Proud to be an American

I received this email today about a background investigation the VA Hospital was running on me (standard procedure).

This e-mail serves as a notification to the applicant that your background investigation was favorably adjudicated (completed). Due to the Applicants position sensitivity level, the Department was required under Title 5, US Code of Federal Regulations (CFR), Part 731, “Suitability”, to conduct a Background Investigation and adjudicate the case using Title 5, CFR, Part 731, Subpart B, Suitability Determinations.

Thank you, for your cooperation during the background investigation process.

I seriously have no idea what this means. I think I passed.

India

As pretty much everyone who knows me knows India holds a very dear place in my heart. My first trip was a tough 3 weeks in Calcutta that left me thinking I would never go back to India. In fact when I landed in Thailand on my way home I kissed the ground (I have a picture of it) and said, "I'm never going back to India". God has a funny way of nudging me to do just those things that I say I will never do. In college I felt a building desire to go back to India and ended up going for 2 months to work at a hospital in the foothills of the Himalayas. It was amazing and life-changing.


I haven't been in 7 years and have had both a longing to go back and at times a dulled interest as I've been quite caught up in my surgical training. In the past few weeks I have sensed God really softening my heart after a pretty brutal 2 years of surgical residency. Heather, my college roommate, suggested I read, "The Hole in Our Gospel" by the President of World Vision.



Before I even started the book something crazy happened to me Sunday night. Kerwyn and I went to church and they took a week break in the series they are doing and had a "vision night". They are very committed to sending missionaries- both short and long term and were casting vision for the teams they plan to send out all over the world in the coming year. I immediately noted the trip to Chennai but told myself that we shouldn't go on that trip. I had all the usual reasons- the high cost for such a short trip, it wasn't using any of our medical training, and it just didn't make sense. Then they showed a video of a guy who went to India last year and he said, "There's nothing like it" speaking of being in India. I found myself getting teary eyed but was trying to hold it together. Then another man got up and spoke. At one point he played a sound recording of one of the 5 daily calls to prayer he heard for the Muslim community. As soon as I heard the sound it took me back there and I just started sobbing. It was crazy because I'm not one to cry but I just couldn't stop crying for the billion people of India- many of whom don't know Jesus and lack the means to even care for themselves and their families. I couldn't stop crying. I told God, "I get it. I'll go, but can you help me stop crying?" I eventually did and headed home confident that we should take a trip together to India to serve and really listen to where God is leading us as a couple. As soon as Kerwyn saw me crying he knew we were going to be going to India soon. I love that he just knew what was going on in my heart.



So anyways, we're going to continue to pray and brainstorm ideas on where to go and what to do. We had planned on having one big trip before going back to real hospital work July 1st so instead of a crazy European bike tour or some other trip we'll hopefully be going to India together for the first time. Thankfully we have no shortage of contacts there. We're open to ideas so let us know if you have any!

Crossfit

A few weeks ago Kerwyn and I took a Crossfit exercise class with our friends Paul and Shawn (she's a trainer at Crossfit Carmel). It was insane. We only did half the amount of each exercise as the regular folks but I was sore for days.

Any workout where they have to explain rhabdomyolysis (muscle breakdown due to over-exertion or injury that can damage your kidneys...) to you at the end is perhaps a bit excessive...which is probably why I loved it so much. At one point Kerwyn looked at me and said something to the effect of, "you're really enjoying this aren't you?" with a look of disbelief in his eyes.

While the crossfit gym is too far to attend reguarly we've been incorporating some of their principles into our workouts. As a result I'm sitting on the couch tonight with a heating pad on my hamstrings from a workout over 2 days ago. Good times....

The Windy City

Twice last week I traveled to Chicago. The first time was with my mom and her small group for a fun birthday celebration for her. It was fun to meet more of her friends and hear some of their stories. I don't have any pictures since I didn't have my camera with me. You'll just have to imagine pictures of mom and her friends laughing with their hair blowing perfectly in the wind.

Later in the week Kerwyn and I spent a day in Chicago wandering around. We had lunch at Harry Carey's (great restaurant), wandered around, saw a couple of wedding parties taking pictures, and took in Navy Pier. We even had a very enjoyable, although short, ride on the ferris wheel. I do have pictures from that trip because Kerwyn is very good about taking pictures.

Neither trip had a very smooth train experience. The first trip was marred by a train sliding door smashing my face in. That might be a bit dramatic but it hit my temple hard enough to leave me pretty dazed for a day or so and with a nice swollen and tender area around my right eye. On the second trip Kerwyn and I were enjoying a peaceful trip when they made us get off the train in Gary, Indiana of all places to get onto a bus for a few minutes and then reload onto a different train a few miles down the track that apparently was undergoing repairs. You can imagine it wasn't a quick process to unload what ended up being 4 very full busloads of people off of and back onto a train (hence the picture of Kerwyn with the thumbs-up in the very classicly decorated bus). Either way it was a fun couple of days in Chicago.

Canoe Trip

Kerwyn and I spent a wonderful afternoon in prime fall weather canoeing. It was beautiful. To call the canoeing company sketchy would be an understatement but they didn't harm us as we feared they might. We decided that next year we need to do one of their longer trips.

Turkey Run

This has become one of my favorite parks for several reasons.
1. It's beautiful.
2. I forget I'm in Indiana.
3. It's where our engagement pictures were taken.
4. We've shared some great times hiking around together here.

October is probably the best time of year to go so we spent an afternoon wandering the trails. Weather permitting, I'm hoping to go canoeing here next week.

