Saturday, August 25, 2012

Brunch and planning

Today was such a fun brunch with my friends.  I'm never quite sure what to say so I always half-jokingly refer to my lady-friends/girl friends/totally AWESOME people!  I'm not sure why I need descriptive qualifiers but in any case, I love my San Diego friends.  We've been getting together for the past 2-3 years now and today we had brunch at Cat and Gary's new place.  It's in Hillcrest and Cat made a killer chorizo/kale/egg strata and breakfast potato hash.  She also made French Toast, but I've been trying to keep my carb intake down due to the upcoming wedding with the tight bridesmaid dress.  I mean, I know strata has bread but at least it's a component rather than the main feature as it is in French Toast.

Gary was out-of-town so it was still just ladies.  It was so much fun with good food and great conversation although it was probably one of our weirder and deeper brunch conversation strings.  In no particular order, we covered cancer at a young age, rectal foreign bodies, horribly needy patients, combative autistic children and various relationship updates.  It was pretty medical but since we are all in the field in some form, I guess it makes sense.

Last night, Shelby, Zen, Mechen and I went to Wine Vault.  The food and wine was delicious.  The portions were extremely moderate and high-quality which was great on one hand and on the other...I arrived too hungry!  But we had so much fun and got along so well.  I'm a little sad because one of the main topics of conversation was how Mechen was leaving at the end of September for about 8-9 months.  He'll be back in SD next July or August but by that point, I'll be gone.  It's such a huge batch of mixed emotions because it's a GREAT job and promotion for him and I get to focus more on work and ending my residency on a strong note but it's really sad on a personal level because I never wanted to do long-distance again outside of deployments and now, here we are.  In addition, it's weird being in such a long-term relationship without being married, especially in the Navy where you don't get to stay together duty-station-wise unless you're married and even then, no guarantees.  Marriage has never been my biggest priority but it's becoming more important and there's just so much change in the next year that it's hard to process.  So, one day at a time and a little healthy compartmentalization should get me through.  Stressing about upcoming decisions isn't helpful, especially with such limited information. Things should shape up a little better when I talk to my specialty leader at the meeting in September.  In a change from what I thought prior, I now really do NOT want to go back to Japan so hopefully, that'll work out.  I hope I get Washington or Great Lakes but that remains to be seen.  It's definitely a stress I'm trying to tamp down for now.

Tomorrow is church, Book Club brunch and maybe beach?  I also rented The Dictator and Friends with Kids from Red Box so hopefully we'll watch at least one of them!

Thursday, August 23, 2012

Awesome weekend!

The past weekend was so much fun.  Mechen and I totally recharged our batteries and had the most mellow, fun time.

Friday, I went to the Padres game with a group from work.  I brought pizza from BASIC which was well-received although I bought too much!  The game was ok, company better.  Inning 3 was particularly incredible as the Giants scored 8(!) runs.  I've never seen that- so terrible!  Not that I am encyclopedic in my baseball watching or even interest but it was pretty amazing.

Saturday, we got up and were pretty lazy in the morning after sleeping in until 10!  Then we went to Del Mar racetrack to see some of the races followed by Ben Harper.  He did a great cover of "Atlantic City" and had some good songs I wasn't familiar with but I was sad that he didn't play "Forever" or "Steal Your Kisses."  Maybe they bring up bad memories for him but that's really all the Ben Harper I know.  We followed up the Race Track with a trip to Pizza Port, which was much needed grease to absorb some of the beer we drank!

Sunday, we woke up, went to church and then had a delicious brunch!  We made Papas Locos, a dish modified from The Mission.  It is Mechen's specialty.  Breakfast potatoes boiled then sauteed with bacon and onions topped with scrambled eggs, avocado, cheese, Greek yogurt, homemade heirloom tomato salsa fresca (off the hook!) and jalepenos.  Then we took a nap followed by the beach and surfing.  Dinner was lighter but we ate out on the deck which was awesome.

So, basically, the weekend was really chill and North County focussed.  I didn't come down to SD once, which was great to take a break from the car.  Although we're not driving ourselves crazy, we're trying to take advantage of the little North County time we have remaining. 

