Falling Leaves

I went for a run the other day. Remember when I told you how much I used to hate running? I don’t feel much different these days….. Anyhoo, twas a blustery day (said Pooh) and the fickle wind was picking up and dropping leaves willy nilly. It got me to thinking, as I am want to do when I run as I can’t seem to successfully run with a musical device.

How do the leaves feel about this wind treating them such?

Are they pleased to be blown about here and there at the discretion of the wind? Does it make them happy to float on the breeze? Does it remind them of when they were young and still attached to their parent tree/bush swaying in the wind? Do they dream of the places the wind will take them, the new leaves and plants and inanimate objects they will meet? Are they dreamers? Wishers? Travelers at heart?

Or are they grumpy old men? Hoping to stay on the same ground next to the roots of their origins. Irritated by the pushing and pulling wind that won’t ever just let them be. Homebodies at heart. Happy for the rain and snow and ice to weigh them down and speed up their decay. Angry at having to make new friends when they are swept from their pile without notice.

Yep, I’m anthropomorphizing them and I think it’s totally valid. Don’t you?

The Things that Really Matter

There is a very sweet couple in my church who have a 2 month old son.

They bring him to church with them every Sunday, they never miss a mass.

They sit toward the back in case he cries (which he never does) and, from my seat in the choir, I get to watch them play with him and make faces at him during the service.

He grins at every parishioner who stops by to smile at him or talk to him.

He coos.

He cuddles.

They dress him up like a little gentleman, ties and sweater vests and so on.

He started wearing winter hats (as it is now November in Detroit) and I can't get enough of seeing the monkey and baseball and newsboy caps.

They have waited a long time for him and he is their only child.

They make sure that every Sunday during communion they have him blessed by the priest.

This Sunday we celebrated the Annointing of the Sick Mass. This couple brought their sweet baby boy forward for healing. I cried.

All 3 priests spent several minutes praying over him and his mother and father. They annointed him with oil and laid hands on his little body.

This precious sweet baby has a very extreme form of Down Syndrome. His poor little heart has such a large hole in it you can hear the murmur when you stand next to him. He is undergoing surgery tomorrow to repair it, pray for him. But he will never be the son they dreamed they would have.

He will be so much more.

so much more

Update:

The baby tolerated the surgery well. His parents were able to take him home this past Saturday and he is progressing as expected. Blessed.

How to Survive New York City without looking like a Tourist or spending money like a Reality TV Star

I had this great plan to do this fantastic blog all about New York City, but I lost my notes on the subject....so please bear with me.

The original thought was that I would have this initial blog post with links to my other posts on specific subjects. This may still happen, but I am nowhere near technologically savvy so it will be taking me some time....I'm sorry.

Nonetheless, without further ado, the following is my recommendation for ways to survive your next venture to the Big Apple

1. Ride the Subway! I know it's scary, especially if you read my previous post on Subways...but it is worth the money you'll save on taxis and parking! Trust me. And it can be pretty and quaint!


2. $2 breakfast. On any street corner, in any bodega, you will find the small coffee with cream and sugar paired with a bagel with schmear or donut for $2 (or thereabouts). DELICIOUS!!! And absolutely perfect for the subway ride. It comes in a paper bag ala Breakfast at Tiffany's. **NOTE** If it is important to you that you have a well-balanced breakfast, this is not for you.
3. Site see on foot. Don't take those silly bus tours (unless you have severely limited time or you broke your leg the week before your trip), just walk. You'll save $$$ and burn serious calories. Plus, you never know what you'll see while walking around the city!
   
4. Go to Macy's. It takes up an entire city block. It really is the Biggest Store in the World! You can walk around for HOURS. And their holiday decorations are fantabulous!
5. Visit the memorials. There are hundreds in Manhattan alone, and they represent a very important part of our national history. Plus, they're free!
   
   
   
6. MUSEUMS! I love museums. Almost all of them have a free day or have a 'donation' box instead of a per visitor fee. 'Nuff said, just go.
7. Eat the street! Don't bother with all the frou frou restaurants (unless you're a total food snob, or you have tons of $$), you can get a lot of those famous chef's entrees in your local grocery store. China Town (I really hope that is the correct term for this neighborhood) is a great place to find cheap eats! I found 8 dumplings for $2. YUM! There are so many little hole-in-the-wall places to go to that have fantastic food for less than $5. I ate all 3 meals from bodegas or restaurants and spent less than $10 a day on food. Totally worth it and you feel like a New Yorker.
   


