Life in Cleveland

Another week of Comp Care (comprehensive special needs care - it wouldn't be medicine if we didn't shorten it to something almost unrecognizable) has flown by. In fact, now we are down to only one and a half days left. It's been a whilrwind, even just from a work perspective. I am not sure which was more dizzying - navigating the commute through the center of Case Western's University Circle or navigating the electronic medical record system. But after 3 weeks, I've got the knack... until I make a wrong turn (either system, just as lost). I am quite sure I know why I didn't take computer classes in college - definitely not my thing. But I'm not sure why I STILL don't have a map of Cleveland. I wonder about this everytime I get lost.

Thanks to Mapquest, though, I've managed to find the friends who've migrated into Cleveland over the past few years. Earlier last week I dropped by Marie (formerly Murray) and her husband Jeff's place to meet the family and have dinner. I got immediate smiles from Moira, a perplexed frown from the one-year old Ella and after a dinner's worth of furtive, side-long evaluations (- Mom, I LOOKED at her!!) Kasha gave in and gave me a green light to come again: I found myself being recruited heavily by both twins to read the bedtime story. Marie intervened, and I got invited back to Sunday Mass & brunch instead. They live pretty close to the Ruics, so that was perfect and I got to spend most of the day with them. Conversation ranges from FBI agents to making your own Christmas beer and maple syrup and crazy ER stories. We had all lines represented: EMS, nursing and physician!

Marie, Kasha & Moira - a mellow post nap moment

Saturday, even out of town, has a way of making itself classic: you can't escape Saturday chores, and you might as well enjoy coffee, bagels, the morning air and good company while you're at it. So Brueggers (not found in Illinois) got paid a call, then all the errands, AND the wash got done - all before company started dropping by around 11:30 for football. Marie is all Michigan, Ed all Ohio. Hannah wore an Ohio shirt and Michigan bib, depending on the parent closest to her. I went back to my birthroots to side with Marie - and the losing team - since nothing but red and gray... or rather crimson and gray as I got repeatedly corrected, followed the guests in.

Somewhere in the middle of the last quarter I slid out to attend the one and only Proculous - the one event in Cleveland where you can witness sausage, bacon and ham being made in the average kitchen. Well, the garage, actually. Enter Ildi & Scott (last sighted by me in 2003 at their wedding!) - their kitchen temporarily became a miniature Penzey's Spices and the garage had enough meat in it to rival a butcher, not to mention send the neighborhood dogs wacky. It was a very fun afternoon and evening. I can't claim any work, but it was a sight.

Also a sight was walking in and finding not only Ildi but another college classmate and music ministry-mate, Ericka. I met all the husbands, kids and good friends-who-like-making-sausage. It's definitely a community oriented task: don't try turning 60lbs of meat into breakfast edibles on your own.

Ericka with her Gabriella, Ildi & I with Ildi's boys Xander and Liam respectively.

Now it's back to work for a few more days... I spent part of today at a unique group home / skilled nursing facility for very advanced cases of cerebral palsy. It's an interesting story of how one orphan special needs baby got dropped off at home of a woman named Hattie Larlham, and eventually it became a farm, then an orphanage, now a high-tech rehab - school - nursing home. It's sad to see how bad the cases can be, but encouraging to see the creativity and commitment of the staff. There's even two artists - a painter and a sculpter - who showed us some impressive creations of some of the kids.

So in few days, it's off to NY for Thanksgiving....

Now Cleveland's more than skyline. :) More great stops on the next Autumn Circuit!

November 23, 2009

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Where in the World?

MetroHealth Hospital, Cleveland, IL

I realize that some months keeping up with my location can be like the old game of Where in the World is Carmen Sandiago? You have to piece together names, destinations, county routes and addresses - until I finally pull my bloggership together and get everyone up date. :)

So here I am - mostly in Cleveland this month. I'm working at the hospital above at a clinic for special needs children and adults. It's a busy rotation and I'm seeing a lot of diagnosis that I usually only see in books. The hours are long, but the company is good and weekends are free! That of course means I'm not staying in one place....

