moving on...

the move's been made, the transition roughly complete. things once again worked out in the 11th hour, and although it's not exactly what we had in mind, it'll work. and we're too tired to think up an alternative at this point.

the drive back from san diego (although i like chip's version better- sandy eggo) was looong. and hot. the central valley is really such drain, a total life suck on so many levels. it was 107 degrees. every last thing was brown. we spent 2 hours in LA traffic before heading into the void, punctuated by a near miss 10 car pileup that was super scary, but probably provided enough adrenaline to keep us awake for the next 8 hours sans caffeine. stopped in marin to visit with friends who provided the boys with plenty of opportunity to play with their numerous dolls and dollhouses (which they were totally into) and we all geeked out on pizza, prosecco, and episodes of the muppet show. it was great. we woke up to views of mt. tam and pancakes, and were on our way again, to a more scenic drive.

which provided plenty of opportunities to reflect on 3 quintessential road trip ponderings really worth answering.

1. how DO you explain to your 4 and 2 year old that you have 8 more hours worth of driving? (and then a fun game is to take bets on how many more times you'll have to explain it before the day is through. it would also make a fun drinking game except for the pit stop ratio would then increase to the point where you'd be adding hours on to your trip.)

2. an obligatory esoteric question like: given a cow's propensity towards um, stupidity, do you think they are susceptible to lonlieness? and if so, then how can CA cows truly be happy? and if they're not happy, then what are they putting in the cheese there to make it taste so good?

3. (my favorite musing thus far) who comes up with the names for RV's?? it's like the testosterone soaked equivalent of the marketing geniouses who are responsible for naming nail polish colors. seriously... a sampling i saw included "hitchiker", "dutch star", "alpine coach", "mountaineer", "windsport"....although my favorites included "patriot warrior", "kountry storm", and "leprechaun". no lie. come on kids, let's hop in the leprechaun and head out for the weekend! honey, it's time to change the oil in the patrior warrior! and do people that own these things call them by those names? i'll bet there are secret clubs.

hours of entertainment right there.

anyways
back in hillsburrito for now. took over the parker family's apartment for the next 6 weeks which will be fine. lots of peeps in the hood this rotation to catch up with. looking forward to it. and looking forward to the next rotation in the ER. day one was today. 2 thumbs way up. i think i might just love it, although i was feeling that it was borderline a little cliche to have classic textbook presentations of the following patients on day one:
1. fractured hip in an elderly woman s/p fall
2. STDs
3. peritonsillar abscess
4. migraine
5. surprise! pregnancy abd pain
6. pneumonia
7. appendicitis

minus chest pain and a good laceration or some sort of trauma, it was nearly EXACTLY what i thought it would be. so i will hope that things will continue on in this manner. cause i actually knew what i was doing and it was FUN.

which is good, cause otherwise this week has been horribly terrible. but i'm thinking that there is a light that is shining a little brighter at the end of the tunnel now. and for the next 6 weeks things will be really great. and then i will deal with another round of chaos and depression and frustration and travel to the middle of nowhere....but i suppose i'll just focus on the good for now.

the grand finale

as far as grand finales go, it was a bit odd and unexpected, but honestly, probably the highlight of my clinical experience this go around...

final eval from preceptor: "Ms. McLeod has the finest pap skills I've seen of any student in the past 3 years."

oh. um....thanks. now there's a feather for my cap. i'll be sure to take that to the bargaining table wherever i go from here.

but i only worked half day today, so as it turns out i will have time to go to the beach one more time before packing up, enjoying one final dinner with friends, and then getting up at the crack of dawn tomorrow to drive to san francisco. with an almost 5 year old who will whine the whole time. and an almost 3 year old who has just finally come around to potty training. this week. both of them now with solid, boogery colds. awesome.

otherwise, the highlight of my week was working with a number of patients that needed translators. one of whom was deaf. which brought on a story from a co-worker that evoked the best laugh i've had on this rotation...

