Bring it on!

In case you are curious I am nauseous, terrified and excited about starting residency in the morning. I feel entirely unprepared, which is ok because everyone does. It has been great spending these days with the other surgery interns, realizing that we are all in this together. Here are the things I am most concerned about:

• Responding to every code in the hospital (when a patient is actively dying). I am not ready to run a code. Since I'm in the ICU that should change quickly.
• Breaking bad news. I feel entirely unprepared to tell families that their loved one has died. Once again, since I am in the ICU I will get a little more rapid introduction to this difficult part of medicine. I can only hope and pray that God's love will shine through in those times.
• Being on call. I don't pull all-nighters regularly. I made it through college and the first two years of medical school with at least 4 hours of sleep every night. Even as a medical student when we were on call we typically slept a little. The one time I have truly stayed up all night in the hospital I fell asleep standing up in the OR, I cried like a baby when I misplaced a sheet of paper.... Now I need to stay up for 30+ hours and actually be mentally aware enough to make important medical decisions.
• Being on call and being paged about both medical and surgical ICU patients. I am training to be a surgeon which involves quite a bit of medicine, but the medical ICU patients are a completely different beast. Not more difficult, just different.

I can't wait to see how God more than compensates and redeems my weaknesses and shortcomings. I am beginning a 5+ year journey tomorrow that is what I have dreamed about since I was a little kid. I wish everyone could see the smirk on my face that I will inevitably have tomorrow when I introduce myself as "Dr. Qualey" for the first time.

What I've learned from orientation

Now that orientation is well underway here are a few things I have realized:

• I am in way over my head
• My responsibilities are beyond what I am capable of
• Since I am the intern on the ICU team I am responsible for going to every code in the whole hospital...a hospital that is a maze and currently beyond my understanding (probably because whoever came up with the "floorplan" was drunk and high at the time). I will be the white blur running around at 3 am trying to save someone's life.
• I will spend the next few days understanding the "floorplan" so that I can promptly find the room of anyone in need of my services
• I actually think I could do a surgical airway if needed
• I am incredibly excited to be at IU surrounded by residents that I already know and for the most part enjoy
• The intern class rocks! There are 4 girls (all from IU and super fun and reasonable people) and 5 boys (2 from IU and three from other schools). We are about to share a whole lot of insane memories together.
  
• My baseline blood pressure is elevated due to my nervousness of all that is to come
• God is good. I have never been happier about being at IU. It has been a blast getting to know residents and faculty better.
  
• I will always have backup. While it is terrifying, the patient care will be just as sound as ever as there are tons of doctors, nurses... who understand that July is a volatile time and they are ready and willing to help.
  

Graduation Part Two

As promised I have much more to say about my recent graduation. It was truly the most incredible day of my life. I have wanted to be a doctor since I was in early elementary school. I used to tell my teachers and parents that I was going to be a heart surgeon... when I was seven. 18 years later and I am a week away from being a surgical resident. I'm not sure if I'll become a cardiothoracic surgeon (it's amazing how the medical community has a fancy way of saying just about everything), but it is one of the options I have thrown around quite a bit.

So on May 10th when they introduced me as "Doctor Angela Hope Qualey" for the first time it wasn't simply a catchy title, it was the realization of my dream. I was a little emotional when I was on the stage, but not as much as I anticipated. Despite being on a beta blocker my heart was still racing. Kelley's dad, Dr. Schreiner, the chief of Riley Children's Hospital gave me a hug on the stage and said a few words to me that I won't soon forget. I grabbed my diploma and ran off the stage before they could change their mind. Not really, but I did check to make sure they really put my diploma in the cylinder.

After everyone received their diplomas we recited the Oath of Hippocrates which was very meaningful for me. I took it seriously. I didn't mindlessly regurgitate the words. I am honored to be the keeper of secrets for my patients. I know things about patients that they've never told anyone. I am honored to treat all patients equally.

The most emotional part of the ceremony was the very end when they had us stand and they introduced us as the class of 2008 and the crowd went wild cheering for us. I ended up sitting right across the aisle from my family and friends and so I was able to look them in the eye as they cheered me and my classmates on and it was incredible. I felt God's pleasure and love in a palpable way through them. God is good!