Wednesday, August 15, 2012

Catch up, Wrap Up!

Mechen and I just had a great weekend.  We’ve been going to the beach more often.  Yesterday, we played paddle ball and watched the sunset.  We also had ricotta pancakes for dinner, although now that I type this, I realize they were quark-substituted-for-ricotta pancakes and they were delicious!  Brunch was DE preceded by a contemporary worship service.  It was a little too woo-woo for both of us, but I’m glad we’re going to church together.  

This week, I’m off to Ft. Lauderdale for a military medical research conference.  I’m excited to meet other people involved in the research machine- I’m not totally sure if I’ll ever be completely into research but it’s a good opportunity to show off my project, meet new people and get more information.  And all in the awesome location of a beachfront hotel!!!

Summer recap

July and early August has been a lot of fun.  It’s been an adjustment to be on call so frequently.  Not that I’m in the hospital all that much, but I always have to plan for the possible interruption.  In addition, I wish my weekends were a little freer but oh well, it’s what chief year calls for and I’m definitely excited to be a chief.

So far, my cases have been awesome.  I feel like my skills are pretty sharp and I’m honing the finer details.  Even otology cases are going fairly smoothly although I still have a lot work to do.  In addition, I’d like to polish my plastic surgery skills.

In terms of events, “Zedna” had a Bastille Day party that was a lot of fun.  There were some great couples there and it’s so nice to meet new couples and talk to them.  It’s weird- I feel like a lot of childless couples I meet have eclectic interests and topics of conversation which couples with children talk about...their children.  I’m sure that will happen to me if I eventually have kids.  I do agree with one woman that I met though, who said that she wasn’t sure how hard she would try to have kids if trying naturally didn’t work out.  I am leaning more towards that direction- I don’t have a huge interest in fertility drugs, IVF, etc.

I also went to a few concerts in the park in Coronado.  Shelby, Zen and I went to Davanti Enoteca on 8/21 which was delicious!  We had the marscepone polenta and daily ragu, grilled octopus, salad and the ricotta/honeycomb spread.  Delicious!   And Zen and Shelby are so much fun to hang out with.  In addition, I had the recent bonus find of discovering this past weekend that there is a DE in Del Mar Heights!!!  Mechen and I had brunch there and it was SO good!  We split a pork belly hash/poached egg dish and “Italian” Toast.  Yum-o!.  There was also a make-your-own-Bloody-Mary bar which was pretty awesome and reminded me of Cafe A in New Orleans.

Other highlights include surfing a few times, house-sitting at Suzi’s, Laddie coming to visit for the weekend, hanging out with Tawnne (Station, local wine bar) and Cat (Hannah’s Place, yummy bar in Hillcrest), going to Bar Cueva and seeing Step Up Revolution 3D with Tawnne and Colleen (so much fun!).  Afterwards, Tawnne and I went to The Office and danced up a storm!

Family Reunion

 I came home on the 4th of July and Mechen picked me up from the airport.  We went home only to leave the very next day for the Tierney family reunion.  We spent 5-8 July in NJ.  On the 5th, we met up with the family for dinner at Navesink.  The next day, Mechen, Brady, Dad and I went into NYC.  We went to Ground Zero, a sushi restaurant and the Met.  Ground Zero is hard to write about- even on the grounds, it’s difficult to figure out what to say or even what to talk about.  I’m so glad I went but even still, everything I even want to try and say sounds so banal.

At the Met, we mainly focused on the Egyptian wing and the late 18th century painters.  We saw the Temple of Dendur, which was pretty amazing.  It’s a gift to the people of the U.S. and the government decided that the Met was the best place to display the permanent exhibition.  I also recognized it from one of the last scenes in When Harry Met Sally.  The Met guide was funny because there’s a portrait of George Washington, in which he looks like he just smelled a particularly ripe fart.  Brady and I laughed about it a lot.

That evening, we went to the Brothers for dinner and met up with the extended family.  The next day was a beach day followed by a lobster dinner.  Mechen helped my parents set up earlier in the day which was much appreciated/major brownie points.  The next day was a slow start and we had breakfast with the immediate fam (save Joe) and then headed to the airport.  It was a great mini-trip.  I was really happy to get back and make preparations for the beginning of chief year.