her friend works at a high school just for hearing impaired kids. she was tutoring a girl after school one day and the girl ripped a huge fart, but went along studying without even a blink. the teacher couldn't help but laugh, and the girl looked up and asked why her teacher was laughing. so the teacher told her (all in sign language, of course) that farting is funny sometimes. the girl seemed puzzled.
she asked her teacher, "but you're sitting across the table from me, how did you know i farted?"
the teacher answered "because it made a really funny sound."
the girl was mortified. "wait a minute, you can HEAR them?"

it would be pretty hysterical to find out in high school that sort of privvied information in high school, no?

and now, off to the beach for the last time in what will probably be a loooong time. sigh. summer will officially be over as soon as we get back to portland. pics from last weekends adventures attached....surfing was a blast and pizza port in solano beach is hands down best pizza and beer in southern california. put it on your list if you're headed this way. kudos to keri and paul AGAIN for showing us such a great time. LEGOLAND was a ginormously huge hit, just as we'd hoped it would be, a superb theme park for kids of all ages. liam and camper had the time of their lives. best. birthday. present. EVER.

arrgghh

it's international talk like a pirate day, which personally i think jumped the shark a while ago but since we're in a seaside-like setting here in san diego, it's sort of hard to resist. plus, with that one sentiment (arrrrggggh) i can totally sum up my experience here.

one the bright side, i have my boys back, and all is well. we've been doing all sorts of fun exploring at the beach, at balboa park, at the maritime museum, at coronado island, visiting some friends out and about, etc. that part has been pretty fantastic. just trying to enjoy the last week here before heading back into the great unknown at this point.

and when i say unknown, i mean it. we're back to pdx but at this moment, still homeless, and then it appears we'll be shuffled off again to somewhere on the canadian border...which continues to be a twist in the plot that i can't seem to come to terms with but at some point here will have to get over. in the meantime it's keeping me up at nite and remains a total energy suck.

i've had some good patients this week, my favorite was a bush pilot from alaska who happened to be in town for a family reunion and thought to get her annual checkup. last annual checkup was 10 years ago. cause that's how they do it in AK, time and health are just sort of these vague backdrops to reality. plus, i got the feeling she really wouldn't want to know if there was anything wrong with her, cause then she'd have to go find someone to take her out back with a shotgun, cause she would rather that than have to go to a hospital for any sort of care. what a character.

everyone else i have seen confirms my suspicion that a little xanax in the water supply here would go a long way. perhaps it's the disaster this of economic times we live in, or the mad pressure to become a VIP...(as witnessed in a woman who came in who gave me- though i declined to ask- the laundry list of her very famous clients that i didn't even know, reasoning that i had to make her "better" so she could go back to work because these people NEEDED her and she would be nothing without THEM....), or have unfounded swine flu fears and are demanding tamiflu left and right...

but really, people here in general seem to be worked up about things that are mostly ridiculous. and i can understand how that can be exhausting. but silly. i long for people with real problems and who can rationalize the bigger picture. and for people who understand the value of comfortable footwear. and i'm not talking about rhinestone covered crocs, although i really REALLY wish i had had my camera for those. maybe i'm misunderstanding their smaller issue for underlying bigger ones, but still....all i am hearing is that these people are too stressed out to go to the spa 3 times a week like they usually do, now they're only going twice a week. i'm not cut out for people with "special" needs like this.

in other big news on the homefront, camper is nearly potty trained, and liam got his first set of stitches this week. smashed his forehead into some steps as he was climbing up mt. soledad. 3 stitches and a bunch of steri strips later, he was happy as a clam...until i have to take them out. then it will be WWIII. scripps memorial hospital ED was great, we were in and out in a hour. our doc was a spitting image of the sarcastic head honcho on scrubs- i don't watch it enough to know who that is, but it was a pretty amusing comparison.

beyond that, we've been highly entertained by our neighbors nightly arguments and boisterous making-of-the-looove episodes afterwards. it's better than TV. conveniently in the middle of the nite. but, at least they're not our roomates....so we can openly laugh AT them without worrying they might see it. for the most part, our condo complex is pretty quiet and serene...with the exception of, of course, the people that live RIGHT next to us. so when camper throws a tantrum, we put him on our bed and let him shake the headboard, scream loudly and work it out. for as long as it takes.