After a lengthy photo shoot we went for a nice lunch at The Capital Grille in the Conrad Hotel downtown. I took the opportunity to introduce everyone, say a few words to each person, and pray for our meal. It meant a lot to me to take that time and attempt to honor each person there who has had a significant role in my life and in helping me successfully graduate from medical school. My parents, Rigel, uncle Brad, Dr. Schreiner and Kelley all gave wonderful toasts. My cousin Brad sang a beautiful song. It was a really special time with family and friends.

After that we had a casual evening of Scat (a card game my family plays often-they even have a website for it), pizza and presents.

I am so thankful for my friends and family who traveled from all over the country to be together and celebrate. I couldn't have done this by myself. The journey has just begun and I am surrounded by the best support system imaginable!

The Long White Coat

I just got my long white coats with Angela Qualey, M.D. embroidered on them and it fills me with fear and incredible joy. For those of you who don't spend your lives roaming around academic medical centers, the long white coats are for doctors while medical students wear the shorter, far less flattering and uncomfortable ones. Seriously, I hated my short white coat. It looked even worse on men, but I avoided wearing it whenever possible. It didn't help that they gave us one that was to last us for two years. I am cheap and refused to pay to have it cleaned and I am also lazy and so I rarely cleaned it. It became a petri dish that I am sure would provide instant immunity from everything to any newborn who was wrapped in it. I pondered saving it for such an occasion, but decided against it. Now I have four coats that will be dry-cleaned whenever I want on the surgery program's tab and I will get several more coats every year.

Life is good. Well it is for another week until I introduce myself to my first patient as "Dr. Qualey" and write an order in a chart that doesn't need to be cosigned before it is put into action.


One of the best things said at graduation was that "society expects a transformation to have taken place". Somehow on May 10th when they gave me my degree and called me "Dr. Angela Hope Qualey" a magical shift took place and I became competent, professional, and everything else you expect of a doctor. I assure you that there is a ton that I don't know and I'm still working on the professionalism (I did have a patient tell me I was treating him like the Jews treated Jesus). These next few months will be some of the hardest in my life (or at least that's what everyone has told me), but I will learn more in them than ever before. In the meantime I've got a few more days of vacation before orientation begins. Let the good times roll!

Texas

I just got back from a wonderful week in Texas. I had a few days with Rigel. He took me to a ranch on the Llano River where we kayaked, learned how to fly fish/got yelled at by the instructor for my poor form (I caught 3 fish thank you very much), talked a lot and shared some high quality time together. He also made a very impressive dinner on the grill. We went out to dinner with a couple that he is good friends with and attended his midweek church service where John Osteen (Joel's brother who is a surgeon) spoke. It was great!
Then I spent a few days with Heather. We went to Schlitterbahn, a waterpark to try and enjoy the Houston inferno. The Tidal Wave River was fantastic! We spent lots of time talking, eating, and laughing. Sorry we didn't take a single picture.
Thanks for a great week Rigel and Heather!

Home Ownership

I am 10 days into being a home owner and I must say I am loving it! Here are some of the highlights:

• I can sing at the top of my lungs without worrying about innocent bystanders
• I truly have the best neighbors imaginable- they are all friendly, they have regular cookouts and parties, they sit on their driveways and talk most evenings, and one neighbor is mowing my yard, doing all the trimming, leaves... for a case of beer per year. Yes, that's right. 1 case per year. I will find additional ways to compensate him, but I already bought him his case. He helped hang my shower rod and trimmed my hedges tonight as well. In the winter he plows out our whole area as well. A single girl with no practical skills couldn't ask for a better set of neighbors!
• I have a garage. My car is a reasonable temperature when I get in it, it isn't getting pummeled with hail, and I won't have to scrape snow in the morning. Plus I have lots of storage space there.
  
• My new furniture is amazing! Seriously my sleep number bed is out of control. I still have decorating to do, but I'm not in a rush.
  
• I have a yard to enjoy. I can lay on my hammock or sit on the bench swing and read a good book.
  
• I get to kill spiders on my own. I didn't have them in my high-rise apartment and growing up I had my parents kill them, but now it's up to me unless I am ok with cohabitation. So far I've had 2 unfortunate encounters, but I won them both and am growing less squeamish.
  
