Friday, April 18, 2014

Work is the time between vacations

I really like my job.  Nerdy, but true.  It was a great week at work because in addition to two (!) OR days, a big project is finally getting off the ground and I'm really excited.  We have a home sleep study project that a contract was finally approved for and in two days, I've already booked 9 patients.  It feels awesome to blast a waiting list to smithereens and it's nice to have success from the very beginning.

What's interesting is that I don't love sleep medicine.  I do, however, LOVE sleep so sometimes my wish for other people to enjoy good sleep helps me focus on the positive aspects of sleep medicine.  The reason why I don't like the specialty is that the surgical interventions are limited with low cure rates and I am a person who likes to operate and achieve successful outcomes.

In addition, there is a large financial incentive for military members to have OSA.  Twisted but true.  If a person is diagnosed with sleep apnea, the VA rates their disability at 50%.  I won't go into the details too much but there are many people who see this as a reward for being fat, since obesity is associated with >75% of OSA cases.  And, despite how it looks in some workspaces, military members are supposed to comply with weight standards.

So, because some people see this money spent as a way to satisfy secondary gain from unprofessional (read: fat) military members, there is resistance to the program.  In response, I say that OSA is a disease with significant morbidity if left untreated.  In terms of "rewarding" being overweight, a large portion of all our health care dollars is spent treating chronic medical conditions linked with excess body weight (coronary artery disease, Type 2 Diabetes).  So, we need to treat the patient population as they are while encouraging weight loss, healthy eating, tobacco cessation, etc and we still need to diagnose and treat OSA.  The home studies are 1/4 the cost of sleep lab studies and equally accurate in diagnosing OSA.  I think the program fills a need in a cost-effective way and more importantly, that's what my boss thinks.  Since my boss told me to take on this project and see it through, I did it.  The end.

Moving on!  My projects are going well and most importantly, they're at a place where I can leave them on auto-pilot while I tour around Japan with my parents next week!  I'm so excited and look forward to all the fun we will have!  After that trip, there will only be 8 more days until SMS arrives in Japan for good.  Hooray!

Sunday, April 13, 2014

Sunday Funday!

A little beach visible from the boardwalk across the street from the Yokosuka Art Museum.  The hills with
the trails are in the background, but the beach and rest stop look good too!
Today was a beautiful Spring day!  I did some Spring cleaning and the apartment looks awesome.  After cleaning up, I headed out for a 6 mile roundtrip run to the Yokosuka Art Museum.  I love the run because it's along the coast, seawall path and a cool dock near the Art Museum itself.  I wanted to run the trails by the art museum but I was out of time since I was meeting up with two friends for Park Golf!  Hooray!  I love Park Golf!


What's in your garage?  Oh, you know.  Just a shrine.  Kind of hard to get the car
out in the morning.
I went to Park Golf with two friends of mine who are also missing their significant others.  Aaron is marrying my good friend book in May and then they will both be here!  Sagoy!  I cannot wait to see Brooke again.  She's a good friend of mine from San Diego and I will be so happy to have her out here.  Carl's wife is deployed and she'll be out here in July.  I can't wait to meet her.  She deployed only a few weeks after I got here and the first month I was here, I was busy dealing with housing and getting ready for the boards.



So, the big news in Park Golf is that I got a hole in one!  Course A, hole 3!  This got a lot of cheers from fellow Park Golf enthusiasts!  However, I still did not win in our group.  Whah!  I had a lot of bad holes but it's sort of ok because it simply means that I will have to play more of my favorite game!


Hole in one! Hole in one!
The course was beautiful and the day was great.  Prior to park golf, we went to a delicious yakitori place where we were painfully ordering the yakitori one at a time.  Since I was very hungry post-run, this was slightly sad for my tummy but in the end, I was very happy.


For dinner, I went out to Hamakura with a group that included Sean who is here from Singapore for the week!  It was great to see him and hopefully, I will see him again before he heads back.  Overall, it was a great day with lots of sporty activities and hanging out with friends. 


Welcome back to Work!

