Tuesday, October 4, 2011

Cornbread and Greens

I just finished up my M4 internal medicine rotation (which is what I want to do with my life). It was an exhausting month, but I thoroughly enjoyed it. I learned so much about so many things, not just disease processes, but also the interdisciplinary aspect and business side of medicine. I had a fantastic team- Team Green! I had a great resident and intern. They were very supportive and took the time to teach us. I was partnered up with another M4 who has been one of my dearest friends throughout med school, and he always had my back-although he never brought snicker or chex mix. It was a fun month.
It is hard to describe to you the bittersweet feeling of the last day of a long, hard rotation. On one hand, I was so glad I was going to be able to sleep past 5:30. I was looking forward to eating breakfast with my husband again. On the other hand, I spent 30 days with these 3 team members. 315 hours. Do you lnow how well you get to know someone working almost 12 hours a day with 3 other people from headquarters the size of a broom closet? You get pretty close. You know their spouse's name, their kids' names and what sports they play, what they drive, what they would drive if price was no object, how they like their mugshots burger, their aspirations, their fears, their struggles, their hope, and their faith. Then after 30 days is up, as my partner would say, "you just throw them deuces and say peace". That is really how it is... we work until everything is done... we shake hands... Wish each other good luck... and leave. Then the next day, you move on to the next month's rotation and start over with a new team.
Just a little side note... I'm so glad to know that UMC has amazing internal medicine residents and that I don't have to worry about team dynamics and being stuck with a rough crew when starting a new month. Every one at UMC in internal medicine seems to have plugged in to the team mentality. There is not "Well I'm done, I'm going home," it is everyone helping everyone get their work done-because we all desire to get home at a decent hour. In my expereince no one gets stuck with a heavy work load alone. The team has got your back.

So... The reason for my post:
My favorite patient of the month is a lady who has been at the hospital for 8 months. She has not been outside those hospital walls since last winter (can you imagine?). The hospital walls have become her prison. I'm going to call her Sassy.
I came on to the medicine service at the beginning of the month and I had heard from those that were participating in Sassy's care how difficult and demanding she could be.
I went in to see her the morning on the first day of the month with those comments looming in the back of my mind. The idea of her that I had formed in my mind from other's comments had caused me to have a flippant attitude concerning her. She is constantly complaining of itching and pain around her PEG tube. She has a trach and it is difficult to understand her when she talks. She had been laying in the bed since February, not really participating in PT/OT. She has been labeled as a “rock” and thought of as someone who would stay her until she died. She was doing well and was still here due to placement issues. There was not a lot that we were doing for her. So I took her complaints with a grain of salt for the most part. It was when she stopped complaining that people would get worried.
I don’t know what caused me to change my attitude towards her. Maybe it was seeing her everyday and God moving my heart to feel miserable FOR her. Whatever the reason, I began to listen to her, spend extra time in the room with her, pop in her room serveral times a day, and attempted to meet her every need-whether it was moving her pillow around, putting her back scratcher within reach, or covering up her toes. Whatever she asked, I attempted to do it. She was exhausting me in the beginning, but after mixing in a little “tough love” when it was appropriate, she and I developed an understanding. I expressed to her that I was working as hard as I could to get her well and get her home to her family, and I told her that I needed her to work with me, to work with the nurses, and most important, I needed her to work with her OT and PTs. When I mentioned going home to her and that it was not an impossibility, her eyes lit up. I honestly think she thought she was sicker than she really was. It was like she thought that UMC was going to be her new home. After this little talk, she was a much better patient- not perfect, but much more motivated. The end of the month came. I told her good bye and passed her care on to one of the M3 ladies that I knew would be sweet and give her that tough love she needed.
I look back and cringe at the approach I took with her the first week. I let other opinions creep in and affect my judgement before I had time to form my own opinion. I wasted a week with this lady. In the last three weeks of the month, Sassy and I bonded. We can now communicate without her saying a word. I can read thoughts by her by her facial expressions (which is why I call her Sassy in this post) and I have learned to read her lips when she needs to voice a concern. She has been participating in OT/PT and is now able to stand up and take a few side-shuffle steps. She prefers to sit in a chair during the day instead of laying in the bed all day long. She started eating a soft mechanical diet the day before I left. Before then she had been getting tube feeds through a tube in her stomach, called a PEG tube. She had a set back near the end of the month and was sent to the MICU and she still wanted the therapists to do therapy in the ICU every day. She is a different woman from Sept. 1st. She has hope. She is motivated. She is trying to get home.