Notes from a TDY, Part 4: Homeward Bound

After the Samar working port, we headed to Subic Bay for one evening of fun before heading to Manilla and home.  Melissa and I had organized a DSS happy hour that was awesome.  It was at Pier 1, a large outdoor bar and the food was delicious.  The night was a lot of fun although I had too much to drink and would have been late to the ship if not for my friend Ty who assumed the camp counselor role.  Fortunately, I made it up the next morning and headed out the door, almost forgetting all of my electronics in my sleepy, still intoxicated haze.

Manilla was pretty cool.  We stayed at the Shangri-La in Makati City.  We went to a Dampa to follow in the footsteps of Anthony Bourdain.  We ate a ton of seafood that we picked out in the stalls and then had the restaurant cook it up.  It was so cool!  Picking our seafood and prep methods was a unique experience and I’m so glad we did it.  Then we went shopping across the street at a large emporium of all Phillipino craftwork.  After spending about an hour there, we headed back to the hotel where I had a massage and facial at the hotel spa.  We went out for dinner at a mall with very high outer perimeter security.  The food was delicious and I had another piece of fish, lapu-lapu- a local white fish.  Then we headed back, slept and started homeward the next morning.  The layover in Narita made me miss Japan.  I’m not sure if I’ll ever get stationed there again but I wouldn’t be opposed to it!

Notes from a TDY, Part 3: Philippines Recap

Whoa, time flies.  The Philippines mission port is complete and it was pretty intense.  I participated in two SURGCAPS, one SMEECAP and lots of surgeries.  Overall, the surgeries were really satisfying and we had some great cases.
My favorite case was the thyroglossal duct cyst case.  Not only is it a relatively infrequent operation due to the rarity of the condition, it was an awesome story of luck and being able to help a young girl.  I met her and her mother at the second SURGCAP.  She was the second-to-last (penultimate?  too grandiose?) patient of the day.  She was getting an ultrasound and I was waiting around for my last patient.  We had run out of papers and hadn’t even registered anyone for the past hour.  Many of the other providers had already left to go walk the nearby streets for snacks, souvenirs, etc.  The Mom was really distraught when I said that we wouldn’t be able to help.  Not in a histrionic sense but in a tears-welling-in-the eyes/look of defeat that really made me sad.  I decided to take her phone number just in case something opened due to a last minute cancellation. I emphasized that it was extremely unlikely to happen.  

The next day, I was reconciling the patient tracker to the next day surgery schedule when I noticed that a patient wasn’t on board.  I had a LCDR who spoke Tagalog to call the patient and it worked out to have the patient come on board the next day.  I was really worried since she had no i.d. but I had sent a picture of her ashore and the beach det spread the word and it all worked out!  She had surgery that day and was sent home two days later.  The surgery went perfectly and we did an excellent Sistrunk procedure.  The Mom was borderline catatonic- I think because she was so overwhelmed.  Even the last day, when it was clear they were both really happy, their affect was really flat.  I mean, they were appreciative but it was clear that while this was a stroke of fortune, life was really tough for them.  It was a reminder to me that, while the compliments and appreciation that come with the job are nice, the real satisfaction needs to come from within me.  It goes back to childhood when my parents would tell me to “just do your best.”  If I give my best effort in preparing my knowledge base, sharpening my skills and staying engaged in all aspects of patient care, I can be happy knowing that it’s a job well-done.  And I think that’s important given that medicine is imperfect and there will be complications and/or difficult patients and while I’m sure I won’t be in the best mood that day, at least it won’t send my entire self-worth as a physician crumbling down.

Anyway, we also did a few thyroids, parotids and skin lumps and bumps.  We did an awesome lateral neck mass excision which turned out to be a pleomorphic adenoma with carcinoma ex in situ.  So that was life-saving!  Awesome!

