when it all comes together.

i got a lovely early christmas gift from my husband...& the best part was that i asked for it months ago. which not only meant that he listened to me but that he remembered it!!!

a few months ago i was struggling with the concept of scrapbooking. the frivilous paper & embellishments all seemed so wasteful--not to mention the time that it eats up. but after lamenting about all the money i'd wasted on supplies, i opened a box of old photos & couldn't remember the names of half the people in the pictures muchless where we were & why we had pink boa's on with facepaint at mid-teenagehood. which is when i had a moment of slight epiphany that i could document these memories in a way that didn't require a huge time commitment or a generous trust fund from some unknown relative to back my paper purchases.

since i'm too cheap to buy photoshop, i downloaded free software from the internet that allows me to change the size of my photos & replace the original 4x6 print with a mosaic of resized photos. i then plan out my pages (the most time consuming part) so that by the time i'm 30 i won't have 57 volumes of "Our Family Album". costco uploads my pictures & delivers them to my door within 3 days. i pick one weekend each month to forego studying & spend all day Saturday (after morning cleaning) working on piecing together the already-planned pages.

i've actually found that i'm having fun again :) and the best part is that i've given myself no size, photo, or layout restrictions; i only promise myself to stay focused on the photos + words & not make pages about how my pant size keeps climbing or how my dryer eats all my black socks. it is JUST THE IMPORTANT STUFF.

in the past two months of my alloted time for these projects, i've managed to make enough layouts fill up this entire scrapbook...maybe i should have told jon i wanted 2 :)

the most satisfactory part of this whole process is that jon supports it totally. once i had the new book filled up, he sat down for a good 20 minutes & looked at pages that span across our last year together...i think i even got a few smiles from him ;)

{i've created a new album in my Flickr account titled "scrapbook pages" for those of you who want to see more...}

christmas: cinnamon rolls

if you'd like to take your tastebuds for the ride of their lives, you'll have to spend a bit of time in the kitchen. but i assure you...you won't be disappointed!

i came across this recipe on The Pioneer Woman Cooks & trumped by skepticism by my accidental purchase of 4lbs. of flour that was sitting in my pantry. needless to say, i've widdled it down to a bit of a smaller volume :)

these cinnamon rolls, although not non-caloric, are a fantastic (& easy!) way to share that holiday-induced pant-tightening experience :) each batch makes about 6 pans of deliciouis, gooey rolls...

HERE is the recipe.

take some to your neighbors. not only will you be the most popular person on the block, you'll also bask in the glory of sharing those holiday calories that were once invading your kitchen ;)

christmas: card holder

i found this cute (& very easy) craft on good ol' martha's website...and thought it would be a fun project since our christmas cards from 2007 just came down at the beginning of december '08 :)...although i'll take the mitten's down this year, this is a super easy way to display christmas cards--& the best part is that it is super cheap!

i hosted the December Coffee for the wives in Jon's batallion a couple of weeks ago. we made these little mitten clips--it was so fun! the best part is that they don't have to be used as christmas card holders...they can be put on gifts, packages, or your nose. and you certainly aren't limited to making mittens...if you fancy starfish or space ships or snot drips, you can make those too!

nervous work.

She was fidgeting. Her toe tapped. Her leg shook. She sat in the corner chair—a green plastic one with little plastic noodles on its fraying edges; wringing her hands, touching her hair. The tissue in her hand was getting wet, evident from the tiny flecks of cotton that sprinkled on the linoleum floor like raindrops. It was quite obvious: she was nervous.

But really it didn’t surprise me that her palm was soaking the Kleenex or that she kept touching her hair. She’d come in for a recheck on her blood pressure, which previously had been alarmingly elevated.

Perhaps more than her nervous habits, my eyes were drawn to her body stature. It was obvious her ankles had lost definition years ago. The cotton house shoes she wore were dirty and the socks that lined them barely made it to the crease of where her ankles should have been. Those little plastic noodles were barely visible—her bottom & thighs covered the entire green plastic chair past its edges. Belly protruding. Breasts resting seemingly comfortable around the level of her tenth rib.

