Beauty in the Northwest

I finished my final required rotation of medical school. All that stands between me and graduation are electives. I will be spending the next several months in a somewhat random smattering of specialty clinics and hospital locations to include: Neuropathology (which I start tomorrow), STD clinic, the Medical ICU (aka the MICU) and the neonatal ICU (aka the NICU). It’s hard to believe that it’s all wrapping up so soon, and yet, it’s easy to believe because it’s been a long road!

I had an incredible time in the ER and to be honest, I kind of wish that I could stick around for another few weeks. Yes, the nights and weekends through off my sleep schedule and time with Tom, but the shift-work schedule (aka 8-9 hours per day and that’s IT) was really nice. I spent more time at the gym, cooking really quality dinners and studying in a relaxed fashion on this rotation than I have on any other! (Maybe it wasn’t the rotation so much as I’m finally figuring out how to do this whole med school thing…but who knows).

I thought I’d share 5 of the hundreds of things I learned on this emergency medicine rotation with you:

1. ALWAYS wear work shoes to the ER at Harborview. 
Don’t worry; this isn’t vomit or some other disgusting bodily fluid. It’s plaster from the splint I applied to a patient’s broken foot. How did it break? Let’s just say that semi-truck + feet does not equal happy feet. 
 
2. Scrubs make sense in an ER.
Image result for soiled scrubs
On a lot of hospital rotations I was always a little curious why we all wore scrubs. A lot of hospital work is pretty hands-off and you don’t really need to walk around in what might as well be your pajamas. In the ER it’s a totally different ball of wax. Between rolling trauma patients covered in blood off of the backboard, draining pus from abscesses the size of baseballs, repairing lacerations, and helping protect the airway of a seizing and actively vomiting human are all reasons that scrubs make sense! Regardless of whether I actually got the scrubs “dirty” at work, I would always change them on my way out the door for a fresh pair so I could greet Tom in clean clothing, and not bring my plaster/blood/pus/puke stained self home!  
3. When you do get away to study, it’s a lot more fun in a cozy coffee shop than a library.
Why didn’t I do this more often in medical school? Oh right, because when you go to a coffee shop you generally have to BUY something to avoid scowls from the shop staff. However, if I bought a cup of tea and a pastry every time I studied in med school I would not only be about 50 pounds heavier but I’d be in a lot more debt! But this week, during the blustering rainy days when I was preparing for my last exam of medical school, it was a nice splurge. I found a home away from home in this shop called A Muddy Cup. I felt like I was at a cabin. 

4. Life is short and I am very fortunate. 
This one is something I’m reminded of on nearly every rotation in medical school, but particularly in the level 1 trauma center for a 5 state region. I saw kiddos that fell from heights onto concrete, adolescents that ran into trees/poles in their cars, elderly that fell and couldn’t get up, and middle aged people that got down on their luck and wound up homeless addicts that are desperately needing help. I had some of the most profound conversations with patients on this rotation.
It’s funny what comes up when you’re sewing up their arm/face/lip/head or milking pus out of their abscess (can you tell I did that a lot on this rotation?). I learned of the desperation and sadness that overcomes someone that is hooked on drugs or alcohol. I was taught all sorts of new lingo about black tar heroin because I asked and the patient was more than willing to explain what it is, how he uses it and how it shouldn’t be used. I found it so ironic that when addicted you learn how to do drugs the “smart way” and never do something ‘stupid’ like inhale melted heroin off of hot aluminum foil, “because that will straight up kill you." And yet the same patient recognizes that injecting it through their veins or snorting it off a line isn't exactly the #1 safest leisure activity out there. 

5. Never go in thinking that you know what’s going on just from the “chief complaint.”
In medical lingo, the chief complaint is the reason that a patient tells the triage nurse that they are in the ER that day. Often it is boiled down to “abdominal pain” or “chest pain.” But just because that pops up on the electronic board DOES NOT mean that the patient has that symptom, nor does it mean that the symptom is the most important. For example:
-         A woman with “Nausea/vomiting” as her complaint was actually a woman who had recently been evicted from her home. She hadn’t eaten solid food in about a month given lack of income and she was nearly hypothermic from being outside for the past 2 days without appropriate outerwear.
-       A man with knee pain wound up having a broken foot and a much needed trip to the “decontamination shower” that is nearly the exit of the Harborview ER—something I learned while listening to his lungs and watched several insects crawl across his chest. You can bet I felt itchy for a while after that
-         A guy with “nausea/vomiting” came in with a brand new diagnosis of diabetes who was really sick because of a complication of diabetes called Diabetic Ketoacidosis (DKA) and ended up going to the ICU.
-          A man with “whole body aches” wound up getting wheeled emergently to the catheterization lab where the interventional cardiologist worked to un-clog the 100% occluded coronary artery in his heart.