someday we'll get it right. in the meantime, it's more rolling of the housing dice, another spin of the moving roulette wheel. T-minus one week until we get to play again! whoohoo!

surf's up...and we're headed out to the beach at del mar to jump on some surfboards with paul and kerri this afternoon, who really have saved the day in terms of us getting to know san diego in a much better way than we would have ever found on our own- followed by LEGOLAND tomorrow. we haven't told the kids. i think we'll just get in the car and pretend to get lost and just show up in the parking lot there and let them figure it out. hoping for a huge kodak moment.

guilty conscience

i'm sort of starting to develop this weird sense of guilt about all the fun i've been having...NOT in clinic. although, this time around, clinic is so bad that really, i deserve every decent moment otherwise...

this is the start of week 3 in san diego. huh. it's been such a weird time so far, it's hard to wrap it up. anxiety and depression might be a good place to start. which seems like odd concepts for me to be grappling with, as they pertain to me.

anxiety as in i can't seem to say or do anything right in clinic, it's all misconstrued and comes out wrong and i look like an idiot. and then i try to make it better by saying something else or changing the subject entirely. which then also lands flat. depression as in what i just said, now famously in print, mirrored in my eval. that came a week early, and with the punch line, "but it's not too late to pull your performance here out of the gutter..."

and there it is. the doom and gloom of performance anxiety gone horribly, horribly wrong. we have a tumultuous relationship at best, my preceptor and i. basically, we just don't talk. i've moved out of his office and into another space just to get away from the silent treatment. it's really no good. i don't know what to do about it. how can everyone else be so great and he is just...not? give me a few days and it will be funny. but right now, i just feel stupid.

fortunately, it's buffered by drug reps hawking delicious goodies and the occasional somewhat interesting schpiel...sometimes twice daily. (lunch and snack time!) there are 3 day a week catered breakfasts for staff.

one doc pulled me aside, giggling madly, and asked me how i've been enjoying my time here so far.
"well, i've not gone hungry, that's for sure", i told him. an honest answer, the best i could do.

"i KNOW!! it's just like camp, only better. i can't believe how much they're paying me and then they feed me too!"

camp scripps. add in mandatory nap time, and this place would be the pinnacle of professional acheivement. they could probably cut salaries in 1/2 and still have a waiting list of employees dying to work here. everyone should be so lucky. everyone should be so deliciously delirious about the simple notion of empty calories...and equally unashamed to show it in mad giggling fits too! i love it. today it was jamba juice. i'm secretly hoping for another round of mediterranean food. the felafels with the cucumber yogurt dipping sauce were fantastic last week. and since we've digressed here, i must say that i could eat fish tacos every nite and be happy. that slot was previously (and hautily) occupied by only sushi and pizza. they'll just have to duke it out for my gastrolove now. nothing like a little fish tacos to beat down my inner wannabefoodiesnob tendancies.

i've been walking to the beach everynite, figuring out the scene at all the beaches in these parts...none are really all that great, but i have finally landed in pacific beach for certain, towards the bay side. it's ok. whatever. i was sick of looking and it was cheap(er) than most. ben is so excited for his slice of melrose place. the sunsets have been great lately due to the fires in LA clogging up the skies and providing lots of cover for the sun to bounce off of.

and went riding bikes with megars this weekend, which was superfun...followed by a dip in the ocean, fish taco heaven, and wine on her deck watching the sun set over san clemente. it was....the gooey center of a reward already encased in the outer shell of happiness. good times. thanks megars! and also, was reminded by the media and my ride, that pretty much all of southern california is desert, plain and simple. hot, hot, dry tinderbox desert. green things amaze me at this point.

and...that's it. nothing more. the climate is vapid, and so are most of the peoples in these parts...although to be fair, i've landed in party central, so this is all in passing, soberly observation based. i'm sure it's WAY more fun to live here if you are none of those things. i've been doing a lot of reading. got a library card so i've been hiding out there a bunch (classic CA...a better movie selection than anything else)....and just hanging tight. the boys get here this weekend. i cannot wait to squeeze me some babies. it's been a looong time and i am starting to feel adrift...but i know when they get here that will be that and i'll really really start to enjoy my time, both being on the downward slope of putting this rotation behind me, and teaching them to boogie board. and possibly just cooking up a little secret birthday surprise for my liam at legoland. he's gonna blow a gasket.