I think my reaction was similar to what many people’s reaction would have been: I felt sorry for her. She had to be at least four inches shorter than me, making her the “average” height of an American Woman. And at 300+ pounds, her height wasn’t handling her weight as well as it could have. Her stature inevitably caused her pain: knee pain, stomach pain, back pain; our bodies were not meant to fight with a center of gravity thrown off kilter by an excess 300 pounds, nor was our blood supply meant to be choked by an abdominal girth of hormone-producing fat cells. Although she could breathe & fidget & shake her leg, each day was a struggle for her cells…a struggle that one day she would lose, possibly sooner than expected.

Through a series of questions, I discovered that she was living with her mother—and had been for the past decade-or-so. She hadn’t had a job since she rounded the track at thirty years old—at least 15 years ago. Her bills were paid each month from an envelope that was delivered to her mailbox: a disability check.

Her disability? Apparently she “got nervous” at work.

I had to clarify the situation with my attending. Because in all honesty, I couldn’t believe it was factual. Here is a woman, in her mid-forties living each day without a job while the government paid for her non-contributory existence.

His answer: YES.

And I can’t get her rounded ankles or tissue raindrops or tapping toe out of my head today. Because this morning I woke up with a painfully swollen arm. And Monday morning I got nervous to go to work. And Jon had a bad day on Tuesday. And one of my parents had the flu yesterday. But we all showed up. And either I need another dose of sympathy or I’m quickly becoming hardened to this tainted world we live in.

This week I’ve heard stories about third-generation welfare families, workers who are addicted to pain pills & suing their employers for workers compensation because they fell in the bathroom & got a goose-egg on their forehead. I’ve heard stories about factory workers who are overworked & injured on the job without any form of compensation, daycare workers who are filing claims because they are required to lift the children under their care that weigh over 40 pounds, and the requirements of businesses to hire people less-than-qualified (physically or mentally) for the job description.

And it just doesn’t seem fair. In fact, it isn’t fair at all. In a case-by-case fashion, it is NOT fair: sometimes to the injured workers, sometimes to the employers…but 99% of the time to the taxpayers.

The taxpayers who are paying for this woman to sit on her couch & walk to her mailbox to pick up her “paycheck”. The taxpayers who are paying for his morphine so that he won’t have withdrawls. The taxpayers who are supporting the economy run by businesses that are forced to employ workers that are less-than-qualified for the jobs they are given for fear of discrimination lawsuits.

The taxpayers who “get nervous” somedays at their jobs too…but who keep working.

the monday curse.

it continues.

despite my being in NC for the month, i just can't escape it.

i got up extra early monday morning to allow ample time for any mishaps that might fall upon me (read: injections of humility from the Good Lord Above). so at 6am i was up and going. i self-groomed (a rarity--i had to make a good impression on the first day of my new rotation), ate breakfast, drank some chai (necessity), had quiet time...and even packed my lunch.

i put on my wool coat (it was 60-something degrees yesterday!) and reached for the doorknob with purse, lunch pail, nalgene, and books in hand, and thought to myself my this morning went smoothly.

the few steps too the car was uneventful. my car started smoothly. the radio still worked, save the aliens that might have abducted it just because it was Monday. my "butt warmers" were warming. and so i backed out of the driveway.

CRUNCH.

whaaaaattttt??!?!?!?!

the nice garbage man had kindly placed the LARGE city-issued forest green garbage can RIGHT in the middle of the driveway. the LARGE city-issued forest green garbage can which was now wedged under my rear bumper at t-minus 5 minutes to my required arrival time at the hospital.

so i got out of the car, butt warmers still blazing heat & non-alien-abducted radio singing jolly carols of the HAPPY SEASON. ohhh...but i was not happy.

the only thing that my mind could muster was: SERIOUSLY??!?!

my wool coat was almost too warm as i wrassled the partly wedged garbage can from under my back bumper. but the orientation of that forest green thing was akward: the lid was splayed open on the street so that when i wanted to good grip on the can itself, i had to step on the lid--completely defeating the purpose of my pulling since my full weight was keeping the can in place. at one point i halfway fell into the can itself...

after a good 3 minutes of pulling i freed that LARGE city-issued thing from under my back bumper. the only problem was that because my car was taking up the entire width of the sloped sidewalk, i had to pull once again in order to get that monstrous thing over the curb.

good thing i haven't worked out in awhile...i was sweating in the wool coat by the time those two plastic wheels popped over the curb & onto the grass.