So, I was back to work on Wednesday and had a pretty busy clinic.  I was prepping for my cases the next day when an Outlook reminder popped up that there would be a DESRON cave tour in 15 minutes.  I debated in my mind whether I wanted to go.  I was leaning towards no when my mind said, "Oh, just say yes!"  So I went.  I figured it would be something pretty unique and paperwork could wait.  I did, by the way, head back and finish it after the tour.
The group walked over from the hospital and met outside DESRON.  The entire concrete building is built within the walls of man-made caves.  The caves were built starting in the early 1940s by prisoner-of-war slave labor, mostly Chinese and Koreans.  The caves were built by pick-axes and the individual strike marks are still visible on the walls.

Pickmarks
First, we went into the conference room, a two-story room with a huge map of the entire Pacific region.  It goes back to the early 1950s and therefore, shows a unified Korea and Vietnam.  I forgot to look over  at India so I don't remember if Pakistan was marked separately.  I imagine it would be since the partition was in 1947, but I don't know.  

It was cool but I was a little disappointed that I wasn't in any cave.  I wanted to go spelunking!  Well, I got my wish.  We went into the caves.  There are room for everything and tunnels that vary in size from shoulder-width to high/wide enough to drive trucks inside!  It was pretty dark except at the very entrance where there were some portable electric lights.  In certain parts of the tunnels with all the flashlights off, we could faintly make out light from the different air shafts.

We saw the hospital area with wooden stretcher holders, canteen and offices.  It was really an incredible tour and I'm so glad I decided to go on it!



Saturday, April 12, 2014

4 Hours in…Chicago


I had to stay in Chicago an extra night since my exam ended after the last flight to Tokyo.  I was really excited to see a little bit of Chicago so the next morning, I headed into the city.  

I had grand ambitions of stopping in multiple shops, museums and parks but I only had four hours, so here's what I did.  I took the subway (El?) into the city from Rosemont and stopped in the Sephora for some make-up.  It was fun to try on the samples and pay American prices, although they were still high.  I left the shop and saw an old man wearing a Korea War Veteran hat.  I walked past him but decided to go back and thank him for his service.  He was sitting by himself and looked a little lonely.  He was super happy I thanked him and we talked about him, his deceased wife and Chicago.  He had a picture of his wife in his pocket.  She was "beautiful inside and out."  He also mentioned that the Chicago Cultural Center was gorgeous and had the largest Tiffany stained-glass dome in the world on the third floor.  I begged off a handwriting analysis by him, saying that I had to go and then I was off to see more of Chicago.

In three blocks, I came across the Cultural Center.  Awesome serendipity!  It was a gorgeous Beaux Art-style building with two famous domes inside.  One was the Tiffany dome, with its 38 feet diameter and 30,000 pieces of glass.  It was restored in 2008 and is in the former public library.  The other was the Healy-Millet Renaissance pattern stained-glass dome in the Grand Army of the Republic Memorial Hall.  For those keeping track of stats at home, it is 40 feet in diameter with 50,000 pieces of glass.

An usher in the Tiffany window hall encouraged me to stay for a concert, part of the First Monday Concert Series put on by the Chicago Chamber Musicians.  Joseph Genualdi (violin) and Robert Weirich (piano) played two pieces: Violin Sonata in G Major, Op. 30 No. 3 (Beethoven) and Sonata for Violin and Piano (J. Corigliano).  I preferred the classical piece over the modern but it was pretty cool to hear a more modern composition.  After the concert, I only had one more hour in Chicago!  Time to hustle over to Millennium Park for the de rigueur photo in front of the Cloud Gate sculpture!

After admiring the Cloud Gate, Pritzker Pavillion and the Crown Fountain, I went over to the Art Institute of Chicago.  There was complimentary admission for active duty personnel, which I was happy about since I only had a short time to peek around.  

I went to the Thorne Miniature Rooms first.  They are 1 inch:1foot models of various styled interiors, mainly European and American from the 1300s-early 1900s.  The detail is exquisite.  They're the best dioramas I've ever seen!  Ok, maybe that's a little too low-brow of an impression but it was a mix of dollhouse and diorama.  The craftsmanship was very impressive.

Then, I went on a whirlwind trip through the Impressionist galleries.  They have quite a few Renoirs, including Two Sisters, which is a painting that I've often seen  a replica of in Mom and Dad's house.  Everything was beautiful and laid out in natural light galleries.  I also loved Eternal Springtime by Rodin.  It reminded me of the time I was lucky enough to see an entire gallery devoted to Rodin sculptures in Philadelphia.  Apparently once Rodin was rich enough, he hired a bunch of models to walk around in his studio and when they were in a pose he liked, that's what he would sculpt- very spontaneous, very fluid.  It is funny to think of being surrounded by a bunch of naked people walking around- like a Japanese onsen!

