alienated by the current gestalt of the Republicans.

Economics

I've read that Republicans tend to favor market forces and believe in individual responsibility.  These are things that many people can rally behind.  They are less in favor of government hand-outs and give-me's, and as such are likely to be more restrictive on social safety nets for the poor or disenfranchised.  Still people can rally behind that notion when they believe they shouldn't "rely" on the government to pull themselves up or have seen others abuse the system.

Taxes
Republicans generally are in favor of less taxes on (preferably) everyone, but the current Republicans want tax cuts for the wealthy to a fault. Wealth is really a matter of perspective.  How much does one need to live comfortably?  How much does one need to enjoy life?  Yes, money is hard-earned, but taxes exist for a reason and without them, many things in society would simply cease to function.

Health Care
Republicans are united against "Obamacare."  Fine, I get that.  It's not a perfect bill.  But if you're going to attempt to repeal it, you better have a viable alternative ready to go as soon as it's gone, because the status quo isn't benefiting anyone.  Is health care a right?  Is it a basic right?  A civil right?  Is it a privilege?  Is access to health care a right?  These are philosophical questions that our society must determine.

Abortion
Alright, Republicans are generally anti-abortion.  Fine.  But I take issue when they say they're "pro-life."  They are not pro-life.  If you're going to oppose abortion, you better set up a support system for the children and mothers whose lives are affected.  If you're going to oppose abortion, you must make it okay for a single mom without a high school degree to give birth.  This takes investment, time, infrastructure, and of course money.  If you're truly pro-life, you'd campaign to have all kids vaccinated.  You'd campaign to have every child be in programs such as Head Start and Birth to Three.  You'd campaign to help single parents find jobs or tax credits for education.  You'd campaign to offer prenatal care at Planned Parenthood, not cut its funding across the board.  This is truly pro-life.  But it all costs money, and where does that come from?  Taxes.

Family
Republicans are pro-family.  But really, aren't we all?  Their problem is that they haven't kept up with what a "family" can be these days.  Yes, a family may be the nuclear family of parents and children.  But it can also be an extended family, where one lives with aunts, uncles, and/or grandparents too.  It can be a single parent home.  It can be a gay or lesbian couple.  All studies suggest that it matters less what kind of structure the family consists of, and more the love and care provided by that family.

LGBT
Republicans are against LGBT rights at large, but particularly gay marriage.  It doesn't hold much water with me from a legal perspective.  There is a difference between a civil marriage and a religious marriage.  Churches and other places of worship may refuse to consecrate a gay marriage, but that doesn't mean that the state should refuse as well.  In America where we profess to be open, accepting, and tolerant of all religions - where we believe in separation of church and state - where is all that here?  The same arguments made against gay marriage is exactly the same arguments made against interracial marriage several decades ago.

Minorities
The Republican party has a dearth of minority representation, and it has so far made little to no attempt to attract minorities.  It's really a shame.  Many African-Americans, Asian-Americans, and Latino-Americans likely agree with the Republican's economic stances and their sentiments about family.  Yet the Republicans have managed to alienate all of these groups.  Immigration reform, if done well, would begin to sway some Asians and particularly Latinos to the Republicans.

Environment
Republicans should be truer to the word "conservative" when it comes to environment.  The US has one of the greatest natural resources on the planet, and while it's something that we should tap into, it's also something that we should protect and cherish.  Investment into alternative energy would definitely open up job opportunities and drive innovation.

Education
There's a distinctly anti-education sentiment in the Republican party these days.  I do believe everyone should have the opportunity to attend college/university if so inclined.  I do believe we should invest in recruiting more people to become teachers, and to hold schools accountable (to a degree, this a very complex topic sufficient for its own post).  Teachers and their unions shouldn't be made out to be the bad guys.  It's not easy being a teacher.  If the Republicans don't do something to advance education, the US will continue to slide further and further behind.

Anyway, this post is long enough.  The point I wanted to make is that the Republican party, at its core and true to its moderate members, is not a bad thing.  But they've drifted so far from where they should be that they've become hypocritical.  Perhaps this election has kicked their butts sufficiently to see that what they're doing isn't working and will never work.

And this is a nice article to end on, "The Great Experiment."

Solitude

I am a single man - an individual -
undaunted by public displays of affection,
unshaken by the pairing and coupling of others.
These symbiotic relations have made them weak,
their freedoms restrained, their hearts softened.
Who needs that?

I can, at a whim, drive to nowhere
and gaze at the light of the stars,
observing the music of the heavens.
I would take in the awe and majesty
of the universe unfurled around me,
and know the meaning of life.

I can hike into the woods
and embrace the beauty of nature -
the sound of crunching leaves, the fires of autumn,
the soundscapes of brooks and creatures.
I would be one with the breath of the trees,
and know peace and solace.

I can lay on the warm sands of the beach
and listen to the rhythms of the rolling waves.
I would dig my toes into the sand,
feel the wind and sun on my face -
close my eyes, inhale deep,
and know relaxation.

I can stay in on a cold winter day
and bake a warm pie while sipping hot tea.
I would curl under a blanket on the couch,
watching the snow falling ever so gently.
I am content and satisfied,
as this is comfort.

I run on my own schedule,
my time is mine, my thoughts and actions are mine.
I need no reminding of the pairing and coupling
that defines the life-course of others.
I am a single man - an individual -
and I with nothing more than to share it with you.