Thank you Mr. Sanitary Engineer. I HOPE YOU HAD A GOOD MONDAY TOO!!!

the mirror.

it is saturday. 10am. i'm home alone--jon has staff duty today (i.e., he has to work for 24 hours this weekend). and although i miss having him here (our down-time together is a rarity), i'm enjoying the quiet at home. the laundry is folded (& yet to be put away). the house is clean, albeit for our bedroom floor which magically grows clothes. cookies are baked. presents are wrapped. the tv is off. and all i can hear is the buzz of the heat blasting through the vents above the doorway to the office.

a bit of a change from the past few weeks, yes?

needless to say, i've been challenged more during the past three weeks than i have in a long time, maybe in forever. my emotions ran high & are just returning to ground-level with the quiet (& the husband) that surrounds me.

in an odd way, my ER rotation highlighted things in my own life that i haven't noticed prior or perhaps, chosen to overlook. life. death. suffering. disease. worried parents & patients & loved ones. tradgedy. joy. relief. burnout. i'd leave the hospital each day emotionally drained. because i connected with those patients. i cried when the wives cried. i was mad when the patients were mad. and even moreso i was frustrated with the often overly pathetic "cries for help". and each day when i got back to my empty apartment there was silence, which made me think harder & longer about each one of their cases. and there was a mirror that i'd have to face each morning, inevitably questioning me about how i'd handle the situation if i were in their shoes.

most mornings i didn't have answers. and the truth is that i still don't.

it's a bit counterintitive, really. i've been fed answers the past two years. certainly not without studying & stress & hours of dedication. but the goal of the past two years has been to find the answers. to look in the mirror and be confident that i know the answers. my brain has been trained. but now that i'm faced with no answers, lack of answers, non-existent answers, and ENDLESS QUESTIONS. i'm confused, distraught, emotionally torn. and because there are no easy answers, & many times no answers at all, i'm left searching.

i'm still searching. something tells me i'll be searching for awhile...

and yet again, in an odd way i'm relieved by my searching. because it reminds me that i'm connecting. that i haven't lost it--that i haven't tucked my emotions in the pocket of my white coat, that i haven't lost the ability to connect with people. i'm humbly proud of my searching. because it is evidence that i haven't unconsciously jumped on the bandwagon of medical thinking that science is god, that my knowledge trumps others' sufferings, and that my patients are subjects to be studied instead of people to learn from.

We have to ask ourselves whether medicine

is to remain a humanitarian and respected profession

or a new but depersonalized science of

prolonging life rather than diminishing human suffering.

--Elizabeth Kubler-Ross

the snail version.

guess what's in the mail?

mom, are you proud??!

i bought this fabric earlier this summer on the clearance rack (it maybe totalled $20)...and finally got around to sewing Holiday pillows last week. jon & i (well, mostly me) decided awhile ago that changing our couch pillow covers would be a very economical way to "decorate" for each season without cluttering up the house. so...here are this "seasons" pillows & coffee table runner!

i will admit that my mom was right 10 years ago when she made me take a quilting class, much to my dismay at the time (the quilt still isn't finished, by the way). the sewing machine i bought used (circa 1974) for $25 this last summer has opened up a TON of new possibilities for creativity & gift-giving. scrapbooking, although i really enjoy it, is a "selfish" hobby to me--i hesitate to give people scrapbooks because each person has their own style & preferences in how to present their photos. but WHO doesn't want a cute holiday pillow cover??!

so, thanks mom. you were right...again.

beyond my understanding {II}.

...continued...

The monitor wouldn’t stop beeping. A red warning flashed across the screen telling us, & reminding her, that her body was failing. Her heart rate was through the roof. X-ray came running down the hall. Her left lung was collapsed. Transfer wheeled her to CT. The radiologist called as the images were transmitting.

On the phone he said he’d never seen anything like it.

Tumors. On the uterus. On the ovaries. In the abdomen. Attached to the bladder. Around the liver. In the pancreas. Growing on the intestines. Everywhere. Gas gangrene was building in her abdomen. Her nurse drained 1.2 liters of stool from her stomach via her feeding tube.

Her cancer had spread. Despite the chemo treatments. Despite the hair loss & nausea, despite the desperation to live. Her cancer had spread…grown…and taken over.