I wish I had more time but I felt I made pretty good use of what I had.  Then it was a rush back to the hotel after a slight subway mishap- the Loop not being connected to the main lines is very confusing…to me, at least. I got to the airport, made it through security and had a few minutes before traveling back to Japan.  The flight was EMPTY and I had a whole row to myself.  I could have had several rows to myself.  Seriously, it was amazing.  Maybe I'll try to travel on off-peak days more often.  

Landing at Narita is always a bit of a letdown since there's still about three more hours to the trip but it was so nice to be home.  After clearing customs, I headed to the Narita Express, which is only Y1500 for foreigners this year although I had to ask for the discount.  I took the NEx to Yokohama then transferred to the Keikyu line.   It was so packed, even at 10 o'clock at night!   I got off at my stop and walked in.  The apartment looked great and fortunately, no smells of forgotten garbage were in the air.  Yay, for the win!

Thursday, April 10, 2014

O'Hare Area Wasteland

Ok, the O'Hare area is fine.  It's just that it still looked and felt like Winter and I was there for my oral boards.  Meanwhile in Japan, the sakura were around for about three days according to people who were here.  Then it rained and the blossoms fell off.  So ephemeral…talk amongst yourselves as I write a poem!

Ok, I'm back!  So, the Osler Review Course was held in the O'Hare area at the Holiday Inn.  I'm glad I went since I picked up a few pointers on delivery technique and it helped calm me down a little bit.  Only a little, since I was still battling my insomnia/jet lag double demons.

After the three day course, I headed over to the Marriott.  I am a Gold member, a carryover from when I spent 90 days at the Courtyard Marriott when I was at MD Anderson.  The Marriott Suites was a beautiful hotel and I rested up/studied on Saturday.

Saturday night, I slept from 10-3 and then 5-10.  My test was Sunday afternoon so I dressed up in my suit from 2001.  Hey, it got me into med school so maybe I'll have luck now?  Candidates were asked not to wear their military uniforms in order to prevent bias although from what I've heard, we're pretty obvious with our Yes Sirs/Yes Ma'ams.

The board examination was simultaneously the fastest and longest experience of my life.  Honestly, leading up to it was long but the exam went incredibly fast.  The information we were given preceding it was pretty good in terms of letting us know the format but nothing can really prepare a person for the experience.  (There was a candidate video and a presentation at the exam site.)  I think I did well, but I won't know officially until mid-June.  Apparently, the "psychometrician" needs to analyze the data.  This is a real word.  A neologism, if you will.  Maybe even a portmanteau!!  Everyone at my table immediately started discussing the similarities to Tobias' professional occupation in Arrested Development.



So, yes, there were brief moments of levity where we didn't feel like our futures were on the line.




Tuesday, April 8, 2014

For the First Time in Forever...

Ha, ha.  I am now on the unfortunate bandwagon of having Frozen songs stuck in my head.  But do you know what this means?  1. The 6-year old cool girl clique might accept me (wrong!  They've moved on to Sherman and Mr. Peabody!) and 2. I have time to watch movies again!  Hooray!  Boards are over!

So, yes, I watched Frozen on the way back to Japan.  I also saw Philomena and started Silver Linings Playbook but since I didn't like the book all that much, I didn't want to spend another two hours of my life on the same story.  Philomena was excellent, though.  I'm also halfway through The Secret History by Donna Tartt.  It's good, but I feel that I'm not the biggest Donna Tartt fan in the world.  Since I read in reviews that some people felt "meh" about The Goldfinch but loved her first book, I wanted to give it a try.  I'm definitely going to finish it but I'm not the biggest fan of novels that focus on the intellectual and emotional angst of New England liberal arts college students.  I already lived it, ha ha.  Another novel that falls into this category is The Marriage Plot by Jeffery Eugenides.  That, too, is a good book but not one I'd tell you to run out and get.  Actually, I'd recommend The Secret History more.