8. Visit Rockefeller Plaza. It's way cool! They do have the store and the observation tower, but you don't need to do those. I stopped by and ate breakfast with the Today Show (while waiting for my train) more than once.


9. Go to the Empire State Building. I didn't go up. $20 was out of my price range. But if you have a sweetie, definitely do it. I thought I'd save my ride up to the land of "An Affair to Remember" and "Sleepless in Seattle" until I had someone to go up with.
10. Stay with friends. Ok, so I kinda cheated when I went to NYC. I didn't stay in a hotel, and I saved a ton of money. But I was there for a MONTH! It would have been ridiculous to pay for a hotel or even a hostel for that long, especially when I was still paying for my apartment in Michigan. Nonetheless, hostels are great to stay in and totally worth the money you'll save, but be sure to do your research on the quality of hostel. And the hotels in Manhattan are much cheaper (if booked in advance) than the ones outside of Manhattan. I know it doesn't sound right, but it's true!

I know the list isn't very long, but it's worth remembering when you travel! And if you go, say hi to the Lady for me!

How to start running...

I'm a runner. Surprise! ha.

I am. It's true. I have loathed running my entire life. Yes, LOATHED.

My mom 'encouraged' all of us kids to participate in sports all growing up. I played soccer until I graduated from high school, and yes, soccer does entail quite a bit of running, but if you play your cards right and get selected as sweeper or goal keeper, you don't run as much as everyone else.

In college, I rowed crew. So I basically sat on my butt for 2-3 hours a day pulling an oar. Doesn't sound very athletic does it? Try it sometime. Tell me how you feel after pulling as hard and as fast as you can for 2000 meters. Yeah.

Then after college, when I was nice and fat because I had ceased all forms of exercise and continued to consume my 4000 calorie a day diet, my mom challenged me to a 1/2 marathon.

Don't ask me why my mother does the things she does. I love her for exactly who she is because I wouldn't be the same without her. But, she comes up with the weirdest crap sometimes! There are so many wonderful stories to tell about my mom, but I'll save those for another time.

Anywho, she called me up one day and said, "Honey, I've signed us up to run the P. F. Chang's 1/2 Marathon in Arizona for the hospital."

"Oh cool! You and dad are doing a half marathon?" note the hope in my voice that 1. my father was actually going to do something athletic and 2. I was not going to be doing any running.

"Well, your father is going to go, but he won't run, you know how he is." yes, yes I do. "So I figured you and I could run together!"

"Oh. Fun! I hope I don't die. If I die in Arizona, please don't let Luke have my car"

She forced me into it, really she twisted my arm! But I love her, so I did it. And I finished the half marathon! AMAZING!

Then she made me do a full marathon. And then another. And another. And in total, I've done 6 full marathons and G-d knows how many half marathons. I can't get enough. UGH! What's wrong with me? My mom has run 10 marathons! SHE'S NUTS! I love her.

Recently, she conned my little sister into signing up for a marathon in Traverse City, Michigan, with the two of us. (If you've never been to TC, please go!)

Please ignore my sister's lazy eye....this truly was the best picture of the 3 of us after the race.

Yeah, yeah, enough about my family and how awesome of a runner I am (which I'm really not, but I digress). Back to the topic at hand: How to start running

This is a no-brainer for some people. For the rest of us mere mortals, it seems worse than climbing the Himalayas without a sherpa or a parka!

• The honest truth is you just have to get off your butt. It seems like a terrible thought, right? But it's true.

• I always tell people, in the clinic and in the real world, that if you get outside every day and go 2 steps further than you did the day before, you are improving! And day 1 may just entail opening the door, that's ok.

• But you do it. Don't push yourself to the breaking point. But don't slack off either. You need to sweat. You need to get somewhat winded. There should be tightness in your muscles the next day. This is NORMAL. Don't freak out. It's a good thing :) You're getting stronger!