and that's all i've got in this momentary morose state of mind. 'spose i'll shuffle off down to the beach now to be reminded why people want to live here. cause otherwise, fun to visit but.........yeah.

transported

oh MAN. where to begin? the last 2 weeks have been insane. but in a nice warm fuzzy way. except sometimes i get a little concerned when i get in that zone and things just seem to happen, and the next thing you know, boom- i'd driven a thousand miles and have arrived in san diego like nothing really happened.

which nothing really does on the I-5 corridor. so.. its not unlike waking up from a bad dream and finding yourself in a strange place- mentally, emotionally, physically. just wipe off the drool and start over already. cause hitting snooze is not an option.

i wrote out a fun list of road trip observations, which i now can't find...and the only thing i remember is basically that coyotes win the darwin award in california hands down....more roadkill than any other species as far as i could tell. although the mostly dessicated cow got bonus points for the most original roadside carcass. i'll try to find the list, it was funny at the time.

spent a fun week catching up with classmates in hillsboro, listening to lectures, pretending to care, trying to get ramped up for internal med and failing, and celebrating graduates and new white coat wearers. there was cake. and wine. it was good.

spent the weekend prior to PPS at the coast with a few amigos participating in some surfing/camping hedonism. what a wonderful thing to drive from the desert up to the mountains, into the city, and out to the beach in a few hours. that is what the west coast is really all about. the best of all worlds. it was a delightful weekend. the blue room was a big hit. audzz and i got to hike up a fun little peak that overlooked pretty much the entire coastline south of cannon beach with a cool knife edge ridge up top. and i got to sample salmonberries along the way, a first. favorite quote of the weekend from chip- "i'm no marine biologist, but i'd say the water is warm, the sealife is onshore...you would think there would be more sharks...." and then there were.... in seaside, a few communities north, where everyone was called out of the water for that very reason. the water WAS warm- hit up a few swims sans wetsuits....but with one on, i think i could live in the ocean indefinitely. minus the shark thing.

and then my rockstar mentee put us up at her place for a week- tanya you ROCK! and we were able to go get our bowl on, hear some decent bluegrass, and then have a danceparty at the one but not only dive bar in hillsboro. that was some good times ladies. and you know who you are.

and then, boom- somehow got transported to san diego- and internal medicine at scripps. which as a facility, is pretty awesome. probably the most expensive real estate holdings of any hospital in the world, hovering above the torrey pines golf course which hovers in turn above the pacific ocean. so far, so good- getting to see and spend as much time as i want with all my patients.

which is good cause although i was prepared for the basics, HTN, hyperlipidemia, DM....i was not prepared for manic depressive alchoholic myasthenia gravis guy, cute little old esophageal cancer man with too many mets to treat, and non-hodgkins lymphoma dude who had bigger fish to fry with his CHF. i've been reading more than anything in the past 2 days, trying to make sense of this stuff. although i did have 2 whole patients today who had NO complaints, took NO medications, and were your basic happy go lucky southern californian types. just wanted an annual once over. amazing.

btw, it's a little weird when your patient is wearing an outfit that costs more than your yearly graduate school loan stipend. even weirder when you open your eyes and look around and notice that everyone in view is wearing sunglasses that cost more than your car.

but whatever. i'm going to let this whole so-cal attitude thing wash right over me. THIS IS NEVERLAND. get with it, mcleod. embrace it. now, if we could get rid of this marine layer crap and get on with the summer at the beach thing, life would be perfect.

survival of the fittest

it's been a long week without anyone (of interest) to talk to....

but on the bright side, fighting off boredom has become the task of my bike, and my bike alone. i know this for sure after attempting a run earlier this week and failing miserably. it's just been too stinking hot lately. it's like running in an oven. i hear that even the locals are getting a little fed up with the 90+ degree days at this point, which makes me feel better. i'm not as big of a pansyass as i thought, hurrah! the past 2 nites we've been graced with beautiful thunderstorms, making for decent sleeping weather AND a free car wash...a welcome bonus.

