Thankful

I just finished a relentless week of being on call every other day and am now rewarded with a week off. The week was full of penetrating trauma (stabbings and shootings). Not many happy outcomes and very hard emotionally, but I felt privileged to minister to the family and friends. Not a typical Christmas, but an opportunity I am thankful for.

In other news, I have a whole new appreciation for my health. I had the biggest health scare of my short life a couple of weeks ago. Everything is ok, but for a few days I faced my mortality in a way I hadn't before. Through the process I have learned the value of not making patients wait over a weekend for test results if at all humanly possible.

Enough of the heavy topics. South Bend here I come!

Primal

I just finished reading Primal by Mark Batterson. The essence of this book is an exhortation to return to our first love for God: "Go back to that place where God opened your eyes and broke your heart with compassion for others. Go back to that place where the glory of God flooded your soul and left you speechless with wonder. Go back to that place where thoughts about God filled your mind with holy curiosity. Go back to that place where a God-given dream caused a rush of adrenaline that filled you with supernatural energy."

He then breaks down our love for God into the four components Jesus spoke about in Luke 10:27, "Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind."

Here are a few of the thoughts from each section:

Heart:

• If you are in Christ and Christ is in you, you cannot be okay with suffering or injustice or starvation.


• It’s much easier to act like a Christian than it is to react like one. Anyone can put on an act. But your reactions reveal what is really in your heart.


• Establish an income ceiling. Most people spend more money as they make more money. Their standard of living goes up in direct proportion to their income. What if every Christ-follower gave away everything above and beyond their predetermined income ceiling?

Soul:

• Awed silence in the presence of divine beauty is a form of worship that is often deeper and truer than sung words.


• The Bible is not an end in itself. In other words, the goal of knowing the Bible isn’t Bible knowledge. The goal of knowing the Bible is knowing God. Anything less is bibliolatry. The truth is that most of us are already educated way beyond the level of our obedience.

Mind:

• Learning isn’t a luxury; it’s a stewardship issue.


• God wants to sanctify every part of your mind for His purposes: sanctified logic, sanctified intuition, sanctified imagination, even a sanctified sense of humor.


• God doesn’t just want you to worship Him; He wants you to know why you worship Him.

Strength:

• God loves it when we break a sweat serving His purposes.


• Anything less than leveraging all our strength for God’s purposes is boring at best and hypocritical at worst.


• God ideas don’t become reality without some blood,sweat, and tears. Oh yeah, and loss of sleep. But that’s the true test of love, isn’t it? If you love someone or something enough, the expenditure of energy isn’t seen as a chore. It’s a privilege. It’s not something you have to do, it’s something you get to do. Love turns work into worship.

Here are a few other quotes:

• Which do you love more: your dream or God? Do you love God for what He can do for you? Or do you love Him for who He is? In its purest, most primal form, loving God with all your heart, soul, mind, and strength is loving God for God. Nothing more. Nothing less. Nothing else.


• The impact God has planned for us doesn’t occur when we’re pursuing impact. It occurs when we’re pursuing God. -Phil Vischer, creator of VeggieTales.


• How much happier you would be, how much more of you there would be, if the hammer of a higher God could smash your small cosmos. -G.K. Chesterton


• Let God be as original with other people as He is with you. -Oswald Chambers

Check this book out!

Professionalism

When I decided to become a surgeon I knew I would have to work with some doctors that were more difficult to work with. I have been fairly fortunate to this point to be sheltered from some of the uglier sides of these individuals. I guess I've graduated to the uncensored side of surgery.

In the past week I have witnessed the 3 most horrific displays of a lack of professionalism among doctors that I've ever seen. All 3 were in the operating room and 2 of the 3 happened during the same 30 minute surgery by both the anesthesiologist and surgeon...with a 3rd year medical student observing it all (and nearly getting hit by a flying instrument). I'm still not quite sure what to do in these situations. My MO so far has been to just ignore it and keep working (and laugh about it endlessly afterwards with other residents). All three were basically huge temper tantrums by doctors. They all ended up looking like adult children with serious issues. Any suggestions on what to do when my staff doctor is screaming, throwing instruments, kicking people out of the OR...? The good news is that I have never been the cause or focus of the anger. Either way it is an incredibly awkward situation.

Giants

Everyone needs to check out the blog post, "The Wet Wipe Warmer Incident" by Rob Wegner, the Pastor of Life Mission, at Granger Community Church. Rob and his wife Michelle have had a profound impact on my life. They were the leaders of the youth ministry when I was in 7th grade and wondering what Christianity was all about. They were there when I gave my life to Christ, felt God's call to the mission field, went on my first mission trip, and countless other milestones in my life. Needless to say I love them, have tremendous respect for them, and can't wait for the day when I can be more involved in the incredible work God is doing through GCC in India alongside them.

Please read the post by Rob. It has been banging around in my head for days as I remember the battle I'm meant to be in and how easy it is to get distracted. Thanks Rob!

Colts Game

I took Tara to the Colts vs Titans game for her birthday. It was kind of selfish really since I wanted to see them play, but it worked out well for both of us. The warmup time before the game was actually more fun than the game since we could stand in the first row and really see the players getting ready for action. My foam colthead did not disappoint (thanks Kerwyn!). Tara's blueberry face was great as well- it was supposed to be blue on one side and white on the other but go figure white facepaint doesn't work well on a white person. So instead she resembles Violet from Willy Wonka.
The only bad part of the day (but also very comical) was the lady behind us who was hacking up a lung through the whole game as she shouted, "Be there" with every Peyton Manning throw.
I'm even more of a diehard Colts fan after the game. Superbowl here we come (preferably vs. the Vikings just to rub it in with the family).

Surfing?!?

Heather and I had a 2nd attempt at surfing. Here is some of the video evidence. Enjoy!

Surfing Divas

Heather and I are having a great week in sunny San Diego. I could live here. We went surfing for the first time ever a few days ago. The surfshop that we decided to not rent equipment through was called, "Surf Divas" as that name seemed ridiculous to both of us. Instead we rented surfboards and wetsuits from some random place by the coast in La Jolla. I think my body has finally recovered from that beating. It was a blast. By the end of the two hours we were able to stand up on some decent waves (3-4 feet). I think I disrupted the peace of others as everytime I successfully stood for any length I threw my arms in the air and shouted "booyah" or some similar term of euphoria. This picture is us after dragging ourselves and our boards back to the shop.

I think we'll go back in a couple of days. While we are there they have a mile-long open water swim course in the ocean that we'll give a go (or at least part of it). Unfortunately Heather is the stronger swimmer so if one of us goes down by a shark or stingray it will probably be me.

Vacation!!!

I am heading to San Diego in the morning with Heather, my college roommate. I am so excited for the trip. I am excited to spend time catching up with Heather, roadbiking, learning to surf, sleeping, sitting by the pool, walking along the beach.... All in all it should be a great week.

It has been 7 months since I've had more than a 3-day weekend. I operated today with the self-proclaimed Bobby Knight of our residency. And I survived with at least a shred of dignity intact.