• I started with half-walk half-running around my block (and it was a SHORT block, mind you). It was everything in me to keep going. Each day I increased the distance I ran and shortened the distance I walked.

• Find an eating pattern that will work well with your running. I can't eat for at least 2 hours before I run and I pretty much have to devour most of what I can reach as soon as I finish. You might be different: you might have to change your pre-run snack to cheese if you get loose bowels while you run. Trial and error. Find what works, but do it before you run any races!

• HYDRATION!!! HYDRATION!!! HYDRATION!!!

• Each day you get off your butt and go outside. Every. Single. Day. You have to. And if you feel like crap, that's ok too, just get outside. You don't have to run a 7 minute mile each day or run 20 miles each day, but you do need to get out there. The more you stick to your guns at the beginning, the faster it will become a habit and you'll actually miss it when you don't go.

• If you are training for a marathon or a half marathon, I recommend using Hal Higdon's training guide. It's flexible with your schedule and prepares you really well.

• Finally: I had a really hard time not thinking about what other people thought of me, I still do. Am I wearing the right clothes? Do I run like an idiot? Am I really that slow? Keep at it. No matter what, you're doing something good for you! And that's what really matters!

Now, get out there and kick some asphalt!

The Subway....

I didn't grow up in New York. The summation of my knowledge of the city came from "An American Tail", "Newsies", and later "Sex and the City". So, I'd say I was slightly biased. I had no idea how this city actually got by prior to my arrival here. Nor did I have any concept of the immensity of NYC.... WOW!

http://www.youtube.com/watch?v=Av77_epf3l4&feature=related

I really did think of NYC just like I saw it in Teenage Mutant Ninja Turtles 2

I will admit, one of the things I was really excited to do was ride the subway. I know, how common and silly, right? But my hometown (and all of Washington State for that matter) was severely lacking an underground rail system....I've been deprived, ok???

I also didn't get to watch cartoons except for Saturday morning, never got sugar cereals, nor did we EVER have an icecream man drive through our neighborhood.... RUB IT IN!!!

So, I bought my Metro pass my first day here and was an avid proponent of just parking the old car (which isn't old, just really really dirty) and tubing it every which way.

*Take note dear readers, this post will give you the creepy crawlies.


And then I started seeing them. Not at first, mind you. They were sneaky. They blend in really well and if you're not paying good attention, you will easily miss them. I think it was about a week into my new found daily activity when I saw my first rat. Yes, RAT!

UGH!!!

It brought to mind some disturbing memories from movies....

And then, this morning, I saw THIS!!!

EW!

What is it???

Where did it come from???

How do I get rid of it?

Are there more?

Is it nice?

Is it poisonous?

Will it become a butterfly one day?

(I have a feeling the answer to that last one is a resounding NO)

Yep. This place is INFESTED! SCARY! Run away!!!

All through my subway ride to work I kept flashing through scenes from Men In Black II, Mimic, and Godzilla (the one with Matthew Broderick). EEK!

http://www.youtube.com/watch?v=eapwXxZNt7s

So, now that I've got you totally freaked out, Happy Weekend!

Sorry I've been so busy....

This is the time of year for us 4th (and FINAL) year medical students that we travel around to different hospitals looking for someone to hire us for residency.

This is a BIG deal! And it is very nerve wracking!

I've been working on my applications (which I actually have finished, I just haven't submitted) for weeks and weeks..... UGH! I'm so tired of talking about myself.

But, back to the traveling.

Last month I got to spend 4 very fun weeks in the tidy city of Tulsa, OK. Now, I'm sure many of you think of this when you hear Oklahoma. I would encourage you to lean a little more toward this or this.

It's such a cool little city and the people are incredibly nice!

But now, I've left. I've moved on to a much bigger city....

Do you know where I am???

Ok, how about in the daylight? Any guesses?

Now, I'm giving you a huge hint. I see this lady (in the red circle) everyday on my way to work!

YEP! NYC baby!!! It's fast! And it's busy! It's also kinda smelly. I thought that might be from the recent hurricane, but I stand corrected, that's just the way it seems to smell all the time.

More on my adventures later. Now I have to run and find patients!

