Thursday, February 28, 2008

The life of a resident...

I was talking to Jeff about how I was excited that I am almost done with this month of internal medicine. Even though I have another month right after this one, it's nice to be halfway done with another long haul.

I was excited because really I only have two more work days until this month is over. Two more work days do not sound like very much. But they are both call days.

So my "two" days left are actually 60 hours of work.

Yep - a week and a half of a normal person's job. All crammed into two days for me.

Welcome to residency.

Tuesday, February 26, 2008

Admission

Seriously, this is whom I admitted the other night:

Right down to the squinty right eye, anchor tattoos, bald head, and prominent chin. He was even in the Navy during WWII. (No Lie)

Or, at least, this guy is how I imagine Popeye would look after all those years of smoking caught up to him, and he moved into a nursing home and developed a little dementia.

I guess I should have tried some IV spinach.

Monday, February 25, 2008

Wildlife As Canon Sees It

At least this is how our canon sees it when squinting hard through a 16x digital zoom. All in all I think its pretty good considering that most of these were taken from inside our kitchen, and the bird feeder is at the back of the yard.

Aubrey got me a bird feeder for Christmas, and the birds are beginning to find it.

Here are Mr. and Mrs. Cardinal enjoying some dinner upstairs, while a chick-a-dee keeps look out below.

















And here Mr. Chick-a-dee is dining with Mr. Unknown Bird.






















And, one of my personal favorites, Mr. Woodpecker, marveling at how much easier this is than banging your head against a tree.






















Look at the camera Mr. Woodpecker!

Saturday, February 23, 2008

Garden 2008 Update

Progress continues to be made on project Tell Garden 2008. Since the first report, the little zinnia seedling has been outpaced by scores of his friends. Our one south facing window has now become our greenhouse...























Wednesday, February 20, 2008

Surprises.

I was a little surprised to learn that my little brother, the one who once stabbed me in the forehead with a fork, who spent countless hours trying to ambush me and my friends with water guns, who once actually fell into a trash can trying to climb a telephone pole (truthfully), not only is getting married (and to an AMAZING girl, at that) but also did THIS for her for Valentine's day.

I guess he turned out allright.

Tuesday, February 19, 2008

I love my husband.

Yesterday, after a very long, rather frustrating day, I came home to find a lovely stack of HOMEMADE cilantro-lime tortillas on the counter, ready to be used for some delicious dinner tonight.

And... (that's right, not just one delicious type of bread) two beautiful loaves of regular homemade bread ready to go into the oven. I got to eat warm, fresh-from-the-oven, soft and chewy bread last night after soaking in a hot bath.

It quickly became a much better day.

Punny!

Back in January I had to sit in on a class about writing techniques in order to hone my writing skills in preparation for my thesis. To lighten the learning atmosphere our prof handed out the usual list of tongue-in-cheek writing advise, with things such as...

3. Go around the barn at high noon to avoid colloquialisms.
13. Exaggeration is a billion times worse than overstatement.

and my personal favorite, which was a new one to me...

34. Puns are for children, not groan readers!

But this last rule is apparently not binding in all situations. Note this delightful sentence from a New York Times article about finding a semi-colon in the most unlikeliest of places...

"One of the school system’s most notorious graduates, David Berkowitz, the Son of Sam serial killer who taunted police and the press with rambling handwritten notes, was, as the columnist Jimmy Breslin wrote, the only murderer he ever encountered who could wield a semicolon just as well as a revolver. (Mr. Berkowitz, by the way, is now serving an even longer sentence.)"
Ha! I love it!

Monday, February 18, 2008

Good Poem

What's that on the ground?
It's what's left of my heart.
Somebody name Jesus broke it to pieces,
And planted the shards,
and they're coming up green,
They're coming in bloom,
I can hardly believe this is all coming true.

Just as I am and Just as I was,
Just as I will be he loves me, he does.
He showed me the day that he shed his own blood,
he loves me, oh, he loves me, he does.