Looking back on this long stretch I think the thing I am most thankful for are the relationships I am developing in the hospital with other staff members. I'm not a name person, but I have really made an effort to learn the names of the people I work with. It's tough because I work at 5 hospitals and on several floors of each hospital. It is worth the effort as I truly am developing friendships with lots of nurses, secretaries, cafeteria cashiers, care coordinators, scrub nurses, nurse aides, housekeepers.... It makes long hours at the hospital much more enjoyable and meaningful.

While I look forward to reconnecting with some of the staff at Methodist when I return, I am not going to wish away a moment of this week of vacation. It couldn't have come at a better time. I can't wait to get away with Heather. I guarantee that pictures and fun stories are to come!

Target practice

I'm loving my thoracic surgery rotation. I'm not sure if it is simply that I enjoy big surgeries or what but I know I am an adrenaline junkie in the OR. Here is my sketch of the area I was sewing in the other day (forgive the rudimentary sketch- it's hard to translate 3D to microsoft paintbrush).

It is so fun to not be the intern anymore. I actually get to operate a lot and am quickly improving my ability to sew in holes with important structures all around me.

As I was sewing a bronchus shut in the OR I chuckled to myself realizing these 3 structures were all within a centimeter or two from my needle and scalpel. I LOVED IT! Oh... and the patient is doing well.

Upcoming concerts

I am really excited for a couple of concerts I am going to see in November- Chris Botti and Joshua Bell. Both are graduates of the IU School of Music. Chris Botti is an unbelievable trumpeter and Joshua Bell a violinist. Here are a couple of samples of their performances. I can't wait!





Joshua Bell plays a 4 million dollar Stradivarius violin (pretty similar to the violin I possess). Gene Weingarten won the Pulitzer Prize for an experiment and resulting article in which Joshua Bell performed in the DC commuter station dressed in street clothes. It was a fascinating social experiment that you can read here: Pulitzer

The value of flu shots

Last week I received what I intend to be my last flu shot. Everytime I have received one I get sick afterwards and this is no exception. It has been the gift that keeps on giving for the past week. I know it may help prevent me from transmitting it to patients but what about the illness I have had for the past week that I've been walking around the ICU with? Sure I could stay home in theory but that isn't how a surgical residency works. The thought that maybe I have swine flu has certainly occured to me. And that brings me to my next topic.

Seriously I think someone is going to have to put me in 4 point restraints if they want to vaccinate me from the swine flu. Swine flu isn't a joke, but neither is getting injected with random stuff that's never been tested on people. I need to do more research to give a truly educated opinion but from what I have read I'm not going to be fighting people to get to the front of the line for this one. As it gets closer to the release I'll keep you posted once I've done some further reading.

Happy Birthday!

Today is the birthday of 3 people whom I love dearly. In order from oldest to youngest:

1. Tara Mix- an incredible friend that I am so thankful to have in my life. She loves people better than just about anyone I know. We have had some ridiculously hilarious times together...the kind you pee your pants while having. Well at least I do. To celebrate her big day we are going to attend a Colts game together where we will cheer at obnoxious decibels. I can't wait!



2. Heather Carlson- my college roomie. Oh the memories we have shared! She is making her mark on the world as a PA at MD Anderson in Houston, TX. I couldn't be more proud of her. Well I could but it would require her relocating to Indianapolis and that hasn't happened yet. To mark her birthday we are going to participate in a yet undisclosed activity while in San Diego,CA where we will be vacationing together in a few short weeks. I'm counting down the days until we get to meet up in sunny California!

Mbali- she is my sponsor child in Swaziland. I choose Swaziland since it is the country with the world's highest percentage of individuals infected with HIV. She is growing into a beautiful young woman. I hope I get to meet her someday. World Vision is doing a little something extra for her and her family for her special day.

And this begins the birthday season for me- from Oct 1 through the end of the year when most of the birthdays of my family and friends occur. Let the parties begin!

Fantasy Football

I just finished my first experience with the fantasy draft. I have no idea how my team will do, but I am optimistic. It should make the NFL season more enjoyable!
Here's my roster:
Starters:
Kurt Warner
Michael Turner
Derrick Ward
Jamal Lewis
Reggie Wayne
TJ Houshmanz...
Owen Daniels
Giant Defense
Nate Kaeding

Bench:
Kyle Orton
Steve Breaston
Donald Brown
Patriots defense
John Carlson
Kevin Curtis
Chris Chambers

If I enjoy this random espn league next year I'll start my own. This will be a good trial run to see how it all works. 5 days until kickoff!

The Most Expensive Triathlon

A couple of weeks ago I participated in my first Sprint distance triathlon. Previously I had only done Olympic distance (roughly twice the length of the sprint distance). I was excited to be more competitive as my focus wouldn't be solely on finishing the race. I was incredibly pleased with how I did and have this great trophy to show for my 3rd place finish in my age group (out of 38). I was only a minute from winning my age group which gives me great motivation for next year. My times (for the 2 of you who care) were:
500m swim- 12:27 (definitely room for improvement)
20K bike- 42:42 (17.5 mph avg)
5K run- 29:52 (9:30 miles- nothing to brag about!)
transitions- 4:30 (wow I need to speed up!)

Triathlons aren't cheap events- it was $65 or so, but let me tell you about the race that keeps on giving.

Immediately after the race I had an extremely sharp pain in my right foot. It seemed odd as I have never had pain in my foot before. I hobbled around for a couple of days with lots of ice and then noticed that it was getting better. Unfortunately as a resident I have these long 30 hour shifts on my feet and everytime I was on call or had a long day in the OR my foot would hurt. So Monday a surgery got cancelled and I squeezed an appt in with an orthopedic surgeon. 2 hours later I left with a $40 copay for the appt, likely $150 worth of xrays, $180 for the walking boot and $60 for the shoe implant to treat the stress fractures of my 3rd and 4th metatarsals. My insurance is new and no copays have been met so this triathlon just got very expensive. But when I feel down I just stare at my shiny trophy (on my mantle)and know it was worth it. Not really, but being active is more cost-effective than not even if it means an occasional injury.
So if you are in Methodist hospital I'm the resident walking around in my aircast.

Oh and I will be competing in more triathlons next year!

Struggles

A little over a week ago I ended what I can only hope was the worst rotation I will ever have in my residency. For many reasons I won't go into any details but it was horrible. Part of the way through the rotation when I realized how badly I was struggling I picked up (in addition to my Bible) my copy of "The Barbarian Way" by Erwin McManus. This is one of my all-time favorite books. Here are a couple of the quotes that really challenged and encouraged me:

When you understand what Jesus means when He says that you must follow Him, you finally realize that this is not a cattle call. He is not calling you to the same life that everyone else will live. He's not even calling you to the same path that every follower of Christ will walk. Your life is unique before God, and your path is yours and yours alone. Where God will choose to lead you and how God chooses to use your life cannot be predicted by how God has worked in the lives of others before you.