She was sitting up in a backless chair eating greens and cornbread the day I left. I never thought greens and cornbread could make me tear up- but I sure did when I saw Sassy sitting up, eating, and grinning that sassy little grin she has.


Pin It A few pictures as always:

These are all from last weekend at the deer camp...We had a blast as you can see!




Wednesday, August 24, 2011

Ms. Bright Eyes


Yesterday, I was in pulmonary clinic... dealing with the usual there- lungs. I was about to leave for the day, when the attending physician asked me if I had ever seen discoid lupus. I had heard of it before and I knew it was an autoimmune process, but I didn't know how it was different from normal lupus. With normal lupus, you may or may not get a rash on your face that looks like a bad sunburn. With discoid, that rash flakes and scales and after it heals as well as its going to heal, it looks like someone burned the skin with acid. It is disfiguring. Google it. I was not prepared for what I was about to see.

This lady was a young african american woman, not much older than me. Her face was scarred up. Her cheeks were varying colors of brown, pink, with the occassional white spot. The skin was leathery and not smooth. She had wrinkles, but not like the wrinkles old people get. She had the tight wrinkles. The wrinkles scars and burns make. She had ulcers and sores hiding under her bangs. You could see the white scar tissue forming around the pink open sore. It looked painful. I imagined that it would sting to get it wet, like a strawberry from sliding on the basketball court or in the infield. I imagine that her sweat on these hot summer days stung so bad and that it hurt to wash her face.

I didn't say much. The doctor just took me in and introduced me and asked if he could teach me about her history and her disease. She smiled and enthusiastically agreed. He explained her disease to me. She had been in and out of the hospital many times. She had been in ICU once for lung complications. She was on several immunosuppresant drugs that keep her prone to infection. She had to take a large amount of pills ever morning and night and she came in every six months to get an iv infusion of a drug that is similar to chemo. After he explained things to me, the doctor thanked her for the learning opportunity she gave me and we left.

I learned a lot about discoid lupus. But what got me was her attitude and sweet spirit. I was not even in there five minutes with her, but I could tell a lot from her smile and her eyes. Her eyes were SO FULL of life. They had the twinkle in them that let you know she had plans. She has a terrible disfiguring diesease that will keep her in and out of hospitals for the rest of her life, and might possibly be the end of her life one day, but she didn't let that phase her. Her bright green eyes were determined and motivated. Her sweet spirit let me know that she had made peace with the cards she was dealt. I felt so sorry for her but she did not feel sorry for herself.

As I thanked her and walked out of that small clinic room, tears began to well up in my eyes. I don't know Ms. Bright Eyes... but she touched me yesterday. She was a living version of James 1.

James 1:2-4
"Consider it a great joy, my brothers, when you experience various trials, knowing that the testing of your faith produces endurance. But endurance mst do its complete work, so that you may be mature and complete, lacking nothing.

It Is Well With My Soul
Lyrics: Horatio G. Spafford
Music: Philip P. Bliss

When peace, like a river, attendeth my way,
when sorrows like sea billows roll;
whatever my lot, thou hast taught me to say,
It is well, it is well with my soul.

It is well with my soul,
it is well, it is well with my soul.

Though Satan should buffet, though trials should come,
let this blest assurance control,
that Christ has regarded my helpless estate,
and hath shed his own blood for my soul.