Rhubarb!!! (part 2)

Here's the second part of my rhubarb adventure!

Rhubarb Upside Down Cakes

Starting with the same raw rhubarb stalks, I washed 'em, lopped off the ends, sliced them into thin pieces, covered them in sugar, and let them sit.

I probably used about 2 cups of sliced rhubarb (3 stalks) and 1 cup of sugar. They sat for abou 20 minutes while I was busy doing other things.

While the rhubarb was marinating in its sugar bath, I greased up a cupcake pan with some butter. Normally with this recipe, you'd use a cake pan and just make one big cake, but I'm single and don't want to have to run another marathon too soon, so I just made some little ones.

Either way, you're getting a delicious outcome, so please just do what feels right to you. :)

Then I mixed up the batter.

• 1.5 sticks of butter at room temperature
• 1 3/4 cup suger
• 1 1/2 cup flour
• 1 1/2 teaspoon baking powder
• some salt
• 2 eggs beaten (don't flog them, just mix up the yolk and white a little
• 1 cup sour cream

*you can add in some orange/lemon zest if you are feeling sassy

Evenly layer your now juicy and well sugared rhubarb in the bottom of your pan

Scoop out the batter and evenly distribute it in the pan

Now for the topping:

• 4 tablespoons melted butter
• 1/2 cup flour
• 1/4 cup sugar
• salt

mix it all up till it's crumbly, and crumble it some more over your batter

Bake at 350 degrees for about an hour.

Mine took a little less because it came in smaller sizes (about 45 minutes)

When they're finished they'll look something like this!

(unless you do one big cake, then you should be worried if it looks like this....)

When you dish it out, remember to turn it upside down on the plate!

Nom, nom, nom.....

I told myself I didn't need to eat the whole thing. I actually stopped 1/2 way through.

But all I did 1/2 way through was snap this picture and then quickly gobble the rest up!

Seriously, I really tried to stop eating it.... It's just so good!!!

Anyhoo, that's the second part to my rhubarb adventure. I hope to have some more soonish. Because rhubarb is so awesome!

RHUBARB!!!

Rhubarb!!! (part 1)

*this post will be a 2-part series primarily because it is so long and also because I'm having some picture difficulties...just working out the kinks :)

On my way home from work the other day, I stopped by the grocery store and what did I see?

RHUBARB!!!

Can you say yummy? Oh my heavens! Delightfulness will ensue!

One of my grandma's favorite stories to tell about my Aunt Janice is that she had never had rhubarb until she married into our family, but once she had it she was hooked and would call all the other members of the family on the first day rhubarb was available in stores because she

was that excited. Can you blame her?

Needless to say, I didn't call all my family members or friends, but I was pretty darn excited. Now that I have it, what do I do with it? I live alone and eating an entire Strawberry Rhubarb Pie by myself probably isn't so great for my girlish figure...

So I settled for some Upside-Down Rhubarb Cakes (recipe will be in Rhubarb #2) and Rhubarb Ginger Compote!

What you'll need:

Fresh clean Rhubarb! (you can use the frozen rhubarb chunks if you don't want to chop, you missed the rhubarb season, or you live somewhere that rhubarb doesn't grow/isn't sold)

Sugar

Ginger root

clean jars with lids

1. Chop up your rhubarb, leaving off the green and rooted ends, and throw it in a large pot

2. Add about 1 cup of sugar for every 3 cups of chopped rhubarb

3. mix it, mix it good, mix it real good, and then let it sit in it's sugary goodness for a bit

*I let mine sit for about 15 minutes while I was busy doing other stuff. The sugar, by all sorts of chemical and physiologic processes, leech water into the sugar--this is what you're waiting for

4. While you wait, scrape all the skin off your ginger. Naked ginger!

*note: this is fresh ginger, not the pickled ginger served with sushi. do not eat this raw...

5. Grate up your ginger. doesn't that look delicious? still, not for eating just yet....

6. Squeeze all the juice out of your ginger. I used a coffee filter to accomplish this. it worked phenomenally well!

7. Turn on the burner under your pot of rhubarb to 4/10. More juice will leech out. Rhubarb will start to get soft and mush. Keep stirring.