But backing up, I left on Saturday, 29 April.  I am fairly certain I missed the Sakura peak so on my way out, I took a little lame photo of a tree that was already in full-bloom.  This will not win any awards, but I didn't want to get closer and miss my bus to Narita!
A picture doesn't do it justice, ha ha.
I studied a lot on my flight and barely slept, like maybe 45 minutes.  This was a mistake.  I had the worst jet lag on this trip.  I haven't had jet lag this badly since I was a kid when we moved to Spain.  Now, I think stress insomnia had a role but it was pretty horrific.  Even the night before the test, I went to bed around 10, woke up at 3, went back to bed at 5 and slept until 10.  So, fortunately, I got enough sleep quantity-wise the night before (and the night before that) my test, but until that point, I was running on 3-5 hours of sleep a night.  My brain did not function very well.

Or…maybe I was excited because I got to see SMS for 3 days in LA! Yes!  On a government ticket, a person can take up to 7 days of "extended layover!"  It's charged as leave but I was so happy I got to see my husband!  We hung out in Newport Beach and had a great time.  He was super awesome in letting me sleep and study, although a lot of my studying was b/t midnight - 5 a.m. and sleeping was from 5-11 a.m.  (See above paragraph).

We also celebrated…my birthday!!!  I love my birthday!  I thought it was going to be a little bit of a wash this year, but SMS and I celebrated with a great dinner out at Fig & Olive in Newport Beach.  The dinner was amazingly delicious- we had oysters, steak tartare, branzino fish ("Glazed with fig & 18 year old balsamic vinegar, snow pea, fig, olive oil mashed potato-"  YUM!!!) and the Fig & Olive salad.  I swear this wasn't as much food as it sounded but it was all so delicious and wonderful.  The restaurant felt very O.C. (lots of plastic surgery) and the people watching was pretty awesome.  After dinner, we headed to Marty and Pamela's where they had bought me a birthday cake and we had a little party.  Yes!  I even had a cake with candles to blow out this year- awesome!

Also, for the record, I really do like celebrating my birthday on my birthday but this year, 31 March was an acceptable stand-in! ;)  Oooo, and you know what I just realized during this little recap?  I've been wanting to go to Fig & Olive for years!  But I only knew of the Melrose Place location.  Yay for accidental fulfillment of life (mini-)goals!

On 1 April, we had a nice morning and early afternoon together before heading out to LAX.  Then it was off to the lovely greater O'Hare airport area for my Osler Review Course and my *dun, dun, dun* BOARDS!

Thursday, March 27, 2014

Holy Smokes!

So, one of my staff said that I would talk as if I were from the 1950s.  Now, this confused me because I think I curse like a modern-day sailor but what I suspect is that my Nancy Drew and Trixie Belden books from my childhood influenced the words I say when I want to swear but feel like I can't/shouldn't.

So…

Holy Smokes, I found such a delicious recipe!  It's chocolate chili and it is so amazing.  I thought I wasn't hungry tonight and I ate a bowl and a half while it was simmering.  Well, it was simmering until it was almost burning but then I added water and saved the day!  Oh my gosh, it is so savory and delicious.  I will definitely eat every last bite before I'm off to the US.  I don't have a picture because even the professional-ish picture from the cooking blog makes it look like dog food.  But it's delicious dog food!

Pretty much same old, same old.  I'm day-dreaming of the awesome reading binge I'm going to go on after the boards.  I'll finally go to the Hospital Ladies book club.  I'll play park golf with my friends and restart the Lonely Hearts supper club. [<--Two of my friends are also in the coupled-off-but-significant-other-not here demographic so we were having dinner together once a week.  Well, it happened twice.  But it was a good idea and we're going to revive it, yeah!]

I also have some pretty challenging/rewarding cases in April and the month is going to end with a week of leave so I can travel with my AWESOME PARENTS!!!!  I am so excited and the envy of all my friends.  My parents are the coolest and you can't have them because they're mine!  (And Ed's, Brady's and Joe's- I can share a little bit:)

Oh, and books I want to read follow.  Share if you have any thoughts! [I can hear my Dad, "Where are the Classics?!?!?"]

Americanah by Chimamanda Ngozi Adiche
The Love Affairs of Nathaniel P. by Adelle Waldman
The Flamethrowers by Rachel Kushner
The Secret History by Donna Tartt
The Impossible Lives of Greta Wells by Andrew Sean Greer