It is well with my soul,
it is well, it is well with my soul.

My sin, oh, the bliss of this glorious thought!
My sin, not in part but the whole,
is nailed to the cross, and I bear it no more,
praise the Lord, praise the Lord, O my soul!

It is well with my soul,
it is well, it is well with my soul.

And, Lord, haste the day when my faith shall be sight,
the clouds be rolled back as a scroll;
the trump shall resound, and the Lord shall descend,
even so, it is well with my soul.

It is well with my soul,
it is well, it is well with my soul.

My Bachelorette Party
The bridesmaids and Huck!


Friday, February 25, 2011

The Heart of the Matter

Its been a while... I'm on Family Medicine now. Surgery was a super busy 8 weeks. It was challenging and not as terrible as I anticipated. After surgery I did an endocrine elective for two weeks. I really enjoyed my time with that team. They are great people to work with and they taught me a lot about medicine and teamwork. They took time to teach different topics to me one on one. AND THEY LOVE THEIR JOB. That is one thing that draws me to that specialty. They love learning. They love their patients. The subject matter is complex. There is great advancement in that field right now with Diabetes and cholesterol. And they have time to enjoy life away from the clinics and hospital. Anyways, enough about that... The real reason for my post:

I did two weeks on cardiothoracic surgery back in February. I participated in 8 open heart surgeries. I saw and held real, live beating hearts. It was truly a surreal experience to see the heart beating. Lub-Dub. Lub-Dub. Contracting and relaxing. 60 times a minute. Pumpling life giving blood through the arteries and veins of the patient.

I understand why people correlate love and the physical heart. It is active and moves. Love is active and it moves. Love can be life giving, and the loss of love can suck the life right from someone... as if their heart had stopped. It only makes sense to put the two together.

14 days until my wedding. I cannot believe how fast time has passed since May 15, 2010. It seems like just yesterday Nicholas was on one knee at the foot of the cross asking me to take his name. Since then we've been super busy. Every weekend since February has been planned for us. We've had 6 showers and the bachelor/bachelorette weekend. It has been non-stop. The reality of it is beginning to set in... Our plane tickets and honeymoon info came in yesterday (I CANNOT WAIT TO HIT THE BEACH!!). This weekend we are moving my furniture to his house and right now I'm checking the weather forecast praying fervently that it isn't cold, raining, or windy. Unbelievable. Time flies.

With the big day approaching, I am completely aware of that I have a heart. Not aware as in I know I have one, but aware as in I can FEEL I have one. I can feel it in my chest. It is fluttery. I have butterflies. At times, it feels so swollen with love that I feel it may burst. I am so excited to be marrying the man God hand picked for me. I'm looking forward to learning about Nicholas, his quirky traits and habits, and how I can best serve him and love him as a wife. I pray that we can be a picture of Christ and the church. Our desire is that our wedding inspires other couples to remember what they felt on their wedding day and to rekindle their love for one another. We want our love to be life-giving-active and visible. Just like a heartbeat.

1 Corinthians 13- The Love Chapter

If I speak with the tongues of men and of angels, but do not have love, I have become a noisy gong or a clanging cymbal. 2 If I have the gift of prophecy, and know all mysteries and all knowledge; and if I have all faith, so as to remove mountains, but do not have love, I am nothing. 3 And if I give all my possessions to feed the poor, and if I surrender my body to be burned, but do not have love, it profits me nothing.

4 Love is patient, love is kind and is not jealous; love does not brag and is not arrogant, 5 does not act unbecomingly; it does not seek its own, is not provoked, does not take into account a wrong suffered, 6 does not rejoice in unrighteousness, but rejoices with the truth; 7 bears all things, believes all things, hopes all things, endures all things.