...the closer you walk with Christ, the greater the faith required. The more you trust Him, the more you'll risk on His behalf. The more you love Him, the more you will love others. If you genuinely embrace His sacrifice, you will joyfully embrace a sacrificial life.

The first quote really encouraged me as I kept comparing my life and all that I disliked about my circumstances to those around me who seemed to have it all together and were enjoying their summer more than I was. The second quote challenged me as I sensed myself wanting to lash out at people all around me for the frustrations I was experiencing. I was reminded that the way I treat others is a direct reflection on my love for God and my ability to joyfully embrace a life of sacrifice is directly correlated with my ability to embrace His sacrifice for me. Ouch...

Wedding Festivities

This is a random picture taken of me prior to performing in the wedding of Osi and Enola last week. I thought I would be really nervous but all of my adrenaline was used up during the day with new trauma patients.





The ceremony was beautiful and it was an amazing night of celebrating. Osi is from Nigeria and his family came dressed in their best. I loved the energy they brought to the whole event. I am so thankful to have Osi and Enola in my life and look forward to many years of sharing life together!

Fiddling

Thursday night is the wedding of two of my good friends, Osi and Enola. They asked me to play my violin in their wedding. Initially I dreaded pulling out my violin as it took forever just to tune it since I hadn't touched it in so long (6+ years). Recently it has been much more enjoyable to rehearse and has made me reminisce on the good old days playing the violin. The rehearsal went well tonight and makes me want to get a better violin and play more frequently. Unfortunately (or fortunately depending on your perspective) I am committed to this surgery gig and it doesn't allow for many hobbies.

Anyways, it should be a great night. Osi is from Nigeria and some of his siblings still live there so the ceremony and reception will be infused with some great Nigerian cultural elements. This song is part of that. They have a semi-choreographed dance to this song with Enola (who is definitely not Nigerian) wearing traditional Nigerian attire. We get to all participate at one point in the song. It is going to be a great night!

I saw this on Amber Cox's blog and had to share it with everyone. What a celebration! Maybe my wedding will start like this someday.

VIP

I just got back from King's Island- an amusement park in the Cincinnati area. It was a fun day overall, but I've got to share the highlight with you. My friend Enola and I decided to wait in the long line for their new ride called the Diamondback. After waiting for an hour or so we decided to wait a few extra minutes to sit in the front row. After we got in the special line they escorted two men our age into line behind us. I had heard someone shout "Hey Jeremy" while we were approaching the front of the line and realized that it was Jeremy Camp (a well-known Christian artist) who was standing next to us in line. I turned around and simply asked him, "Are you Jeremy Camp?" to which he replied with a smile "I am." We then introduced ourselves and had a very pleasant conversation. Enola and I didn't know it but he was to perform later in the evening at the park and so he got to ride a couple of their big rides. The sequence of events that placed him in line right behind us was crazy! It was our first ride of the day, we waited over an hour, he just happened to walk up at that moment, they let us wait to ride in the front row (which they didn't let our friends do later in the day).... The whole experience was fantastic- waiting in line with Jeremy Camp, riding on the front row of their new AMAZING ride...and getting to share it with a great friend.

This all got me thinking...I sure have had more than my fair share of interactions with famous people in the last few years-especially for someone who lives in Indiana. Here are the ones I can think of off the top of my head:

• Riding on a plane with the Newsboys
• Riding on a plane with Ron Luce (founder of Teen Mania Ministries)
• Meeting Norah Jones
• Running into Jim Caviezel at GCC
• Shaking hands with George W Bush (while he was President)
• Shaking hands with Bill and Hillary Clinton (Hillary on 2 different occasions)- I don't care what you think of them it was still incredible to meet a former POTUS
• Meeting Natasha Bedingfield
• Randomly walking by Michael W Smith while on a hike in Nashville
• Talking with Jeremy Camp while in line for a rollercoaster
• Meeting countless leaders in the world of surgery. A couple of surgeons that you might actually be interested in include the neurosurgeon who removed all of Lance Armstrong's brain metastases and one of the surgeons who performed Charlie Weis's gastric bypass surgery/disaster.
• It doesn't count but I almost got to meet Barack Obama. The secret service people were searching us when they bailed out during his campaign.

While I don't place these individuals on pedestals it is fun to interact with them and gain a better appreciation for them as people.

Intern year in a nutshell

Worth: Just because you're necessary doesn't mean you're important.

What I'm Up To

Here are a few of the things that have been occupying my time...

1) Who knew that a day made such a difference in my responsibility level. I have some weird precedent of crazy 1st days. My first hour as an intern was spent intubating someone emergently with an unstable cervical spine and my first morning as a 2nd year resident was spent in the OR doing two emergency laparotomies (belly surgeries). The second patient was coding (ie. chest compressions, massive hemorrhaging while we were trying to control the bleeding). He only required about 27 units of blood. My favorite green shoes were ruined (I know I shouldn't have been wearing them in trauma surgery but who knew that as a second year resident I would be exposed to so much bleeding. Plus I put booties on for traumas except when you have to sprint into the OR with no warning because your patient is coding.) Anyways, it's all in a day's work I guess. Except that it was a very long first day because I was on call and I had to wear super bloody shoes all night. One set of observant and horrified parents asked me before I took their daughter to the OR that night "Is that blood all over your shoes?". Oh what I would have done for a pair of crocs.

2) Celebrating! Us second year residents have been partying in a big way. We went out the night we were done being interns and again on the 4th. I learned Texas Hold 'Em. For a while I was doing really well. It was fun and then I lost it all (all $5). Alas I went and joined the girls for some serious rock band.

3)Wedding preparation. No not mine silly. Somehow I got roped/privileged into performing my violin at the wedding of two of my close friends in a few weeks. I'm not sure if perform is the proper terminology. Let's just say I hadn't touched my fiddle in 5 years and when I tried to tune it my bridge flew off. And I'm performing 15 minutes of prelude, while they walk down the aisle, while they take communion and while they have their recessional. No pressure. I might ruin their wedding or in the least make a total fool of myself. I would tell you where and when so you could come and heckle but some creepy internet stalker might show up and that would be bad.

4) Long walks. I love taking walks and I have had a lot on my mind besides the above-mentioned topics. It has been incredible to just walk and enjoy the silence and think and listen. I think I hear more clearly from God while out in nature just walking and being silent than at any other time. It's not a magic formula but give it a try some time. I can't get enough time outside just listening. And the cool thing is that God is speaking and He is up to some pretty incredible things that I am thrilled to be a part of. More to come on this I promise!

ps. my camera is broken, but soon enough I shall have a new one and flood you with pictures!

Bye Bye Internship

I don't have much time since I've been out celebrating with my fellow ex-interns, but our first year is over. I'm no longer an intern!!! I was nearly skipping into the hospital this morning out of enthusaism to be moving on to the next phase of my training. I am on call July 1st for trauma and my responsibility is going through the roof. People are telling me I'm ready although I am fairly nervous. I am also very excited as I have been wanting more responsibility for the past 6 months or so.