And now it was killing her. Right in front of me.

She stopped squirming. Her eyes focused on her husband as he held her hand. And then they rolled back. She didn’t talk after that, except for the occasional groan. The wiggling stopped.

Her husband stood by her side. Her mom paced the hallway. Her sister dialed numbers from a black address book. And I had to turn away. It was all I could do to maintain my composure. I stuck my finger in my eye—the finger I’d just cleaned with hand sanitizer. It burned. But I didn’t cry. I saw a few more patients—people who’d come in for things that certainly were not emergencies. But I didn't cry. Phone calls were made. Surgeons were consulted. Her case was declared a surgical emergency. They wanted her transferred. She would die on the trip. Heck, she would die in the ER if somebody didn’t do something quickly. Her monitor beeped. The man in room 2 who had overdosed on narcotics hit the police officer & was restrained. Her chest heaved. The woman in room 1 wouldn’t stay in her bed. Her husband cried. But I didn't cry.

I watched her husband. I watched her mom. I watched her sister. And I peeked in on her.

Her monitor beeped. Her chest heaved. Her eyes rolled back. Her husband cried. But I didn't cry.

And I had to walk away. Out of the ER. Out of the hospital….where the tears finally came in the car. And again over dinner. And again in the shower I took just to feel the hot water on my skin—a reminder that I’m alive. And they’ll come again tomorrow. When I look into my own husband’s eyes…when I hold my own husband’s hand…when I talk to my own family…when I look in the mirror & see that I’m alive.

Yes. They’ll come again tomorrow. When I ask God for the millionth time: WHY?.

beyond my understanding.

The tears finally came in the car. After three hours of holding back emotion, three hours of avoiding room #3, three hours of straining to maintain composure, finally, I broke. It was cold--I could see my breath. It only took a couple of minutes for the rain covered windshield to fog. The fingertips of my gray fleece gloves were wet with salty tears. And still they came.

She was pale on the yellow stretcher. And when I first looked at her, the frustration I’d felt toward most of the patients earlier in the day quickly faded. This was an emergency. Her young husband trailed behind the stretcher—he’d ridden in the ambulance with her.

She was gasping for air, struggling to breathe. Her swollen belly sat firmly below her swollen face and cracked lips. The fuzz on the top of her head served as the only evidence of the brown hair she’d once had. Large purple bruises covered her elbows & forearms where needles were stuck to try to find veins. She was moaning, miserable, wiggling on the stretcher from the anxiety provoked by the carbon dioxide that was quickly building up in her body.

Transport was called for a stat transfer of the gallbladder patient in room 3 to the second floor. We needed a room for her yellow stretcher…and we needed it now.

The middle green line on the monitor said her O2 sat was only 76% on 6L of oxygen--mine would be 100% without any supplemental oxygen. Her brain, heart, & kidneys weren’t getting enough oxygen. And at the rate she was going, they’d shut down within the hour if something wasn’t done quickly.

And then we heard her story.

I’m not the same person that I was this morning, nor this afternoon. Because at 5:24pm when her yellow stretcher was wheeled through those double sliding doors, I changed. I stared death in the face. I stared down my own road ten years from now & saw myself in her, possibly. I stared at her husband by her side & thought of my own husband. I stared at her pacing family in the hallway & considered my own family. And for a few seconds, I was her. She changed me, her story changed me.

They were excited to have a baby. And probably ecstatic when they found out it was twins. I’m not for certain, but I’m going to assume fertility treatments were involved because of her age. She was a few years past thirty, likely waiting for love & contentment before bringing new life into the world. I imagine they set up a nursery, decorated it with matching cribs & blankets—one pink, one blue.

Nine months they waited to hold those bundles in their arms. They thought. They dreamed. About what the two people growing inside her would become. About the adventures they’d share—together. They dreamed about finally being a family.

The c-section was pre-scheduled, as it often is with twin deliveries. The OR (operating room) was prepped, the doctors scrubbed in, nurses gloved & dressed in blue. Double warmers were ready to welcome the twins into the world.

Iodine. Scalpel. Incision. Uterus. BIRTH.