Notes from TDY, Part 2: Singh

SMEE time!  The name makes me think of the hapless first mate of Captain Hook in Peter Pan and the adjective “hapless” is not entirely inappropriate.  The situation is borderline ridiculous- here we are, not speaking the language AT ALL and entirely at the mercy of the hired drivers and translators.  And, as it turns out, we have an Indonesian military and police escort!   I’m not sure if they are watching out for us or watching us but either one is fine.  

So, yesterday, we left Manado around 1900 and arrived at Sanghe shortly thereafter.  I think the ride is 3 hours although I definitely have no real idea.  We mustered this a.m. at 0630 (classically, I underestimated my rounding time so I was almost late).  Then we waited around for a bit then headed out on the Bandaid boat.  This time on the bandaid boat, I was completely fascinated by the driver who was this MMC guy who was the screensaver on all the command computers for about 5 days.  In that picture, it looked like he would knife you and then take your cash, even if it was a known fact that you were carrying less than $5.   When driving the boat though, he looks pretty different and is wearing glasses.  This alarms me.  I mean, is it that easy to disguise a person’s nefariousness with glasses and a safari hat?  Apparently, for me, yes.

So, we arrived in Singhe, milled around on the pier and were taken to the helipad/MEDCAP site.  There, we picked up too few bottles of water for the six days we’re here (this was mildly disconcerting).  Next, we went to the hotel which is actually pretty nice.  There is AC, clean water, no bed bugs and two separate beds!  (I’m rooming with another resident).  

We had breakfast/lunch downstairs which was pretty good.  Then, we went to the beach.  It was awesome!  It was a black sand beach with some pretty good snorkeling.  The water felt amazing.  The beach was beautiful and we were definitely a spectacle.  White people in bathing suits on the beach are a pretty uncommon sight.  Although the island is gorgeous, it’s pretty remote with little to no tourism.

Then, our civilian OIC brought us to the pier to pick up the rest of the water.  Great news on the water, not so great showing up in our beach gear.  Le sigh.  But now we are set with water and I’m pretty stoked we’re here.  We’ll go to dinner in a few hours and then go to the lecture hall tomorrow.

Dinner was pretty good.  It was at a seafood restaurant just down the street.  There was rice, fried whole fish, noodles and a delicious egg drop asparagus soup.  Dessert was fresh fruit, which was pretty awesome!

Oh, I also learned that we were WAY underdressed at the beach.  Apparently next time, we should wear gym shorts and a tank top.  Ooops.  Fonne, the health ministry person working closely with our group said in reply, “People fool around in more than that!”
SMEE, Day 1.  So the SMEE started on Monday after a fun Sunday.  There were about 140 people there.   The intro lectures were fine, but then our OIC launched into a pre-made talk from the USNS Mercy that was so awful and awkward.  The translator had difficulty with a lot of the scripted flowery phrases and for whatever reason, she did not paraphrase.  Yikes.  Fortunately, the next lecture was way better with a nice ice breaker.  Dr. Medina greeted the audience in Indonesian which they loved.  

 When the conferences were over, there was an extended photo taking period and some time to talk with local physicians.  One woman asked about a child with a cleft lip/palate and another asked if we fixed VSD (ventral septal defects) on the ship!  That’s crazy!  While there is lots of state-of-the-art equipment, we are definitely not set up for CT surgery.  It’s interesting how many people think that the Mercy is a miracle ship that can fix anything.  This was also apparent at the MEDCAPS as well.

After the SMEE was over, the group headed to the MEDCAP site where we had heard we were desperately needed.  The obnoxious AOIC of the group asked us what we were doing there, but everyone else was happy to see us.  Melissa and I saw several patients and then I watched a few dental extractions.  After the MEDCAP, I did a yoga DVD in my room and then headed to the restaurant down the street.  

After dinner, I headed out with a group from dinner but then soon joined another that included one of the peds resident. 