I'll try and sit down and really reflect on intern year sometime soon, but let's just say I am thrilled with how the year went. I could count on one (or two) hands the number of times I have seriously angered an attending and no patient has ever been harmed by a decision I have made or a technical error in the operating room. I have gotten incredibly positive feedback from staff and upper-level residents and really couldn't be much happier.

I never once went over the 80-hour work week rules and feel like I am beginning to understand how to balance my professional and personal lives.

Onwards and upwards! Tomorrow at this time I might be a puddle in the emergency department up to my eyeballs in traumas and consults. I'll keep you posted on how my new role shapes up.

Thank you for all of the encouragement over the past year! I couldn't have survived without the support of family and friends.

Bunnies

Does anyone know how to keep cute little rabbits from eating the nice plants I have laboriously planted in my yard (with my parents help). I thought of rabbit poison but then I would have to deal with rabbit carcasses and that is suboptimal. I could hunt rabbits in the morning before going to the hospital (I do have good aim according to the man at Don's guns), but I would be left with the same rabbit bodies and blood in my yard. Plus I'm sure the neighborhood association would not tolerate gunfire at 3am for very long. Surely there is a repellant of sorts that would deter them without fatally poisoning them. Any suggestions?

In other news... the little "kiddos" (as every person in the hospital outside of surgeons apparently refer to them) at the hospital have now given me a sore throat. It's a good thing those punks are cute or I might be annoyed with them. I don't know how teachers put up with this. I guess the immune system adapts.

I'm sick

So my insides are completely rejecting me right now. It only took the kids on my pediatric surgery rotation one week to get me sick. Actually I have a full differential for why I am sick:

1. Sleep deprivation- I could go on all day about the way my lack of sleep has affected my life. In fact I'm missing time with friends right now because I know I can't safely drive to the other side of Indy. I fell asleep while driving to the dentist (3 miles away) a couple of weeks ago. Don't worry that won't happen again.

2. High caffeine-containing beverage to water ratio. I think that this has amplified my dehydration at the least

3. Pediatrics- kids have a way of spreading germs and I am in contact with them every day. The only time all year that I have been sick until now was when I ate too much fried food at the fair and vomitted my brains out (seriously). Coincidence? I think not.

4. My body completely rejecting intern year. Seriously. 4 weeks!

5. Bad food. I think this should be higher on my list especially since I have eaten more hospital food recently out of desperation.

6. Residual parasites from my fateful trip to India 10 years ago. I doubt it.

Regardless of the cause I hope to bounce back quickly since I'm on call again tomorrow and would rather not have to trade calls.

I'm a convert

I never used to appreciate country music but the newer pop country is growing on me. Lady Antebellum is becoming one of my favorite groups to listen to. Here are a couple of their best songs (in my opinion of course). Enjoy!

Risks

I'm praying a lot about taking a really big risk. I've been reading over some of my old journals and found a few relevant quotes:

• Generally speaking, you are probably never going to be more than 80% certain. Waiting for greater certainty may cause you to miss an opportunity. - Andy Stanley

• I think our greatest regrets will be the God-ordained risks we didn't take. We won't regret sinking. We will regret sitting. - Mark Batterson

• Hell begins the day God grants you the vision to see all that you could have done, should have done, and would have done, but did not do. - Johann Wolfgang von Goethe

• It is madness to wear ladies' straw hats and velvet hats to church; we should all be wearing crash helmets. Ushers should issue life preservers and signal flares; they should lash us to our pews. For the sleeping god may wake some day and take offense, or the waking god may draw us out to where we can never return. - Annie Dillard

Not that I'm counting

I'm over being an intern. It's been a great year of learning and all sorts of opportunities and experiences that I wouldn't have imagined having, but I'm ready for more. 43 days...

In the meantime Indy 500 here I come!

Teeth

Dear psycho dental hygenist,

I'm not sure where you trained or why you have chosen to be a gum butcher but I have a few thoughts:

1. Smile and attempt some amount of polite conversation
2. Stop stabbing my gums
3. When I am hesitating to let go of the suction it's not because I don't understand the concept, it is because I want a break from your attacks
4. When I ask you to stop because you are hurting me it's not a joke
5. When I chuckle and smirk after you make a rude comment to me that is not your cue to be more violent
6. Focus on professionalism. I'm not quite sure what I did to anger you but your nasty tone and blatant rudeness were unnecessary.
7. Goodbye. I'm finding a new dentist.

The hospital is empty

It has been brought to my attention that my blogging frequency is abysmal. This is mostly due to the fact that I am on a string of tough rotations and my life is fairly out of control. I assure you that by the time you finish this blog you won't think I have taken to guns to vent my aggression towards the world. Here are some updates:

• The hospital is eerily empty as Clarian (the bureaucracy that owns several hospitals I work in) has closed its doors to all visitors except spouses/parents and chaplains because of the swine flu. It speeds rounds up as there are fewer people asking questions, but the waiting rooms sure are quiet.

• I'm not sure what to make of the swine flu. 35,000 people typically die from influenza every year and 20 people have died from H1N1 so far. Diverting planes when someone has "flu-like"symptoms and canceling schools/events seems a bit drastic, but if we're going to go to these extremes it seems like we should have more standardization.








• I think I'm going to Boston. That's right. After next year I am calling a "time-out" and taking 1 or 2 (likely 2) years "off". I'm hoping to get a Masters in Public Health degree from Harvard. Backup options include Hopkins (don't tell them that they are a back-up), Univ of Minnesota or IU. Concurrently I plan on participating in some meaningful transplant research through IU. The plans are all still in the making, but I am getting excited about the possibility. If all goes my way I'll be in Boston for 8-9 months to get the degree. Why Boston? For starters, it's a fantastic city. Two great friends will also be in the Boston area adding to the appeal. Harvard's program is specifically designed for individuals with a doctorate degree and so the whole program is accelerated which is nice. Most importantly though, Harvard is the place to get an MPH especially if I want an international concentration (which I do). The contacts and experiences I would have would help me be in a position to do anything from head up the CDC, be the Surgeon General, or start a transplant program in a developing country (which is ironically enough exactly what I dream of doing). This is all contigent on God as I am highly inadequate on my own, but we serve a big God who is capable of much more than I could ever ask or imagine.

• I am on a softball team made up of surgery residents. We're called the Big Whacks. Of course we are competitive. Our record is 1-1. The ortho team beat us in extra innings which was unfortunate. We're having a great time though and I am getting to see a lot of residents in a whole new light.
  
  


• This is an awkard transition, but I am a pretty impressive marksman. Tara and I went to Don's Guns yesterday ( a very "classy" establishment in Indy known for letting you rent and shoot their guns-you can even rent an uzi). We had a fun time learning to load and shoot a gun. Doesn't it look like I'm in the middle of a heist in the next picture? That employee in the background sure must have regretted teaching me to use a gun. My man is covered with holes in the chest and head and other potentially fatal areas (the spleen, aorta and other major vasculature...)- my anatomy knowledge has to pay off sometime. The employee said after inspecting my target, "You've got a helluva shot for someone who's never touched a gun". So watch out. I might start packing heat if this swine flu gets out of hand.