All of my life I've held on to this fear,
These thistles and vines, ensnare and entwine,
What flowers appeared.
It's the fear that I'll fall one too many times,
It's the fear that his love is no better than mine,
(but he tells me that)

Just as I am and just as I was,
Just as I will be he loves me, he does,
He showed me the day that he shed his own blood,
He loves me, oh, he loves me, he does.

Well it's time now to harvest what little that grew,
This man they call Jesus, who planted the seeds,
Has come for the fruit.
And the best that I've got, isn't nearly enough,
He's glad for the crop, but it's me that he loves.

by Andrew Peterson

Sunday, February 17, 2008

Trip photos II

So here is Jackson showing us all where his belly button is...

Mmm...breakfast....

Sweet Ashlyn...with her serious face.

Happy!!

Saturday, February 16, 2008

It was bound to happen sometime.

Yesterday, the church where Jeff is preaching Sunday called to let him know that the pianist is out sick and can't play. They wanted to know if maybe I played and could fill in. (To be fair, they also asked if Jeff could play.) Because, after all, pastor's wives ALWAYS play piano, right up there with teaching children's church, leading women's bible studies, or maybe singing in the choir. If they had needed a fill-in to deliver a baby, make a stuffed animal, or do an ultrasound, then I'd be their lady.

Alas, I just did not work hard enough at piano. If only I'd known I was going to marry a pastor...

Friday, February 15, 2008

A Pet Peave O' Mine

When people put those ribbon shaped bumper stickers on their car sideways or at an angle, as though we would not be able to read the text on the ribbon unless it is exactly parallel to the ground. It just looks ridiculous folks. Put the stickers on straight already.

Thursday, February 14, 2008

Cute Jack...

Fun video from our trip!

Apparently someone likes to watch football with his dad.

video

My least favorite thing....

Although there are LOTS of things I LOVE about being a doctor, there are still plenty of things that overwhelm me and are tough to do. Trying to manage very sick patients in the ICU. Figuring out which antibiotic is best. But the hardest thing for me is having to have a certain conversation with patient's family. Now that I'm back on medicine I feel like I'm having this conversation almost every day, the conversation about when to stop treating someone.

We have lots of very aggressive treatments in medicine. We can breath for people. We can keep their heart beating. We can use a machine to act like their kidneys. We can give them big whopping doses of strong antibiotics to try to treat a raging infection. Usually when someone is admitted to the hospital, we start doing these things. We use the technologies we have available to try to do everything we can. But some people are incredibly sick. They have bodies that are aged, broken down by years of living in this fallen world. And even with the most aggressive therapies, some people are not going to recover. They have terminal illnesses like Parkinson's, Alzheimer's, or cancer and even if we use these treatments, we will not fix those problems.

It is my job to go to that patient or their family and tell them that I'm sorry, but nothing can be done. I have to try to get them to understand that instead of continuing to use these aggressive measures, we should stop fighting against the inevitable.

And I have such a hard time. It's hard to know what words to use, how direct to be, and how to make sure they know that I'm so sorry for what I'm saying, and sorry that medicine does not have all the cures. It's even harder when it's a patient with something like Alzheimer's who is no longer able to eat and drink. Sure, we can give them IV hydration, or try to force food into them, but really they are just at the end of their life. Nothing that we do will fix the underlying problem they have. But it's hard to know when withdrawing care becomes something more sinister. I want to respect people who are made in God's image and honor the life that God has given them. During medical school, I thought that it would always be very clear what was the right thing to do. When you are actually in a hospital room, sitting at the bedside of a dying patient, things can be a little more muddy.

So I continue to refine the language I use with my patients, and pray that God would use me in the lives of those who are dying, as well as in the lives of their families. And also that he would continue to help me see when I need to fight strongly against death that is NOT a part of his original plan, and when it is OK to realize that simply prolonging life should not always be the ultimate goal of doctors.

Monday, February 11, 2008

Growth!