If you ever asked what I thought I’d do in my life, singing karaoke in Indonesia would not be something that would have rolled off the tip of my tongue.  But after a delicious dinner and wandering the town, we ended up back at the dinner place and started in on the karaoke.  It was so much fun.  A few of the guys from the MEDCAP and I hung out and it was awesome.  
MEDCAP day 2.  While the rest of the SMEE group headed to the conference, I went to the MEDCAP since I wasn’t lecturing and I had been asked to screen a potential surgical patient.  There were SO many patients.  There were several easy-to-treat problems, but there were  many patients that we couldn’t treat effectively.  Just like in the States, it seems hard to convince people that chronic medical conditions are not curable with 1 month of medication.  In addition, some of the “miracle worker” expectations carried over with people bringing their children (peds and adults) with cerebral palsy, Down’s Syndrome and epilepsy.  There was also a woman with a huge football size, fungating, necrotic left breast cancer mass.  It was really sad.  Apparently, they don’t do breast cancer screenings, even the practioners.  There was a right infraorbital mass that was eventually brought on the ship (she underwent a huge cervicofacial advancement flap after excision of the biopsy-proven basal cell cancer two days ago).  The translators were uneven in quality- Dr. Patricia was wonderful while Desmi flat out made up symptoms up to fit her vocabulary.  It was a long, tiring day and very interesting.  After dinner, I reviewed my lectures and went to bed on the early side.   

Day 3, SMEE: I gave my lectures on pediatric airway and burns.  It went really well.  People were interested and some even took notes!  The funniest moment was when the translator “translated” my impression of a stridorous baby.  We had lunch at the Chinese noodle cafe which was pretty delicious.  Then we went to the internet cafe, I wrote Rob through another girl’s email (cue my jealousy ;o).  We didn’t go “swimming,” much to the disappointment of the security detail.  I went shopping instead and bought two recorders!  One for Melissa and one or me.  We played many songs and have several song title!  That afternoon, we hung out and ended up getting “caught” with an open beer by the bitchy AOIC.  She went straight to the OIC for the MEDCAP who told CAPT Medina, “Are you going to handle this or am I?”  Buzzkill!  We were pretty distraught at the time.  We were worried that somehow we’d ruin it for all the residents.  Fortunately, when we got back, both of our bosses were like, “Wait, how is that a problem?”  There wasn't a policy for the SMEE, boo-yah!  They also intensely dislike the AOIC.  Yes!  That night (back to Day 3), we went to the same restaurant and had a lighter dinner- I was getting tired of fried food.  That night, there was a culture show with a batik bamboo instrument band and really good Church singers.  Miss Indonesia 2010 made an appearance.  She really wasn’t trying very hard.  While a woman doesn’t have to wear make-up, you would think if you made your fame and fortune on your beauty, you’d try and work it while you had it. 

On Thurday, we finished up at the SMEE.  We toured a nursing school, went to dinner and then decided to go on a mini-Blue Bus as a group.  The first van had no sound system so we switched vans and went into our “Club Techo” van.  We toured around Singhe with our police escort close behind and bumped to some totally bitching music.  It was hilariously fun!  When we came in, Melissa and I were first and the AOIC was SO pissed that it looked like we were having fun but we made sure that she knew we were “chaperoned” and accompanied by the rest of our group. 

List o' Surgeries

That Friday, we travelled back to the ship and I got to scrub in on a superficial parotidectomy.   The rest of the surgical schedule looked like this-
Sat: BCC right infraorbital and Left parotid
Sun: Left parotid, left hemithyroid
Mon: 14 y/o male left hemithyroid 
Tues: Deep parotid tumor (amazing case on really rough seas!)
Wed: Nasal Polypectomy, Lipoma- operated with Suzi!
Thurs: Z-plasty/LASER case, lecture at the shipboard Grand Rounds, thyroid meeting with the gen surgeons and I got to talk to Mechen!

Notes from a TDY, Part 1

Before I went to the Mercy, it was a busy last week.  I ordered invites to the Hail and Farewell (way too few as it turned out).  Packing was pretty crazy but I got Asics for 20% off (yay!).  I also finally scored a Mercy ball cap which were perpetually sold out.  I went to Blue Ribbon with Mechen.  Shelby, Zen, Mechen and I had a couples date at Banker’s Hill that was crashed by Edna, Amy and Cat but was a ton of fun!  That Saturday, Jenny, Mechen, Cat and I were going to head out to the Padres game but instead hung out at the Mission brewery and a random bar in the Gaslamp for dinner.  