Happy Easter

I took this picture at the Garden Tomb in Jerusalem- this is the tomb representative of where Jesus was buried and from which he rose. No one knows if this is the actual tomb, but I love this sign that is on the door to the tomb.

Have a great day celebrating. We have much to be thankful for!

Wait

I read this poem from my cousin Stacy's blog and wanted to share it with everyone.

If you read her blog it is the incredible story of a God who loves us and who is working in our lives in ways much more amazing than we could have ever asked or imagined.

I hope this poem encourages you!

Stacy if you read this thank you for your vulnerability and incredible perspective on all that you and Ryan have experienced in the past several years. Myself and countless others are blessed by your transparency. I can't wait to see your children!

Transplant

Well the word is out. I'm planning to specialize in transplant surgery. I've met with some of the transplant surgeons who seem very enthusiastic about training me over the next 7 or 8 (yes, that's not a typo) years and I'm meeting with the transplant chairman soon to plan for the coming years. I'm ridiculously excited about it and therefore I'm sure those I've spoken with recently have heard entirely too much about it. I never would have seen this one coming. Of all the specialties I have pondered this one never made the list. The lifestyle can be insane, although I've learned that it doesn't have to be. The lifestyle has kept me from deciding sooner and if anything causes me to change my mind down the road it would be the potentially long and irregular hours.
Here are the reasons I'm taking the leap:

• Transplant truly changes and saves lives. We snatch people within days of dying from liver failure and give them a new chance at life. We free individuals from 3 days per week of hemodialysis. Diabetics are done with insulin injections and saved from any further devastating effects of diabetes.
• I like maximally invasive surgery and that is precisely what transplant surgery is- the only time we do laparascopic surgery is to take kidneys out of donors. In general I don't really enjoy working through tiny holes- I like having blood and bowels in my hands to feel most effective.
• The surgeries are incredible- I will train to transplant the liver, kidney, pancreas, small intestine and what is called a multivisceral transplant where you transplant several organs at once- often a liver, small intestine, stomach and possibly pancreas and kidney. In the multivisceral transplant you basically take all the organs out and have an empty abdomen and then put the new ones in.
• The procurement (going to get the organs from the donor) is amazing as well.
• I will do transplants in people of all ages: infants through the elderly which provides a nice variety and different technical challenges.
• The future of transplant is intellectually stimluating! Xenotransplantation- basically taking organs out of pigs and other animals and placing them in humans. I will work in the lab of one of the premier transplant surgeons in the country. Many believe that he will likely be the first to figure out how to prepare the immune system to successfully do this. Can anyone say Nobel Prize?
• This may sound crazy but I like the setup of the transplant system, at least here at IU. I get along phenomenally well with the transplant pharmacists, NPs, nurses, case managers and other team members. In general surgery the patients are scattered all over with dozens of nurses and support staff taking care of them but with the transplant patients they are all huddled in one unit with the same pharmacists, nurses, secretaries, care coordinators... and it builds a comraderie that I love. I'm even trying to coordinate a flag football game with all the transplant nurses.

I am full of about as many questions as you might be. I have no idea what my life will look like. What I do know is that I am in a position to not only be on the cutting edge of transplant surgery in the US but to help developing countries begin transplant programs. This leads not only to higher qualities of living but is also much more cost-effective than a lifetime of dialysis or other medical support.

I keep thinking of Eric Liddell in Chariots of Fire who said, "I believe God made me for a purpose, but he also made me fast. And when I run I feel His pleasure." God has made me to glorify Him and I truly believe that one big vehicle for me to do that is through transplant surgery.

Palm Sunday

Palm Sunday is usually a holiday that gets overshadowed by Easter for me. This year, having been to Jerusalem last year, the day has much greater significance. These pictures are from mom and I walking the "Palm Sunday Road" where Jesus triumphantly entered into Jerusalem- with the view he had from the Mount of Olives leading into Jerusalem. Sorry they are microscopic- I'm going through a computer transition and they are all I could do from snapfish.

As he rode in majestically I love what he said when the Pharisees tried to silence the crowds, "If they kept quiet, the stones along the road would burst into cheers!" The work of God cannot be stopped.

Jesus entered Jerusalem knowing what would take place. As He approached Jerusalem he said, "I wish that even today you would find the way of peace. But now it is too late, and peace is hidden from you. Before long your enemies will build ramparts against your walls and encircle you and close in on you. They will crush you to the ground, and your children with you. Your enemies will not leave a single stone in place, because you have rejected the opportunity God offered you."

Jesus' words came to fruition shortly thereafter when the temple was destroyed in 70AD. Today the Western Wall, which is part of the western retaining wall of the temple mount, is the only remnant of the Temple from the days of Christ. The Foundation Stone, which is where the Dome of the Rock (one of the holiest sites for Muslims) stands now, is also believed by many to be the spot of the Holy of holies from the Temple. Hence the tension between the Muslims and Jews for access to this site.

Here are Mark Beeson's (senior pastor at Granger Community Church) words on this day:

"On the day Christians celebrate the Prince of Peace riding into Jerusalem, North Korea does a product demonstration for potential buyers of nuclear weapon delivery systems - with free advertising from the American Press. This week, the cover of Newsweek magazine proclaims - in the bold shape of a cross - "The Decline and Fall of Christian America."
The world is watching. I can't help but wonder what the people of the world see.
The One riding into Jerusalem was hailed as king, but who guessed by week's end He would rise from the grave?
But will the world see Jesus this week?Will the world see Love, Forgiveness and Hope?
Or will the world see no better way than the path of hate, fear and decline?
The world is watching. What does your life proclaim?
If others do what you do this week, what will the world see?If others say what you say this week, what will the world hear?If others emulate your manner, what message will be communicated? Hope or despair? Courage or fear? Confidence or discouragement?
What will your life proclaim during Holy Week?
You get to decide."
John 12:12-13 - On the next day the large crowd who had come to the feast, when they heard that Jesus was coming to Jerusalem, took the branches of the palm trees and went out to meet Him, and began to shout, "Hosanna! Blessed is He who comes in the name of the Lord , even the King of Israel."

My heart

Just a quick update for those of you who are aware that I've had some "issues" with my heart and who know that there have been some recent problems as a result. Basically I've had an occasional abnormal heart rhythm and exceptionally fast rate that is usually associated with exercise but occasionally it happens randomly.

I had what I thought was an exhaustive workup at the beginning of medical school, but this year I was denied disability insurance because there hasn't been a diagnosis attached to my symptoms. Now I know some people aren't supporters of insurance, but I am (especially given my tendency to injure myself and enjoyment for more high-risk activities) and will save that dialogue for another day. I have had some recent concerning symptoms and went to see a cardiac electrophysiologist here in Indy for what I thought would be simply the beginning of annual EKGs and routine follow-up.