8. When all the rhubarb is nice and soft, after about 10 minutes of heating, stir in the ginger juice. It might change the color, be forewarned. Mine took on a touch of pale purple.

9. Pour your compote into jars. If you're in a small family of 1 or 2 like I am, I recommend using smaller jars. You just won't get through the large ones quickly enough.

Normally, I have my own jars. Apparently, they're all being used currently.

Thus the use of the salsa jar....

10. Utilize your compote/spread for good, not evil.

You could use it to top off pork chops, or on a chicken breast, or ice cream, or straight off the spoon!

I put mine on toast, nom nom nom.

ENJOY!!!!

What would you do?

Dr. Jacob Kevorkian died this week. In case you don't know who he is (where have you been living??? under a rock???) Wikipedia does a decent job of summarizing his life and his work here. Or you could read this book:

He actually died in a hospital not far from where I live. I had no idea he was from Michigan. He was born in Pontiac, Michigan, about an hour north of me. He practiced medicine here (as a pathologist, not a general practitioner), did his research in transplants and transfusions here, and advocated much of his end of life beliefs in Michigan.

Whether or not you agree with his politics and convictions, you have to admit the guy had moxy and brought serious attention to a very valid issue in medicine today.

Now, be forewarned, this is not a commentary on my opinions about physician-assisted suicide. So please don't try to glean my thoughts on the matter from what I write here. If you want to know, please ask me directly, don't assume.

This is, however, a thought process on end of life issues that I am currently going through.

I am going to be a doctor one day, it is coming faster than even I realize, and the final days of a patient's life is something I need to know how to handle.

I admit, I have not been in the room during a "final code" on a patient, I haven't had to tell a patient's family that the patient died, nor have I had to look a patient and their family in the eye and tell them this is the end. I dread those moments with all my heart. I have no desire to be the one who has to drop that bomb and explain why what we did/are doing is not enough. It breaks my heart to even think about it. However, it is part of what I am choosing to do with my life and I pray for all the grace and peace in the world when those moments come.

But what breaks my heart even more, is seeing patients in the hospital connected to every machine possible to keep each organ functioning as close to normal as they can. I have seen this all too often.... How can that be considered good quality of life? Yes, it is life, but how would you feel being strapped to a bed surrounded by beeping, clanging, whooshing, clanking machines 24 hours a day, unable to move, not able to relieve yourself, at least not of your own will?

In the hospital, we have meetings for the students, residents, and physicians that are to specifically address Morbidity and Mortality. Notice they are not solely for "mortality", they consider "morbidity" too--that is the state or quality of life. Unfortunately, it is often we find that mortality is the common outcome of a hospital stay. But I wonder, of those patients that we keep alive with their colostomy bags, g-tubes, ventilators, and IV medications, fluids, food, how many are truly happy to be living that way? Yes, life is what we all want, but do we always inform our patients of what "choosing life" will actually mean for them in the long run? And what of their families? Are we even considering what we put their families through, especially now with insurance companies breathing down everyone's neck?

How many physicians take the time to sit down with each and every patient who is broaching a morbidity and mortality issue to discuss the possible outcomes and what they choose for their long term care? Sadly, I think it is very few. I have yet to see any physician do this.

Keith Olbermann has been very vocal about his thoughts on these issues. There was a great interview with him today on NPR regarding his outspokenness on this issue, specifically regarding the death of his father last year. I was really impacted by this today. He and his father had an extended period of time to discuss their choices for the end of his life. They were very fortunate in this, though they had recently dealt with the hospitalization and death of his mother so they were somewhat prepared for what might incur.

As I don't have any patients yet, I haven't spoken with any regarding this yet. I was afforded the chance to talk with my own family about it, very recently. In September, my dad was hospitalized for a number of days and my mom and I had some good discussions regarding his care and what she thought he would want. We were very fortunate that he came out alright with only a few life-long complications resulting. And then, a couple months later, my aunt was hospitalized and my dad, being the eldest and closest to her, had to make some tough decisions. He and I were able to have some very serious and poignant discussions about what was the right thing to do in these circumstances and what he thought would be best for his own long-term care.