• I have plenty of room for visitors. So far it has been a revolving door of guests and I love it!
  

Traveling with Kay

It was really neat to spend some time with Kay Arthur during our trip. Several years ago I would have idolized her or placed her on a pedestal, but thankfully I now realize that she is just an ordinary person being used by God as she is obedient to Him. Due to the overwhelming amount of studying of the Bible that she has done I have a lot of respect for her insights and understanding.

One day in Jerusalem I was with my group at what seemed like the 100th excavation site that we visited. It wasn't really that bad, but our tour guide was a walking encyclopedia and I am just not that interested in old rocks. He kept using the "E" word- excavation. I had a sudden urge to just leave. I can't explain it, I just felt the need to get away. So I decided to just leave the group and take a break by myself. As I left the area feeling like a total slacker it so happened that I left the site just as Kay Arthur was there and needing someone to walk with her and carry her Bible to the next teaching site. So as everyone else was enduring a long discussion on the significance of a pile of stones I was escorting Kay around Jerusalem and talking with her about God and medicine and miracles. She was a nurse as a young woman, so she had a great perspective on medicine.

We talked about the power of prayer, and if it really matters to pray for someone to be healed. The basic premise of what she shared with me is that of course prayer matters and God does perform miracles sometimes. It is also possible to think we know what God wants to do and be completely wrong. She told me that she felt the need to pray for her dad to be healed and so she did and then her dad died. She said she obviously misunderstood God on that one. I really appreciated her honesty! We talked about the "name it and claim it" theology, which her and I both believe is not Biblical. God isn't a vending machine and He certainly isn't going to be strong-armed by us. I personally would rather have God's will than mine for my life. God knows far better what I truly need and what is best for me! We discussed the often used passage, "by His stripes we are healed" and how people often use this to think we should be physically healed when that passage and the context make it clear that it is about God healing us spiritually from our sins through His death.

All in all, it was a really neat conversation as we walked around Jerusalem. Her Bible was heavy and full of markings! I am so thankful for her obedience to God. Watching and interacting with her makes me want to dive into the Bible at a much greater depth to truly get to know God better, not just have an emotional response to what I read.

Mom is Afraid of Camels

One day we had lunch at a Bedouin (nomadic desert dwellers) place. It was really neat. They had camels and goats all over. In fact, one donkey gave birth while we were there. It got fairly uncomfortable to sit on the ground eating, but it was well worth the experience. While there, I wanted to get a picture of mom and I in front of some camels. She was hesitant. I think she was afraid of a camel spitting on her. I convinced her to stand with our backs to them long enough to get a picture. Right after this shot was taken, I grabbed her butt in a way that I thought was similar to a camel-bite. I have never seen her move so quickly. It was hilarious! Thanks mom for being a good sport!

Mt Carmel

While in Israel we visited Mt Carmel which is where Elijah met with all the prophets of false gods to see whose god would send fire (1 Kings 18). Not only are the views breathtaking from the top of the mountain, but it was incredible to read about Elijah's faith as he taunted the followers of Baal and Asherah. I kept thinking of a quote that I heard during some message, "Stick your neck out for God and watch the Holy Spirit defend your testimony." Elijah stuck his neck out big time and God came through in power.

The second picture is where I stood as we sang "Days of Elijah". It was an incredible time of remembering God's power and faithfulness.

One Prayer

I am really excited about the One Prayer movement in churches around the country this June. For those who haven't heard One Prayer was started by Lifechurch. Over 1,000 churches across the country will be watching messages delivered by pastors at various churches addressing their one prayer for the Church. I'm not sure if us common folk are supposed to, but I logged into the One Prayer pastors site and have watched some messages. So far they have been incredible and very thought provoking. I plan on watching many more in the coming month.

Today I watched one from Steven Furtick at Elevation Church. His prayer is for God to make us audacious. He spoke from 1 Samuel 14. The point that stuck with me most came from vs. 7 where his armor-bearer said, "Do all that you have in mind. Go ahead; I am with you heart and soul." That empowered Jonathan to truly follow God and lead them wherever he believed God wanted them. Do we have this mentality in our churches with our pastors? Do we allow them to lead boldly? What would it look like if pastors around the country knew they had the freedom to truly follow God's leading with their church without concern for pleasing those who resist all change?