He is a leader in the field, covered with my insurance plan and so I thought the man I picked was a great selection. During my first appointment he went crazy on the fact that I need a diagnosis and came up with these over-the-top tests we could do. He threw out words like pheochromocytoma, electrophysiology lab, implantable cardiac monitor... all of which seemed a little aggressive.

Needless to say I was taken aback and resistant to this. We reached a compromise and so far I have had another echocardiogram (ultrasound of the heart) and all sorts of external monitoring. I just got a new device yesterday that will monitor my heart at all times externally and I am off my heart medication to try and unmask the "events".

We'll see what happens, but I think we've decided that if this comes back ok we will be done and he will give me the diagnosis "benign inappropriate sinus tachycardia" and hopefully I can get disability insurance and rest assured once again that my heart is ok.

Shoulda woulda coulda

I'm trying to pick a new computer unless I am able to resuscitate mine in the next few days with the help of tech-savvy friends (hence the sparse blogs...plus my life is thoroughly out of control). Any suggestions? I'm leaning away from a mac since I will be doing research and using programs regularly that aren't mac-compatible. I've gone with Dell before, but am open to Sony or another brand.

Mexico

I don't have the time or energy to load any pictures (not that I took many) but here are a few highlights of Puerto Vallarta:

• sleep- I slept 11-12 hours every night for a week. It was ridiculous but oh so wonderful
• the sun- I hadn't seen the light of day in a long time and it was great to bask in it
• hanging out with my parents- it was great to spend a week with them catching up and laughing
• crazy tour guide man who thought I was 12 or something. he was talking to me in an incredibly condescending juvenile way. he asked if I saw santa claus when we celebrated Christmas in Mexico a few years ago. he pointed out pineapples under a tree like I didn't know what a pineapple was. My mom, continuing in the fun, pointed out bananas and other items to try and bring me to a 5th grade vocabulary.
• eating on the beach. it is one of my favorite things to do and we biked to a restaurant on the beach for lunch a couple of days.
• watching the bachelor with my parents. my dad actually sat through the whole finale and after the final rose drama. good times...
• reading for fun. it was so great to read a couple of novels for the pure pleasure of it.
• the spa- hot tub, steam room, sauna, rain shower... so much so that I went twice a day on a couple of occasions.
• the food. i ate enough chips and salsa to last a year.
• getting a tan. i know it is superficial but it feels good to have some color to my skin and blonder hair.

Thanks mom and dad for a great week!

Fire

I saw the largest fire today that I have ever seen. In fact it is the largest fire in downtown Indy in 20 years. I love a good spectacle, especially when no one gets hurt (maybe I should have worked to be a news reporter). Being able to witness this fire was one of the few benefits of driving to the hospital at 4:45 am. I saw the smoke from my house, and the flames from the interstate. It was insane! Because of my ridiculous work hours I wasn't stuck in the traffic jams that were apparently horrible as rush hour ensued.

It is a devastating blow for the builders and those with homes or businesses nearby. The miracle is that not a single person was injured.

If you want to see pictures go to wishtv.com.

Black Clouds

There is a joke around the hospital that I am a black cloud. Basically I have been on call a ton in the past few weeks (6 nights in 2 weeks) and every one of those nights has been full of disasters. The chief residents (who take call from home) have picked up on it and seem less excited to have me on call with them as they will inevitably have to come in and take a patient to the OR with me.

Let me preserve my dignity by saying I didn't in any way cause these problems but they all arose while I was the only "surgeon" in the hospital (someday I will be able to call myself a surgeon without using quotes). Several of the patients were transferred in from smaller hospitals in the middle of the night and were incredibly sick. Another several presented to our emergency department and a few were already in the hospital being treated by other services.

The common thread is that they all (yes, every last one) required emergency surgery. That is exceedingly uncommon. We usually get consults for all sorts of non-operative issues, and a few that need surgery. Last night was my last night on call for a while. A patient we have been taking care of for a long time started hemorrhaging rapidly from somewhere in the intestines. I was transfusing the patient as fast as the blood bank could send blood up and he managed to pull through the night. I explained to the family how grim the prognosis is in an effort to get them to reassess how far they want us to go in what seems like futile care. In the end, the decision is theirs, but I feel a moral obligation to be clear about how serious a situation is so they can make educated decisions.

The good news is that most of the patients have done very well and I have gained all sorts of experience in resuscitating patients, counseling families and quickly delegating and getting things done. I seem to have earned the respect of the staff surgeons which is always a good thing. The bad news is that I am exhausted. I have been basically pulling an all-nighter every other night for 2 weeks without a single day off in several weeks.

The even better news is that this will quickly be remedied as I fly to Puerto Vallarta in the morning for a week of bliss. My pager is being left behind, my phone is off, I won't be checking email. I will be all there...resting...having fun.... Adios!

Slumdog Millionaire

I saw this movie tonight with a couple of friends and was completely blown away! It resonated deeply with my burden for the millions in India and around the world who are victims of horrific crimes. I understand why this movie won Best Picture. I pray that this platform not only helps spread the word for the horrors happening still today around the world but invokes real change.

FYI- if you are interested in learning more check out: International Justice Mission. This is an organization strategically speaking up and defending the rights of those whose voice is not heard. Another organization getting things done is Emmanuel Hospital Association in India- the organization I worked alongside for a summer at Landour Community Hospital.

How To Save a Life

I had the incredible privilege this week of being involved in saving a life. I'm sure that happens regularly, but it is usually not as obvious. It is likely the most significant moment of my intern year so far. Here's the short version...

At 5pm our team was paged to come see a patient of ours who had had surgery several days prior. Acutely his blood pressure was very low and he felt light headed (there's more to it but I'm trying to keep this brief). I quickly transferred him to the ICU and as soon as we rolled into the ICU he started seizing and became unresponsive and his abdomen instantly became distended. We quickly noticed (he was in the process of being hooked up to their monitors) that he had stopped breathing. I was unable to feel any pulses so we quickly started CPR. I taught the medical students to do compressions as someone ran to get blood, paged anesthesia to intubate the patient, started giving code drugs, paged staff to come to the hospital stat... I quickly ran to the OR and told them that we needed an OR now as a patient was hemorrhaging and would be dead within minutes. They told me that there was no room available, no staff, no anesthesia and therefore we would be unable to bring our patient back. At that moment I made it clear that this wasn't optional and we didn't need anything but instruments. Since the charge nurse was less than helpful I ran from OR to OR calling for any available help and managed to round up 3 anesthesiologists, a scrub nurse, and several other OR nursing staff. We grabbed an available surgeon who was in the hospital and wheeled our patient to the OR within minutes. The staff surgeon (who drove in at 110mph on the highway) ran in as we were ready to open the abdomen. As soon as we did we were met by 5+ liters of blood (an average adult has approximately 6 liters of blood). Staff told us we had one chance to get to the bleeding artery (a branch directly off the aorta) before he exsanguinated entirely. We succeeded and quickly controlled the bleeding as the anesthesiologists frantically kept resuscitating the patient. When we were done the room looked like a slaughter house. It was amazing!