When at my current home base, I'm in Cleveland Heights with a lovely family Marie & Ed Ruic, and their 2-year old, Hannah. Jeanette knew Marie from Franciscan. I'm sort of a late evening arrival every night, but Hannah gets used to checking in on me before she goes to bed. Marie generously prepares hot dinner nightly - what a treat!

Fall has been beautiful here, barring a few truly "November Gray" days. The perk of some parking garages is that they give you nice views... the taller one where I usually end up parking on the top floor has a great view of the city. I tried for a nighttime skyline shot, but my camera couldn't quite capture the city lights (given the background lights!). Still, I enjoy the view!

So last weekend I went down to Franciscan and we fortunately had the same great sunshine - it actually was warm. Walks were definitely in order! Donna hosted me (far L), incidentally in the same house in which Justyna had first hosted our Honors' dinner senior year. (They were roommates then.) Justyna and I enjoyed a relaxing Saturday afternoon and her mom served us some lovely meals! As usual, I always learn something new... like pomegranates & feta cheese with balsalmic vinegar makes an outstanding salad and cocoa powder is a fantastic topping for vanilla bean ice cream. (We did talk about more than food!)



Of course, the Blackburn family is the other main attraction! Lydia is the newest addition, so we made acquaintance. Hannah (R) and Cecilia (L) are very happy in their shared role as older sisters. We endeavored to be adventurous and check out local cusuine... Fortunately pizza is really hard to do badly so we had a fun lunch if a little squished in our old-fashioned wooden booth.

We had a lot of fun at the park before I took off north on Sunday afternoon!


Little Cecilia - very ticklish!

That's all for now, folks!

November 11, 2009

Cathedral of Our Lady's Assumption from the Peoria River

Peoria, IL - July 2009

So imagine going through college and your only exam was once a year - one exam for everyone in your major, which you all take at the same time. It occurs on a random day in the middle of the week.

There's no prep or cramming - you're supposed to be studying all year, of course, because this covers every subspecialty imagineable whether or not you have actually trained in it yet. (There IS a study guide based on last year's exam, which the truly test-oriented students actually use.)

Your grade is a mysterious number comparing you not with your whole major but year-for-year with your peers across the nation. Your goal is to hit a general range, improving gradually over your course of studies -sounds almost reasonable, but slightly crazy - because wait - did I mention this exam is 8 hours long?

Yes, internal medicine Intraining Exams are at hand.

Mine is tomorrow - all 8 hours of it. :)

Say a prayer that double vision, spinal cord compression, comatose-like sleep, insanity or other asundry conditions do not set in while surviving the Ordeal.

By tomorrow night, I suspect I'll be doing the classic Kemba-thing (above)!

Jer. 29:11

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On the Road Again... Omaha!

I-74 over the Illinois River, Peoria

It does not seem like a year ago that I took a cross country trip east in October.. This year I have taken the opposite direction, with a little different purpose. Then, it was reconnecting with family and friends. This year, I hopped into a Suburban with Caron Easley and three little Easleys and made a brisk 6 hr trek to Omaha Nebraska. That was Friday afternoon. It was filled with funny conversations from the 2 & 4 yr olds, Henry and Violet, minor dramas from the same department, entertaining commentary from 6 yr old Annabelle, and great conversation with Caron. The scenery was somewhat obscured by pouring rain, but that didn't really dampen the enthusiasm for the journey. I really am looking forward to the trip back for an encore of such good company - it far exceeded making the drive solo in my tired post-nightfloat state of being.

Currently, I've settled into the Comfort Inn in Omaha for a 9-day course on the natural regulation and management of fertility, woman's health and the psychosocial, medical and ethical issues that all play into this. It's challenging and fascinating. There are a group of Ob/Gynes with a special clinic devoted to this - associated with Creighton University - leading this research.
I come with a healthy mix of curiousity and lots of questions. I think I've had such a broad exposure to so many women's experience that I come in with a lot of ideas about ths particular system's benefits and limits. It's a great opportunity to delve into the medical aspect of things for myself and to meet lots of other (young!) residents, nurses, moms & dads, some older doctors too, becoming practitioners - trained experts who will help teach patients how to use this. Tapping their wide experience - from converts to previous patients (with and without underlying problems) - has shed a lot of light on my questions. I think i'll be putting a lot more work into this in the future, partly because I see so many ways it can be applied and how it needs to grow as well.