And this is where the story of joy & triumph turns tragic. This is where the nine months of hope is covered in gray—where the dreams of being TOGETHER fade into the realm of reality this family abruptly entered:

Tumors. On the uterus. On the ovaries. In the abdomen. Attached to the bladder.

Newborns. Late nights. Soft babies. Joy.

Chemo. Surgery. Nausea. Heartbreak.

That yellow stretcher held a brand new, first time mom. A mom who, I’m sure, looked at her babies with more love than even I can fathom. A mom who cradled those little swaddled bundles in her arms & rocked them to sleep. A mom who looked into her husbands eyes with wonder & awe at the miracles they created, together.

A mom who wouldn’t live to see their first birthday.

…to be continued.

daily {pixels}

i found this interview with a professional photographer about setting up portrait shots, including clothing tips & poses. :) it was very insightful...

and--get this--this photographer has only been taking pictures for two years. she taught herself! pretty amazing!

ENJOY!!

up next....

conversation.

[knock knock]. Hello, hello Mrs. G! I’ll be talking with you briefly before the phys…

Get out of here.

What? Mrs. G I’ll be talking with you bef…

Get out of here.

Okay. You don’t want to talk to me?

Oh gawd! My back. My back. Help me. Help me. MOVE MY LEGS. MOVE MY LEGS!!!!!!

Umm. Okay. Mrs. G I don’t know how to help you. I don’t know what is wrong with you.

Oh honey. I’m hurting so bad.

Okay. Well where are you hurting?

Oh gawd! My back. My back. Help me. Help me. MOVE MY LEGS.

[reaching out to move her legs]

Get out of here. DON’T TOUCH ME. DON’T TOUCH ME!!!

Mrs. G, you just asked me to straighten your legs.

I know honey. I’m hurting so bad.

You hurt your back? When did you hurt your back?

My legs! My legs! MY LEGGSSSSS!!!!! Oh gawd! My back! My back!

Mrs. G, I don’t kno…

Get out of here. I’ll break your wrists. I'll just snap 'em. Right in two.

Mrs. G, I…

Out! GEETTTT OOUUUTTTT!!!!

I…

Straighten my legs!! STRAIGHTEN MY LEGS!!!!!!!!!!!!

You just told me to ge….

I want my doctor. I want my nurse. I want some drugs. Oh gawd the pain!!! THE PAIN!!!!

And her voice faded into the air as I walked out of the room, shook my head, and went to fetch her doctor. Patients like these I am THANKING THE GOOD LORD ABOVE that I don’t have my license yet :)

looking.

He threw back the curtain, making the patient in room #3 jump. The poor man had come for a wound cleaning & they had to kick him out of his room because a more urgent case was about to arrive at the sliding double doors.

When the yellow stretcher crossed the threshold the scared man was out of room #3 and a slightly overweight woman was wheeled in.

In a way, it was like slow motion—the bag that was breathing for her, the frenzied nurses who slapped her arms to try to get IV lines, the two techs who took turns pumping on her chest, the shuffling feet of the xray tech standing by his portable machine, and me who just stood there.

I’d crammed myself in a corner, trying to be as “out of the way” as possible. Codes can get kind of crazy at times, especially if there are changes in the leads stuck to the patients’ chest.

But we didn’t have any changes. Just a flat line.

And each time we checked & re-checked & checked again, it was still just a flat line. No heart beat. No voluntary respirations. No blood flowing through her veins without pumping on her sternum.

I think I noticed her toenails first. They were freshly painted, neatly trimmed. Her legs were shaved. Her hair was combed. She loved herself. And now she was naked, aside from her underwear, on the yellow stretcher. Surrounded by no less than 10 people. Pushing. Poking. Feeling. Moving. Sticking. Testing. Looking.

Her hands fell to the sides. Her head bumped against the hard plastic mattress with each chest compression. Her obese belly jiggled.

The bag was squeezed. The Epi was given. The leads were checked. The chest was pumped. The monitors examined. Pause. Assess. Repeat.

The bag was squeezed. The Epi was given. The leads were checked. The chest was pumped. The monitors examined. Pause. Assess. Repeat.

The bag was squeezed. The Epi was given. The leads were checked. The chest was pumped. The monitors examined. Pause. Assess. Repeat.

Five times. We repeated five times…and still, just a flat line danced across the monitor.