The next day when I walked into the ICU I saw a man breathing on his own, talking and asking for more pain medicine. It was the most incredible realization that this relatively young man is alive without any real residual damage (other than a large scar on his abdomen) when he was within minutes of losing his life. I had fun walking around to the nurses on the floor that had picked up quickly on his unstable condition to tell them that their quick thinking was essential to his good outcome.

I spoke with the patient and without getting too graphic explained how miraculous it is that he is alive.

I am so thankful to have been an integral part in resuscitating this man!

Momentum

I don't have many blogs on my Google reader, but one person I follow regularly is Mark Batterson. He is the lead pastor at National Community Church in Washington DC. He recently said,

I've always been convicted and challenged by something R.T. Kendall wrote in his book, Yesterday's Man: "A person with a tremendous anointing yesterday can continue to see the momentum of that anointing continuing to manifest itself. He or she may hastily conclude that 'the anointing is still with us' when it is but the momentum of yesterday's anointing. If I do not experience a fresh anointing every day, it is only a matter of time before I become yesterday's man.

This has been bouncing around in my head since I read it. Am I just living off of the momentum of my past or am I truly growing and allowing God to change and refine me?

25 Things

There's this thing going around facebook where you list 25 apparently random or little-known facts about yourself. Since I actually have a free evening I thought I would give it a shot.

1. My Myers Briggs test flipped and apparently I'm an extrovert now. I used to be solely energized by alone time and now (maybe out of necessity) I am very energized by time with others. It's kind of fun being more extroverted. I do enjoy my alone time though!
2. I played a blue guitar for a semester in college. I loved it but I think all the girls in my dorm secretly loathed the guitar...maybe because I could only play one song but I loved it so I played it over and over and over and over and over and over and over.
3. I've been craving the Grasshopper shake at Ivanhoes for 9 months now. Sure I could make my own but it's just not the same. This weekend my college roommate Heather is coming to town and our whole clan from Taylor are reuniting for a day of fun including Ivanhoes.
   
4. I took voice lessons in college. I somehow got roped into a solo performance of some Enya song. I have blocked out the details, but it was amazing...amazingly horrific and appauling but oh so funny. I still sing along to Enya for a few privileged individuals.
   
5. I gave up Mountain Dew. It was a decision based on the high fructose corn syrup and desire to be a little healthier. Diet Coke is the new Mtn Dew.
6. I give the best musical performances while driving and trying to stay awake. I use props, interpretive dance, the steering wheel drum, and sign language (don't worry it's not all at the same time). I get some confused looks, but I'll never see those people again...right?
   
7. The Fray is one of my favorite bands and their new cd came out today. My copy is in the mail. I saw them perform a couple of years ago in the craziest outdoor concert. They had to turn all the stage lights off because the bugs were so bad they couldn't sing. Isaac Slade called it "Armageddon"
8. I am obsessed with exercise. The rougher the day at the hospital the harder I exercise. Not a wonder I'm in good shape right now.
   
9. I am a recovering people-pleaser. This year has cured me of any desire or effort to please others as I realized it is physically impossible to do so in a surgical residency.
   
10. I've got some freakish heart issue. I'm seeing a new cardiac electrophysiologist next week so we'll see what happens. It's thrown a wrench in obtaining disability insurance.
    
11. I like to read 5-8 books at a time.
12. I am so excited to travel around the world training surgeons in developing countries whatever specialty I decide to go into.
    
13. My neighbor does all my yard work, snow shoveling, house maintenance. He's amazing and I'm humbled by his generosity.
14. I am addicted to cornbread pancakes now that I know how to make them.
    
15. My two fitness goals for this year are to compete in another triathlon and to swim in the Big Shoulders open water swim on the lakeshore in Chicago.
    
16. I am actively serving in a very amazing local church. I am all in and so excited for our future together.
    
17. I probably have 6-9 years of training remaining. The future is still very undecided but transplant surgery is at the top of the list for now. I guess I like flying around in private jets.
    
18. I can't wait to go snowboarding again.
    
19. I dream of going to Antarctica someday as the physician at their station. Another option is the international space station (which my mom's cousin heads up) but I think the isolation would be difficult as a newly proclaimed extrovert.
20. I am insanely competitive at sports. It's not because I care about winning as much as I love playing hard and having a good game. 99% of the time I truly don't care about the outcome.
21. I am a diehard Colts fan. I dream of getting a blue foam colt head and cheering like crazy in Lucas Oil Stadium in an upcoming season.
22. I long for the day when I can go back to India. It's been over 5 years and I miss it.
23. I am a sock snob. If they don't have built in arch supports and just the right fit I won't buy them. I'm on my feet too much to go cheap on socks.
24. I have a recently revealed talent on the drums in Rock Band. I'm thinking of trying some real drums soon.
    
25. I miss my family and friends who aren't in Indy a lot. I am blessed beyond comprehension!

Snowboard 1 Angie 0

Yesterday I went skiing/snowboarding with Brad, a good friend from my house church. I apologize for not having any pictures. The majority of skiing was nighttime so they wouldn't have turned out well had I had a camera with me. Your imagination will have to suffice.

The skiing was great. As Brad said, "it is like riding a bike" and I was quickly able to maneuver around thanks to lots of previous experience. My one fall was hysterical. I saw a ramp, gained speed and was surprised by how airborne I became. I landed fairly gracefully on both feet but was laughing so hard at my stunt that I totally lost it. When Brad came around the corner I was lying on the grounding laughing and rolling around. It was pretty funny.

After much prodding on my part we traded the skis for snowboards. I had brought wristguards for just this occasion knowing that just about everyone I know who has tried snowboarding has broken a wrist and my livelihood now depends on the functionality of my upper extremities. We carried our boards to the bunny hill- hill might actually be too generous, it was more of a flat clearing to learn to turn on. There was a treadmill to take you to the "top". Brad had warned me that I would feel fairly physically handicapped with one leg stuck to the board. He wasn't kidding. I felt like I had some congenital hip dysplasia that prevented any forward progress. When we got to the "top" I locked my other foot in and lasted about 10 feet before being forcefully thrown on my face. The wristguards worked though! Getting up was a serious struggle and one that I was determined to win as other newbies were barreling forward in my direction. I couldn't stop laughing as I was so shocked at the violent nature of this sport. This continued for an hour of so with unending laughter and rolling around in the snow. I told Brad that "our" goal would be to ride the ski lift and go down a real hill before the night was over. We indeed did accomplish the goal and miraculously didn't have to cart either of us down on a sled. There was a close call when Brad flipped end-over-end after losing control. We must have been a sight to behold!
Today I am quite sore. My knees are bruised but my spirit isn't. I can't wait to go back for round two!

Axiom

I picked this book up thanks to the recommendation of Judy Gregory. (an amazing woman who is changing the shape of youth ministry in our nation whom I was privileged to serve alongside for many years).