I flew to Guam via Seattle and Narita.  In Guam, we arrived at midnight and ended up cabbing it to the ship since there was no duty driver to pick us up.  The next morning, we went through check-in quickly and headed to the Sheraton Laguna.  We spent all day at the pool and had the best time!  There was a water slide and pool volleyball net in one pool and the most scenic infinity pool.   It was an amazing way to start and also a nice way to meet the other residents.  I only knew Suzi and Ty, two friends/classmates from med school.  We also went to the Hotel Santa Fe for dinner which was pretty awesome.

When we went underway, I took a picture of the pier where the Kitty Hawk had docked (memories!).  The shipboard indoctrination was pretty ridiculous.  Picture tons of boring lectures punctuated by complete ridiculousness from the last two speakers.  Namely, the tech guy talking about going to “ass-pounding prison” if anyone was caught looking at child porn and the video of electrocution via high-power lines from one of the safety guys.  It was very disconcerting but also, kind of hilarious in its inappropriateness.

First days of surgery in Indonesia started slowly after a pretty crazy SMEE at a beautiful, brand-new private hospital with the most mega-goiters I have ever seen. Day 1 was an EIC, Day 2 a post auricular cyst followed by a right hemithyroid.  There were 3 staff surgeons watching/giving input/”advice” which was pretty stressful.  But successful outcome! 

Road trip to WV, 5/7-5/9

After JazzFest, Mechen and I had a morning in NOLA.  We went to the WWII museum which was pretty awesome.  I had been once several years ago and not too much had changed but it is really impressive.  The exhibit narrative flows well and is thoughtful with a lot of multimedia enhancement.

The WWII museum is in New Orleans because the original amphib boat design that ultimately allowed D-Day to happen at all was based off the Higgins boat.  Higgins was a New Orleans ship-builder who built these boats to navigate the shallow bayou water.  His design was adapted to the military platform to transport in troops and equipment to the beach.

Before we went into the main exhibit, we went to the second floor where there was a special 9/11 exhibit on loan from NYC.  There were several artifacts recovered from that day in addition to personal stories of victims and survivors as well as surrounding events of the day.  By being reminded of 9/11 and the more vivid “realness” of the lives lost that day, it made it seem even more real to understand the effect and sacrifice of all the lives lost in each battle of WWII.

After the WWII museum, we went to Mahoney’s for Po-boys.  I had a fried green tomato and grilled shrimp po-boy while Mechen had a Cochon.  Mmmmm....delicious.   Then we were off to start our road trip to Mechen’s grandmother’s house.  We made it up to Nashville around 11 p.m. that night.  The next morning, we walked around for a bit then completed the trip by arriving in Dunbar, WV.  We had a delicious dinner and visited with Mechen’s Gran.  We spent the night, had breakfast then were back on the road!  We stopped in Nashville for the afternoon and had an awesome time.  We had amazing ice cream at Jeni’s.  I had salted caramel, goat cheese and blackberry and an Icelandic Skyr flavor.  Oh, deliciousness!

Next, we headed downtown to Robert’s Western World.  There was an awesome live music by Rachel Hester and the Tennessee Walkers.  Mechen also convinced me to go to Gorrin’s hat store where we both bought hats!  I was excited to get a super-cute hat that actually fit my big noggin!  After that, we were off to Birmingham to be a little closer to New Orleans before calling it a night.

The next day, we made it to New Orleans in time to meet Mechen’s cousin Scott for lunch.  We went to Cochon butcher...oh, man was it good!  Cochon was a restaurant I had actually wanted to go to but the butcher was its more informal sandwhich shop around the corner.  I had a muffelleta sandwhich and Mechen and Scott had pulled pork.  It was all so tasty.  We walked off a part of lunch by taking a lap at the Audubon Park before heading to the airport.

And that was our vacation!  Kind of on the busy side, especially at the end but it was nice to combine fun and family.  I’m not sure where our next vacation will be but I’m hoping we’ll get to do something in September/October timeframe after the Summer tourist rush.