And sometimes, the patients “read the textbooks” before they come in. This is what we say when a patient presents with all of the classic, textbook symptoms of a clinical problem. Like a woman who had a sudden onset “worst headache of her life” with associated nausea/vomiting—that one line along makes anyone in the medical field think about a subarachnoid hemorrhage. Sure enough, that’s what she had. 

I learned so much more, but in the interest of keeping this blog post from being 2 miles long, I’ll stop with the long-winded descriptions of life lessons and move on to other fun things.
First off, Tom was surprised by his classmate with the best, most ridiculous gift ever! As many of you know, Tom uses an igloo cooler for his lunch box and he has been asked all sorts of questions in his day like “is there a human organ in that?” or “you headed out to the construction site?” Well, now he also has a ridiculous “bro-tank” to go with it. 
 
This Valentines weekend we spent a lot of great time outdoors having adventures! We met up with Diana on Saturday for a trip to Steven’s pass for snow-shoeing fun!
We hiked along the “Stomp-n-stoker” trail which took us alongside the stream with it’s beautiful, calm, crisp, clean water.
Tom learned that UP hill is much easier than DOWN hill
 
We paused half way to dine on some DELICIOUS banana bread that Diana brought as we took in the view of the creek. 
 
 
 

 
For the most part it was a nice smooth flat trail but we had some hills to discover along the way too. 
 
 
We got back to the rig just as it started to sprinkle down rain. We had an eclectic assortment of food as we dined on some left-over homemade pizza, hot chocolate, mandarin oranges, skittles, and pretzels. 
 
We weren’t quite all tuckered out after the snow shoeing so we decided to make a quick stop at Deception Falls and explore the beauty of the woods under the tree cover as the rain started to come down even harder. 
 
The colors of green, white, and grey were breathtaking. 
 
 
 
We came across a familiar stump from hikes of the past
 
But the falls on this trip were particularly full and gorgeous!
 
 
 
 
 
 
We stopped in at a very popular bakery on the way home, the Sultan Bakery for a little warm-up and dry off time with some of the most delectable treats we had ever seen!
 
 
Tom and I split this giant apple cupcake thing (what else do you call it?) and it was FABULOUS!
 
We didn’t have our fill yet of the great outdoors so instead of our traditional walk around Magnuson on Sunday morning, we found ourselves at St. Edward State Park for a walk through the woods and down to Lake Washington (from the other side of the lake that we don’t get to see out of our backdoor). 
 
Well, I can't fail to mention that this walk was fueled by some amazing French toast made by my sweetheart!
Once again I was taken aback by the beauty that lies just 20 minutes from the city. And, the joy and love I’ve found in my Valentine!
 
 
It was foggy and misty so we couldn’t see much across the lake, but that kind of made it all the more magical. 
 
The inside of a hallowed out burned tree felt like a little log cabin on the waterfront. 
  
 
We added to the pile of pine needles and dirt in our front entry way and got ourselves gussied up for a night out on the town. We didn’t plan ahead very well so we were making reservations for Valentines night with less than 48 hours notice…so that meant we dined early at 5:15. We had a lovely time at Little Water Cantina right on the water in Eastlake. 
Image result for little water cantina
Because we dined so early, it meant we had time for dessert before the show started at 7! What could we choose except the delectable Pie Bar for our venue! 
Two slices of strawberry rhubarb ala mode to go was just the ticket!
 
I have to admit it was the most amazing dessert in the truck, in a parking garage, I’ve ever had!
 
Then it was off to the theater for the main event: How to Succeed in Business without Really Trying—a hilarious satire about the business world. 
 Image result for how to succeed in business without really trying
As usual, the 5th never fails to impress with its gorgeous architecture. 
 
Even with our pit stop at the pie bar we were still early to the event, so we decided to check out the orchestra pit too. 
At intermission we found or usual perch on the stairwell in the lobby to be the creepers that we are and people watch the masses waiting in line for their over-priced but delicious snacks and beverages.
 
What a spoiled day we had! We are so grateful to have each other! And, we feel a bit old and a bit luckier because this year we were celebrating our 10th Valentines together! Can you believe it? We will have to see what next year brings, but for now we’re soaking in the beauty of the pacific northwest and the lighter schedule on my plate for the next few weeks before the intense month and half in the adult and neonatal ICU’s before graduation is upon us.
Happy Valentine’s Day everyone!

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