As a doctor I naturally have a leadership position in the hospital setting, but I don't want to be leading out of a title but rather by my character and example. I'm only a few chapters in but here are a few quotes that really stood out to me:

• …words really do matter. And leaders must pay the price to choose the right ones, because when they do, the payoff is huge.

• The truth is leaders rise and fall by the language they use. Sometimes whole visions live or die on the basis of the words the leader chooses for articulating their vision.

• When handled properly people are actually quite flattered to be asked to do significant things for God.

The first two quotes resonated with me as I have recently been made aware of the power of my words- both in destructive and constructive ways. I want to be a person who speaks intentionally and has the insight and control to know when to be silent.

The last quote struck me because I sense that significant things are happening in Indy right now with my church and we are asking a lot of people (myself included) to step up and do "significant things for God" (not that I'm implying we haven't already been doing significant things). Instead of the increased responsibility coming across as a burden I view it as an unspeakable privilege because of the way the vision has been laid out.

I'll keep you posted on the book, but so far I would highly recommend it!

Favorite Memories from 2008

• Graduation day- I might as well start with the obvious. This was one of the best days of my life. It was amazing to realize how far God has brought me and even more special to celebrate with so many people that I love.
  
• The first time I introduced myself as "Dr. Qualey". I wish I had it on video. It was hilarious because it felt so weird. The only time I call myself "Dr. Qualey" now is when I need to get something done over the phone or can sense that people don't understand my role, but it sounds much more natural.
• The day a patient told me I was treating him "like the Jews treated Jesus" right before Easter. It was priceless.
• Closing on my first house. It was a fun process to choose a home and I absolutely love being a homeowner.
  
• Random weekend days with my house church doing work projects/playing basketball and goofing off.
• Flyfishing for the first time. Sure my form wasn't perfect but I caught fish!
  
• Being baptized in the Jordan River. The obvious significance is that it is where Jesus was baptized, but knowing that this was where my maternal Grandparents were baptized made it especially meaningful.
• "Swimming" in the Dead Sea. It was an odd sensation, but really fun. As an extra perk my skin and hair have never been softer.
• Converting Arch and Connie's house into a Christmas wonderland.
  
• Spending what ended up being my last few days with my Grandma. She was an extraordinary woman and one of my biggest supporters. She is loved and deeply missed.
  
• Surviving a ram "attack" at the Grand Canyon on New Year's Day 2008. It wasn't so much an attack as a horrific encounter. If you desire more details click here.
  
• Meeting Hillary and Bill Clinton. For good or bad they have influenced our country and it was fun to meet them.
• Standing in line for hours to see Barack Obama speak. We almost got to meet him too but he was feeling antisocial or something.
• Riding a camel in Israel. They are much taller than I imagined and they smell horrible, but it was worth it!
• Camping at Weko beach with Tara, Amy and Erin. Beach volleyball in the rain and smores...need I say more?
  
• The night on call when three people tried to die at once. It was an experience that made me stronger and everyone survived.
• Flying to South Bend to procure organs. I've never felt more like a rockstar.
• Climbing boulders with Heather at Joshua Tree National Park.
• Countless Thursday evenings at Arch and Connie's engaging in meaningful conversations and hours of sports/games with cherished friends.
  
• Sprinkles cupcakes with Shannon on her official LA tour.
  
• Competing and doing fairly well in the TriIndy triathlon.
  

It's been a great year, full of incredible memories with people I love deeply. God is so good!

Climbing

Just for the record, indoor rock climbing is a blast! My good friend Brad and I have gone a couple of times recently and are pretty convinced that we will be professionals soon. I'm thinking of giving up on the surgery gig and going with this fulltime. It is a phenomenal workout and a blast. If you are in Indy check out ClimbtimeIndy. They have the full range of difficulty levels and TONS of walls to climb.

Angie's Favorite Things

In honor of Oprah's favorite things I have compiled a list of my favorite things from 2008.

• My bianchi road bike. It is just that good. The road becomes a sanctuary for me when I'm out in the sun, reflecting on life and enjoying the view.
  
• My sleep number bed. I probably average 5 hours of sleep per night but those hours are full of delightful sleep thanks to this bed. In addition my Homesource International bamboo blanket (best blanket ever!) and down comforter complete the triad.
  
• My Biddeford heated mattress pad. Close friends are probably sick of hearing about it, but I look forward to climbing into a pre-heated bed in the winter time. It is amazing and it allows me to keep my house at "meat-locker" temperatures- per my family's experience.
  
• My house. Not only am I thankful for a roof over my head, but a place I can come home to that is comfortable, clean and peaceful. Plus my neighbors do all the yardwork so you can't beat the setup.
• My portable hammock- when the weather was nice and I had a little time off it was amazing to lay in the sun reading a good book or talking on the phone. Hammock= immediate serenity.
• Smartwool socks- no matter what season we are in my feet don't overheat but they stay warm. They have athletic socks in addition to casual and hiking versions. They're not cheap but you can find them on sale oftentimes at the REI outlet.
  
• Nike swimsuits. Since I've been consistently swimming laps I have found they hold up much better than TYR and even speedo.
  
• Bosch dishwasher- this thing is amazing. I throw very dirty plates in and they come out sterile. It's quiet, efficient and easy on the eyes.
  
• Diet coke- I'm very addicted at this point. I'm cutting back some but this beverage has gotten me through countless call nights, early mornings and roadtrips while sleep-deprived. Mountain dew used to be my drink of choice but I've made the switch from high fructose corn syrup to artificial stuff.
• North Face glacier quarter-zip fleece tops- I have several and seem to always wear one when I'm in scrubs at the hospital. They are warm, durable, not too thick, and have stood up well despite very frequent washings. Since I fit into the little boys sizes they are fairly cheap too.
  

Life is not about stuff but these are a few things that I truly believe have increased the quality of my life. Some in very superficial "comfort" ways, but others in more meaningful ways.

Karaoke

While in Nashville we went out with a friend of Tara's from high school who is trying to make it in the big leagues as a musician. Not only was her voice incredible but she was accepting of those whose voices are not as polished. We had a good time! I was amazed at some of the talent although it makes sense in Nashville. My favorite performance was when all 3 of us sang 'Wide Open Spaces' by the Dixie Chicks. Never underestimate the entertainment value of making a complete fool of one's self. Also, these pictures don't do justice to my crazy dance skills.

Aquarium

Tara and I stumbled upon a restaurant called "The Aquarium" in Nashville where we had a fun dinner. Well, the food was mediocre at best, but the atmosphere was top notch. Afterwards we were able to feed stingrays. I have attempted this stunt in the past with very little success as it is too big of a mental obstacle to allow a stingray to place its mouth around my hand to feed. I know that the stingers have been removed and the nice fella told us that they can't hurt us but still. My disability insurance isn't what it should be yet. So Tara talked trash about how she had done this before and mocked my inability to truly feed the stingrays. Then it was her turn. She literally threw her shrimp at the stingrays. By the end of the time she came closer than I did but never truly fed a stingray from her hand. She declares that she did, but I was there and do not believe that she truly fed one from her hand. Anyways, here are the pictures...