With the anticipatory taste of garden fresh tomatoes already in our mouths, last week Aubrey and I planted some seeds in indoor containers as a prelude to a summer garden. I've never been much of a green thumb, so I've been skeptical all week that anything is going to happen. But this morning we awoke to find this...

















Which if you look really closely, squint, and kinda turn your head sideways just a little bit,you can see that it contains this.....

















Ta-Da!! Our first seed has hatched! Isn't it cute? This particular bi-leaf structure is going to grow up to be a Zinnia. Along with tomatoes we also planted some flowers, and various herbs, peppers, and cantaloupe. Mmmm, just a four or five more months and there will be fresh cantaloupe on the Tell family table. I can't wait.

Saturday, February 09, 2008

Trip photos I

So here are a few photos from the last half of our road trip. We had to download the first half onto Andrew and Melanie's computer, and then we burned a CD, but of course, on arriving at home, we couldn't find it, so Melanie is sending us another. But here are Sam's highlights. I must say, though, that photographing a 15-month-old is tough. They do not sit still. They may or may not look at the camera. But this does not stop them from being exceedingly cute.





Thursday, February 07, 2008

Another project

Ok....so I found another pic from a recent project I made for our sweet niece. And I couldn't resist posting it.


The pants I made from simplicity 3765, but just made them reversible. (This might sound complicated, but these pants are a breeze to make.) For the onesies, I used some wonder under and fused fabric to a plain, cotton onesie, and then stitched around the edge.

I think the fabric-embellished onesies are my favorite, even though freezer paper stencils are also fun.

Oh yeah...I forgot to mention that to make the shoes, I used the tutorial found here.

Wednesday, February 06, 2008

More projects

I realized that there were lots of crafty projects I hadn't posted yet. So here they are:

A fun library bag for Sam and Jack.


Cute shoes for Ashlyn:


A Knitting needle case for Jeff's mom:
Just looking at these photos makes me want to sew some more....

Tuesday, February 05, 2008

Sewing

This month on ER, I've discovered that in addition to enjoying the sewing of owls, penguins, bags, trees, and other crafty things, I also enjoy sewing:

fingers, scalps, faces, hands, or what ever other body parts get injured.

Sounds fun, huh? I guess there is something immensely satisfying about putting something back together, and getting it sewn up nicely. But instead of cute pink fabric, my materials are skin.

Monday, February 04, 2008

Jeff's January Reads

Against Christianity by Peter Leithart - Intense. Thought-provoking. Good. (9)
A Son To Me by Peter Leithart - Commentary on 1 & 2 Samuel. I never knew how much I was missing. (9)
A House For My Name by Peter Leithart - An overview of the OT. I want to read a lot more Leithart. (10)
The Making of a Man of God by Alan Redpath - Strength: lots of personal application from the life of David. Weakness: It reads like it was transcribed from sermons preached in the 1940's. (and Redpath was a pastor back then, so it might have been.) (5)
Me Talk Pretty One Day by David Sedaris - He's no Christian, but he's a darn good writer. I was sad every time a chapter ended because I wanted him to keep telling the story. (9)
The Elements of Style by Strunk and White - For school. 2 good pages. 149 other pages. (2)

Sunday, February 03, 2008

Tests.

Just when I think I'm done with testing, I realize that in this profession...there is ALWAYS another test.

I took "Step 3" this weekend. Not too different than "Step 2" or "Step 1." And I was thinking that this would be the last test of my career.

Except that it isn't. Every year during residency I take an inservice exam. (Which doesn't really count for anything, but it's still a test nonetheless) Then, after I finish, I have to take the Family Medicine Boards. And then every 7 years, I have to retake this test. Just to prove that I'm not getting stupider. Not to mention that it seems every day (some more than others) feels like a test....trying to use my medical knowledge in a way that lets me be like Jesus to people who are sick and dying.

So basically, I'm saying I will NEVER be done with tests. I guess maybe God thinks that eventually, just maybe, I'll get it through my head that my value does not come from my performance (or from the way I look, or from what other people think of me, or....) .

And I obviously still have a long way to go.