so between the boredom and the frustration of living in a house with the least bend-ish person i can imagine who drives me absolutely insane, i've been spending a lot of quality time on 2 wheels. it's my new part time job, really. it's pretty awesome.

today i ventured out on a hutch's bike shop sponsored ride...if you're in town and need anything pertaining to bikes, go see them, they are sooo good to their customers. $5 for a 50 mile ride- the cascade lake loop. i did it because it was cheap, i didn't have to carry food- their rest stop was top notch, and i thought maybe it would be nice to chat with some like minded people, ride with someone for a change. i had heard that the hutch's crowd were a force to be reckoned with, but whatever. it was 50 miles. i had all day. in fact, the longer the better cause i sure as hell didn't want to go home and get another lecture in anime. so i envisioned a quiet, long, relaxing ride.

yeah right.

seriously, does anyone in this town cruise under 25 mph...uphill??

granted, i found out later that 2 of the guys riding were just off the tour de france, so i'm sure it was a full out sprint for them. but the thrill of getting to boast that i rode in a group with tour riders was immediately lost when they dropped everyone pretty much by the end of the parking lot. it was a brief 2 minutes of fame. and while i had nothing to prove, it did sort of suck to be dropped by pretty much everyone else within the first 5 miles or so. but it did fulfill that vision of a quiet, relaxing ride. until the last 10 miles (bonus!! it was actually a 60 mile ride...surprise!!) that were all uphill, 5-9% grade...and hot. by the time i got back up to the summit at mt. bachelor i could hardly see straight. highlight of the ride was having a little blue butterfly land on my handlebars for a bit while i was drudging uphill. that should give some sort of indication of how slow i was going... meh. but i made a bit of a recovery when it was all said and done and decided that a swim might cure the double vision, so i headed over to todd lake apres ride and did just that, which totally did the trick. at that point, the thunderstorms were beginning to roll in again, and i resigned myself to going home, hoping to avoid my roomate once more because i didn't want to hear anymore about how wonderful her cat is. in baby talk.

i can't stand that cat.

so i took a nap instead. and then i avoided her some more since i could hear she was watching a movie. she is the kiss of death to any sort of movie enjoyment. i tried (really really hard) last nite to watch one with her. she told me when to laugh. i pretended not to hear her. she asked me why wasn't i laughing because it was really funny. it wasn't dark enough to roll my eyes, so i pretended i had a phone call that i had to take. (like that ever happens to me).

***but if anyone out there has EVER had a reason to call me, this next week would be really good timing. the best. really. truly. make an effort, people. i'm nearly begging.

yesterday was a similar story, trying to find something that would keep me out of the house from morning till nite. i decided to check out green lakes, not because i really wanted to- it has the reputation as being the most overcrowded spot in the 3 sisters wilderness area- but because i figured everyone else talks about it, i should know what they're talking about. just this once. it's like going to yosemite valley. hard to resist despite the fact you don't want to admit to doing it and adding to the cluster.

so i hiked up the fall creek trail, the wildflowers were unbeliveable, the waterfalls stunning, the bugs unbearable. not too much foot traffic, actually, so not very dusty, a pleasant surprise. got up into the green lakes basin- very nice alpine lakes, not the most amazing i've ever seen, but still nice. hiked up to play in some snowfields on south sister. went for a swim. had a picnic lunch. enjoyed the bug free breeze. didn't actually see all that many people. good times. hiked back down just as the thunder and lightning started. went home, fixed up my bike for today's ride (new tires, whistle whistle cat call) and watched it pour rain.

and now i'm back into the avoidance holding pattern. there's (horrendous) music playing in the living room, and she is singing along at full volume. she does this a lot. i suppose i should be glad for the distraction of background music that's actually in tune this time. i suppose i should also be glad that (as far as i know) she has not yet cast a spell on me since she's a witch after all. she told me so with great fanfare. it was another important phone call moment for me.

i seriously could not make this up if you paid me. it's that good. for one person to have so many annoying qwerks is almost mind blowing.

or miserable. but tomorrow's monday and it's back to real work. the kind that will hopefully be better than the last 5 weeks combined. fingers crossed...