And once again, as if time had slowed down, the bag that was breathing for her was laid by her face. The frenzied nurses looked hopefully at the monitor one last time and then hung their heads. The two techs stepped back from the yellow stretcher. The xray machine was wheeled back down the hallway. And me, I just stood there.

I stood. And I looked. At the sheet that now covered the body that once was a woman with painted toenails & combed hair. And I looked. And I looked. And I looked until I walked into the consultation room & listened to the sobs of a husband who’d just lost his wife. And then I listened.

I listened to the “Oh God’s” and caught breaths. I listened to the wails & the crying. I listened to the nose-blowing and chest heaves. I listened. And I listened. And I listened until I couldn’t listen anymore. And then I excused myself.

The bathroom mirror didn’t lie. It wasn’t the fluorescent lights that made me blink, and it wasn’t the eyelash that had “fallen” in my eye. It was sadness and surprise and grief and “what if this happened to me”; it was “it’s not fair” and sympathy and “I don’t think I could handle this”. It was real. And there were tears. My tears...from my eyes. The eyes that had looked. The eyes that had seen life slip away as those shaven legs mottled & turned blue. The eyes that had seen the naked body. The eyes that had seen the love torn apart. The eyes that had seen the unexpected grief.

…the eyes…the ones right above the heart that didn’t understand.
…the eyes…the ones leading the faith that didn’t dare to ask why.

the monday curse.

after three weeks, i think i'm officially authorized to call it a "curse". and really, although i don't believe in "true" curses, i just might have to change that point of view. the first week, i got lost. the second week, i had an eventful day of charcoal fountains & open zippers. and now, on week three, i'm basking in the glory of my airheadedness.

i feel it necessary to insert a brief disclaimer before telling the full story that i AM quite competent. i DO take care of patients. i DO sew up wounds & cut people open. and so far, my record for the latter is an A+. not even one time (!!!) have i left gauze or sponges in people. and not even one time (!!!) have i personally caused a medical catastrophe--at least, one that i've been informed of. so despite the pure blonde that may be coming across on these stories about the monday curse, please trust me when i say that when it comes to scalpels & medications, i HAVE BROWN HAIR.

so there i was. packing my bags in NC. i'd been spoiled to be off for the entire week of thanksgiving (that monday, i will note, was flawless). we'd just decorated our christmas tree, found places for the collection of nativities, and i'd had a good cry about leaving once again.

i'm going to go ahead & blame it on the swollen eyes. i looked in my closet & grabbed by workout shoes, throwing them quickly into the hamper of clean clothes that needed to journey back to my WV closet.

fast forward four hours to my unpacking of those clean clothes into my WV closet.

i took out one shoe.

and then the other.

and saw this lovely PAIR:

and if that isn't a monday curse that happens to ruin ALL the workout plans i had for this week, I DON'T KNOW WHAT IS.

stupid monday.

givingTHANKS

the Clark's came into town to celebrate the anniversary of "the feast" with us. i was lucky enough to be home the entire week (& i got to clean!!) and got to sleep next to my husband for SEVEN WHOLE DAYS!!! (which quite possibly was better than all the world's turkey's combined...)

anyways.

we walked. we ate. we read. we ate. we laughed. we ate. we watched movies. we ate. and then i stepped on the scale and fainted.

okay, not really.

but my pants are tighter, much to my dismay. and i have a few extra workouts scheduled in my upcoming weeks. which could be a big problem with my humerous shoe situation....

perhaps the cutest part of spending thanksgiving with our family was the interaction between jon & alec (my little brother). if a 10 year old boy was ever an admirer of a 24 year old man, i'm certain alec would be the poster child. their days were filled with Light Saber battles and deals struck on 30 minutes of xbox (with a pre-set timer, controlled my me). they talked army. and tanks. and airborne operations. and mostly Star Wars. which would lead to another Light Saber battle--the second of which was Alec against an invisible dude-whose-name-i-don't-know-because-i-haven't-seen-all-the-movies-nor-do-i-understand-them opponent.

they left at o-dark-thirty in the morning on Saturday & were kind enough to put us up in a hotel in Raleigh so we could enjoy the last night together before their departure. jon & i spent the entire day Saturday on an extended "date": Christmas shopping & movie-seeing & yummy-food-eating :)

in short, it was my kind of holiday.