In the meantime, I mostly here to learn - not dream - unless that's in bed, where I should be, as we actually have an exam on Tuesday so tomorrow night is study night. :)

~ ~~~~~

All About Watermelons

A brief note to all my fellow gardeners - or semi-gardeners - whom I pestered with the question about when to harvest a watermelon... This is what I found. Of note, the famed sound of a ripe watermelon is NOT hollow, but dull (which makes more sense, given its increased water content).

Thanks to the Univ of New Mexico and their agricultural program:

Picking ripe watermelonsQuestion: How can I tell when my watermelons are ready to harvest? Every year I waste several, picking them before they are ready or waiting so long they are overripe. Thumping them doesn't work for me.
Answer: Choosing a ripe watermelon is a challenge. In the field or garden it is much easier than in the store because you will have more clues. The indications to look for in the garden are the drying of the "pigtail" or tendril closest to the melon on the vine. If it dries while the leaves and rest of the vine looks good, the melon should be ripe. The tendril is not available to melon hunters at the grocery store. A second clue, which is available at the grocery, is the color of the "ground spot," the place where the melon rested on the soil. If this ground spot is yellow or a cream-yellow color, the melon is ripe. If it is green or white, it probably is not ripe. The rind at the soil spot should toughen and resist denting with a fingernail when the melon is ripe. Finally, for those with an ear for music or who can easily distinguish sounds, the ripe melon will have a dull thud when thumped, while the unripe melon will have a tighter, ringing or hollow sound.
New Mexico State University Extension Guide H-216, "When to Harvest Vegetables" is available at your local county Extension office. This publication gives guidelines for determining when to harvest 40 common garden vegetables, including watermelons, cantaloupes, and pumpkins.

Basic Owl Time...

Everyone knows I am apt to go MIA for months at a time. This summer proved to be no different despite hopes to the contrary! Most recently I have been working the nightfloat shift, 7pm-9am for 5 days a week, aka "Basic Owl Time." (So-dubbed by Julie.) I thought perhaps there would be quiet nights where I could caught up on important things, like medical records and blogs, but these proved to be rare and elusive. In fact, when the quiet hour hit I was just happy to catch up on the work from earlier in the night or catch a catnap. The latter happened a grand total of 3 times.

My team had a lot of fun together, though. Entertainment ranged from talking the midnight chef into making fresh French fries (my intern Maxine's specialty) or making coffee & chocolate cake runs, calculating how to correct low sodium levels or run fluids for DKA (diabetic ketoacidosis), or laughing at how our sleepy dictations turn out when the hardworking transcriptionists attempt to guess at what we were mumbling. There have been some choice mistakes - have you ever tried "teething" the details of a situation out of a patient? (I meant teasing out the details.)

As proof that Basic Owl Time is amenable to cross-country travel, disregarding time constraints and zones, I did manage to get out to Maryland to see Julie, Stephen & the boys...

(Speaking of entertainment!!)

And I made it to Chicago for Amy & Clif's wedding, complete with many friends.

In retrospect, perhaps one trip would have been plenty as I have now contracted one of our malignant, nosocomial, highly contagious and persistent hospital viruses. But life does not wait on residency schedules and the trips were well worth it....

So, on we go.... Heading of to Omaha, Nebraska next! I'll keep you all posted.

Today I admitted a 55y-o type 1 diabetic and went suddenly into diabetic mode. ... Then I got wistful about the great outdoor time at camp and all crazy insulin calculations I can now do in my head. (no calculator! My gradeschool teachers would be amazed and proud.) General adult medicine is complex and thoroughly brain-fatigueing in the hospital, but it's almost fun for the same reason. If only we named our teams after Wild West characters. :)