action packed

sadly, this rotation is now officially a wash- i just can't seem to convince anyone that i can see patients. on my own. so, it's more of a shared affair, a threesome where generally at least one of the particpants is totally unwilliing. sometimes more, and then it gets weird. but mostly it's just bump on a log boring. at this point though, i figure i've got nothing left to lose, so i can be as pushy as i want. i like everyone there, i just can't understand why they've chosen dermatology as their career.

oh wait.

because they live in a mountain town mecca and have stupid amounts of time to spend enjoying it.

surely that must be it, since i cannot for the life of me figure out any other reason. so i'm gonna go with that...in which case i better ramp up the enjoyment part for the remaining 2 weeks. last weeks enjoyment menu ran something like this:

thursday nite: one last family munch 'n music fest, complete with elephant ears and reggae.

friday: went to check out the cascade classic up at mt. bachelor, a pro bike race in town with some big names to go watch...floyd landis, levi leipheimer (out with a fx wrist, i heard) and the winner of the stage we watched, oscar sevilla. ben rode up from town and got to cross his own finish line and then ride back down with the pros. then there was some packing up the boys for their journey back east and doing some riding around town on bikes to find mexican food and cold beer. success.

saturday: drove up to portland to be a taplister ambassador at the oregon brewer's fest. ben lined it up since it involved of his 2 favorite things- beer and iphone gadgetry. free admission and free beer as long as you twittered like mad and went around chit chatting it up with people. i bailed at the last minute, which ended up being the right decision based on the heat and crazy drunk people factor. i spent the afternoon playing with the boys, which was delightful. lego mania. good times.

then we went to this INSANE crawdad fest in NE portland with our friend bryce- which was pretty much the best.party.EVER. live cuban music, heaps and heaps of crawdads (toasted my n'owleans peeps- fred, amy and shay- of course- with ice cold PBR you can pretty much toast every last person you know and still stand upright) vats of cold beer and large quantities of watermelon....and the quintessential peach and berry cobblers rounded out the smorgaasbord. it's a house/garden party this guy throws every year, just for fun. i will now aspire to hold such a party. it was amazing. and his garden was unbelievable. total sight to behold on all fronts.

then (sniff) dropped the boys off at the airport for their red eye back to boston (smelling pleasantly of spicy crustaceans)...very sad. (for me, not the other passengers). 7 weeks of familylessness. on one hand, i'm sort of excited to be completely spoiled in do-whatever-i-want time, but coming back to bend without them really sucked. walking into our room and seeing their stuff there without them hit me hard. no one to cuddle with, no giggling, no little boy bodies running around like crazy...
digression done.

to cheer up, i went to stay with erica and phillip for the nite, which was super fun. met them at a friends post wedding gathering and chatted with some fun people. got to taste test the deschutes new gluten free beer- good news abby, it's DELICIOUS!

sunday- decided to tag along with erica and phillip and friends up to frenchman's dome to go climbing. it's been a loooong time, which was immediately and quite pathetically felt. i thought it would all come flooding back, i mean, shit... i used to climb for a living. turns out, it's gonna take some more poking and prodding before i feel the way i used to about it. but i had a super fun time despite the fact i think i was brooding the whole morning about the boys being gone. the view of mt. hood from the top of the crag was pretty stunning. and it was shady with a nice breeze, not something to be taken lightly on a 95 degree day. the company was super fun- a few folks from the previous nite, AND i got to meet boone speed, a famous climber whom i've read about for years and years...so maybe now i can give up looking for lynn hill in bend's nooks and crannies. one climbing celebrity just might do it.
then i drove back down to bend in some sort of weird daze and when it cooled off a bit at 6:3opm, i went for a 2 hour bike ride out mt. washington road and all around, just sort of riding...cathartic healing. and it was goooooood. have i mentioned i love this town??

and that's my plan pretty much. wake up, eat, work, bike, eat, sleep for the next 7 weeks. maybe try to find a decent swimming hole every once in a while. cause i've got nothing else to do or anyone else to take care of. just me. and if i think about it for too long i'll get bored, lonely, or sad....and chocolate only cures one of those afflictions. so...yeah. it's just me. huh. weird.