For all those health professionals out there reading this, please consider having these discussions with your patients. Even if they're 85 and in great health, they are more likely than a 16 year old boy to get into a serious car accident, and then what do you do?

And for everyone else, I encourage you to bring up these conversations with your loved ones. It is unfortunate when we have to spend hundreds of thousands of dollars to keep trying to save someone who wouldn't have wanted the care anyway, but no one was there to tell us that.

Again, this is not meant to be a diatribe about end of life issues, but rather a discussion. I hope it brings thoughts and discussions to all who read it.

*Note: I am writing this and listening to Rosie Thomas. Her music inspires deep thoughts in me and I would recommend her for any thought provoking situation or rainy day or long walk.

Ahhhhhhh! Summer's here!

And we all know what this means:

Hot weather!

Along with all that hot weather comes many a wonderful joy in my life: swimming pools, water parks, studying outside, frappuccinos, suntanning, and cold foods!

(fyi: for the sensitive stomachs, there are a few pics at the end that display some of my sun experience this weekend. you are now forewarned)

Yep, I said it, cold food! I am a big proponent of leftovers, and if you know me you know I'm that girl that eats last night's pizza straight from the fridge -- YUM!

There are so many great choices of cold food recipes. Many of my favorites come straight from the recipe collection of my sweet mom: Chinese Chicken Salad, Gazpacho, No-Mayo Potato Salad, a giant garden-fresh salad, chunked cantaloupe, frozen grapes, frozen chocolate chips (a personal favorite year round), and so many more.

But today, because I was super hungry when I went grocery shopping (which we all know is a huge no-no!), I decided to make a recipe slightly modified created by a friend whom I have known for ages: Mrs. Maggie Bettger. She also has a blog, but her's is way cooler because not only does she not have to go to work, but she's got an awesome husband who moved her to Ireland! You should check out her blog.

Anyhoo, her recipe is for a delicious salad that she didn't name....so, since I've made it, modified it, and devoured it, I named it Saucy BLT Salad (minus the "L").

Here's the gist of the recipe:

• tomatoes (I used red and yellow, because I love colorful food!)
• olive oil
• vinegar -- red wine is best, but whatever you happen to have/find will work
• herbs -- again, whatever you have on hand will be great! I used oregano and thyme
• bacon
• white onion (red would be delicious too)
• mushrooms

1. chop your tomatoes as finely or roughly as you like. I take out the seeds and extra pulp (personal pet peeve, sorry)

2. add some olive oil and vinegar and whatever herbs you found in the pantry. Stir it around, give it a real good stir, or if you're using a bowl with a lid (like I did) put on the lid and give it a few good shakes.

3. while that is marinating, slice up your bacon and get it cooking. Mmmmmmm..... I love that smell!

4. while it cooks, chop up those 'shrooms and onion

*note: if you are vegetarian/vegan/halal/kosher or just don't eat pork, you're free to add turkey bacon, facon, tofu, or whatever suits your fancy as long as it is tasty!

5. once the bacon is finished, take it out of the pan to dry/drain on paper towel or a plate. See all the crusty deliciousness stuck to the bottom of your pan? All those bacon leftovers? Using a wooden spoon, scrape all of that off the bottom of the pan and throw in your chopped up onions and mushrooms.

6. when they're finished cooking, throw 'em into the bowl with the tomatoes and top it all off with the bacon.

See? Isn't it purty? I just love the splash of color from the yellow tomato!

Ugh! I just love this stuff!

FYI: I ate my first serving while it was still fresh and hot off the stove and it was fantastic!!! The rest of it was eaten out of the fridge. It was chilled and crispy and fresh and oh so wonderfully perfect to hit the spot!

My second serving, I put over a bed of lettuce. One of the hospitals in the area serves all its salads in this manner. I've always been pretty skeptical about this method of serving salad, but it was so delicious!

And then I ate frozen chocolate chips for dessert. Mmmmm! Seriously, you'll never go back once you do this. I keep mine in a tupperware with a blue lid. So worth the calories!

*** beware : terror lies ahead!!! ***

Now, the pics from my rendezvous with the sun this weekend. I promise I wore sunscreen! I really did! I slathered it everywhere! Ugh. Oh well.