8 Love never fails; but if there are gifts of prophecy, they will be done away; if there are tongues, they will cease; if there is knowledge, it will be done away. 9 For we know in part and we prophesy in part; 10 but when the perfect comes, the partial will be done away. 11 When I was a child, I used to speak like a child, think like a child, reason like a child; when I became a man, I did away with childish things. 12 For now we see in a mirror dimly, but then face to face; now I know in part, but then I will know fully just as I also have been fully known. 13 But now faith, hope, love, abide these three; but the greatest of these is love.




I always end my posts with pictures. This was the only fitting picture of LOVE:


Thursday, January 27, 2011

My Fight Song

August 8th, 2008. The first day of med school. I was nervous. Excited. Anxious. Scared. I got ready like did every morning. I sat down to do my quiet time. In all the excitement of moving and getting ready for school, I had fallen behind in my scripture reading plan by two days. I think that was ordained. I ended up reading Psalm 62 that morning. It was exactly what I needed to read. It calmed me, gave me a peace that passes all understanding. This post is about how Psalm 62 became my fight song.

Psalm 62:1-8
1 I wait quietly before God,
for my victory comes from him.
2 He alone is my rock and my salvation,
my fortress where I will never be shaken.
3 So many enemies against one man—
all of them trying to kill me.
To them I’m just a broken-down wall
or a tottering fence.
4 They plan to topple me from my high position.
They delight in telling lies about me.
They praise me to my face
but curse me in their hearts.

5 Let all that I am wait quietly before God,
for my hope is in him.
6 He alone is my rock and my salvation,
my fortress where I will not be shaken.
7 My victory and honor come from God alone.
He is my refuge, a rock where no enemy can reach me.
8 O my people, trust in him at all times.
Pour out your heart to him,
for God is our refuge.



Med school is tough. That is not a secret to any one. I knew this going in, but I didn't know it was going to be THAT though. I've always been a good student. I pick up on things easily. But... I didn't know what studying was until I got to UMC. It isn't normal to sit in a chair for 8-14 hours a day studying textbooks, power points, and charts and graphs. It takes some discipline to make yourself push on for another hour, another chapter, one more slide.

One of my favorite people at UMC told us on the first day of orientation, "Life doesn't stop for med school." She was right. Life still happens as you study the days away in the library. Somehow you've got to find a way to press on through the difficult times. On the opposite end of the spectrum, you can't let joy or excitement distract you.

I am not saying that I've had the most difficult journey that any med student has ever had, but it certainly was not the easiest. Here are just a few bumps in the road I've experienced throughout the first 2 1/2 years of med school.

The first thing that happened to me M1 year was someone breaking into my car and stealing all my books, laptop, and purse... Two days before my 2nd Biochemistry test. Its hard to study without the powerpoints or text books. I had some great friends that reached out to me and let me borrow notes and books, and a few even offered me a laptop.
The second major thing that happened to me M1 year was a broken leg... requiring surgery... in the middle of Gross Anatomy and Biochem. I missed a week of classes. (The day after I came back, my class voted me Intramural Chairman. They have a great sense of humor.) One of our gross anatomy professors suggested I drop out of school and try again next year. God provided. I passed... with an A and made in the 96th percentile on our national board exam. Praise the Lord from whom all blessings flow.
Between M1 and M2 year, I lost 20 pounds and was getting horribly sick after almost every meal I ate. They scoped me and found out that my lower esophageal sphincter is lax. They put me on an extended release PPI. It worked almost instantly. And the medicine was free for me. Cheaper than the Wal-Mart $4 list. Only by God's provision.

Fast forward to M2 year. Mom had a lump in her thyroid. Her doctor sent her to have it biopsied. I got to watch them do a fine needle aspiration on her with ultrasound guidance. I saw the mass on the ultrasound screen. It had calcifications. I wasn't far along into pathology, but calcifications are rarely ever a good thing. I got a sick feeling in the pit of my stomach... It stayed there for days. It was a Tuesday. I was driving to school for micro lab (parking in the garage illegally). Dad called me. He and mom were on their way down to Jackson for a doctor's appointment. I was expecting an update on when they would be arriving, but he dropped a bomb on me. "They said its malignant." My mind went blank. My body went numb. Fear gripped me. CANCER. She was set up to have a thyroidectomy followed by iodine radiation in November, right before Thanksgiving. Surgery went smooth. Radiation wasn't to harsh on her. One year later- her scan was clean. God answered prayers from 2 scared children and a worried husband.

After M2 year we take the STEP1 exam. We have to pass it to move on to M3 year. The score we make also can make or break us for residency choices. The more desirable the residency position, the higher you must score on the exam. For someone who doesn't know what they wanted to do yet, I wanted to make high enough that I didn't limit myself. I was super focused, very high strung, and a little too stressed. Nicholas was studying for his last few law school exams and getting ready for the bar exam. It was a little tense on Hanover Place. 11 days before exam day... Nick hit a knee. He proposed to me on his graduation day. I was excited. My to-do list grew exponentially in a few seconds. I was distracted from my studying. I didn't get much done the last week. That was a blessing in itself. My mind was well rested for the test. God provided for me yet again, this time in the opposite end of the emotional spectrum. He allowed me to rest and focus during a time of joy and exitement.

Third year of medical school is such a change from the first two years. You start doing clinical rotations, seeing patients... actually getting to do medicine. The hours are demanding at times. The patients can be difficult. You see bad things happen to good people. You have to learn to be flexible. You have to see death and get to know it well. You see sad circumstances and bad family situations. I've grown a lot this school year. I've grown as a future wife and I'm growing into my white coat, so to speak. There have been tough times for me this year during all this adjustment and God has brought me through it. I was with Nick as he mourned the loss of his last living grandparent. I was there with his family as they went through Uncle Jim's bone marrow transplant, complicated hospital stay, and his passing. I had my home burglarized and many material possesions stolen. My grandmother had 2 strokes within two weeks of each other and now has right hemianopsia (she cannot see anything past the right side of her nose. She is blind in the right visual field of both eyes.) My dear companion, Doc, was stolen from me on New Year's Day. Yet, God has sustained me. I have peace. Though loved ones pass from this life, I know that they reside with God. Though material things were taken from me, I know my treasures are in heaven. And though my dog is gone, I was blessed enough to have him for the 1 1/2 years he was with me.

Why do I write this post? Why do I look back and remember the hard times? I only write this to remember how God has brought me through stormy seas. I am boasting in His strength prevailing through my weaknesses. He has carried me every bit of the way on this rocky journey. I owe it all to Him.



Nick and I are having this song played during our wedding. It will be played while we take communion-- our first act as a married couple.

In Christ Alone- Getty and Townsend
In Christ alone my hope is found
He is my light, my strength, my song
This Cornerstone, this solid ground
Firm through the fiercest drought and storm

What heights of love, what depths of peace
When fears are stilled, when strivings cease
My Comforter, my All in All
Here in the love of Christ I stand

In Christ alone, who took on flesh
Fullness of God in helpless Babe
This gift of love and righteousness
Scorned by the ones He came to save

'Til on that cross as Jesus died
The wrath of God was satisfied
For every sin on Him was laid
Here in the death of Christ I live, I live

There in the ground His body lay
Light of the world by darkness slain
Then bursting forth in glorious Day
Up from the grave He rose again

And as He stands in victory
Sin's curse has lost its grip on me
For I am His and He is mine
Bought with the precious blood of Christ

No guilt in life, no fear in death
This is the power of Christ in me
From a life's first cry to final breath
Jesus commands my destiny

No power of hell, no scheme of man
Could ever pluck me from His hand
'Til He returns or calls me home
Here in the power of Christ I stand

I will stand, I will stand
All other ground is sinking sand
All other ground, all other ground
Is sinking sand, is sinking sand
So I stand

My favorite pictures of my buddy, Doc:

Puppy cast


Cruisin'


Helping me study


Deer camp


Napping