Julie and Julia

The first movie Kerwyn and I ever saw together was Julie and Julia. I did not enjoy it. He did. I think I just wasn't interested in cooking so I felt like I was watching a cooking show for two hours. However, thanks to the generosity of many people who have blessed us with a well-stocked kitchen I am thoroughly enjoying cooking. Plus, I miss operating like crazy and so cooking is the only opportunity I've found to cut stuff. Kerwyn and I are enjoying trying new meals together. This was my first time making steaks (thank you mom and dad for giving us Omaha's finest). Kerwyn mastered the side dishes.

Go Irish

Kerwyn and I were given tickets to last week's ND vs Pitt game for our wedding. It was Kerwyn's first college football experience and we had a great time cheering our (I use that word loosely although I think he's becoming a fan) Irish on. We even went to the pep rally Friday night with my parents. It was quite the scene. I could have done without the cheerleaders but that's pretty typical for me I guess.

The Nations Triathlon

Let me just say that before the race it was miserable- pouring rain (hence our soaked bodies in the first picture) and we had to be there by around 6 am. Kerwyn started 95 minutes before I did but we both stood in the cold for a long time. I was soaking wet and cold for 3 hours before my race started. I regretted signing up for those hours of shaking in my pruned body.

As you can see once I was close to actually starting the race I was very excited to just get started (hence the thumbs up). I went into it with the mentality that I just didn't want to drown in the Potomac River and I was planning on a leisurely ride and walk through the city (I trained, but not as well as I could have). The swim went ok, but I hoped for a better time. However I also hoped to not get clubbed in the face with someone's nasty foot so it just wasn't my day in those regards. I drank a fair amount of the Potomac but my body has managed it well (it couldn't be worse than the Zambezi River).

After lazily drying off and getting on the bike crazy competitive Angie reared to life when I felt as strong as I ever have on my bike. Despite the rain I pushed my tempo faster than I thought sustainable and saved nothing for the run since I was planning on walking it anyways. When I got off the bike my legs felt better than expected for the brutal transition to running. So I decided to keep running as I believed I was having the race of my life. It was rainy and cold which is pretty ideal weather for running at least (apart from the water-logged shoes).

It turns out my overall time was 10 minutes slower than my last Olympic distance triathlon but I was still happy with my performance. I spent 8 minutes in the first transition since at that point I didn't care about my time so that didn't help the cause. Here's the breakdown for all 3 of you who care:

Swim 1500m 34:35
Transition 1 8:31
Bike (40K) 1:20:20
Transition 2 3:04
Run (10 K) 59:30

Overall 3:05:59
I came in 190 out of 393 for 25-29 year old females. Yes, it was that huge of a race, plus I'm in a pretty big age group.


I'm sure there will be many more triathlons to come in our future!

Washington DC

Kerwyn and I had a great time traveling to DC and participating in the Nation's Triathlon. We didn't die and it was our first road trip together and we weren't even tired of each other by the end so it was a success all around. We stayed at my aunt and uncle's apartment in VA which was great (thanks again!). They have a trail we could bike all the way into the city on which we did. It was surreal, but nice (catch the Notting Hill reference?) biking around the White House and all the monuments. We had a nice stroll through Roosevelt Island with Brad, Jodie and Meryl and they were able to help us maneuver the tricky logistics of such a huge triathlon. They even stood in the rain cheering us on.

We took a tour of the US Capitol building complete with tours of both the House of Representatives and Senate galleries. By the way, those tickets are harder to get as US Citizens than as someone from another country which we found to be quite ironic. I am somewhat obsessed with the State of the Union address every year and so it was amazing to sit in the gallery where that occurs. The picture of us with cool headphones on is in the Rotunda ignoring our incredibly lame tour guide.

We also wandered through the Library of Congress, Bureau of Engraving and Printing (the new $100 bills to be released next year are pretty nice), the typical monuments.... Our bike ride into the city was a fantastic way to spend a day and burn some serious calories. The crazy hair was immediately after I took my bike helmet off so please don't judge.

Muddy Buddy

Upon the immediate return from our honeymoon we repacked and headed to Chicago for the Muddy Buddy race with our friends Osi and Enola. We had a fun day wandering around Chicago and then on Sunday got up early for our race. It was much more intense than we expected. It was 5.6 miles or something like that of running and biking- in a fair amount of mud obviously. The biking was ridiculously hard (thanks to the mud and hills) and the running was just tough because I wasn't in shape to slosh through mud with water-filled running shoes.
It is called Muddy Buddy because it is a team event. We had a competition- girls vs boys (they won by 2 minutes). They started over an hour before us and so were already cleaned off when we finished (hence they are clean in the pictures). The end of the race is a swim through a mud pit which ensure that your entire body is covered in mud. It was a blast!

Married Life

Our honeymoon in St Lucia was great but being back home and settling in together has been even better in my mind. It has been a blast being a newlywed for the past nearly 2 months. It is amazing how much you learn about someone by living together! Kerwyn is seriously hilarious. He makes me laugh on a daily basis. Sometime you should ask him about his laundry regimen. He is very particular about the way his clothes are washed and I have yet to understand it, but it cracks me up every time I think about it. The transition has been really smooth for us and tons of fun. I'm sure my work schedule (or lack of one) this year has helped significantly. I never thought I could love someone as much as I love Kerwyn. I am so excited for our future together! Just for fun here are a couple of pictures from our honeymoon. Yes, we look dorky in our horseback riding helmets- that is the beauty of the picture.

Expect the Unexpected

I can't restart blogging without first telling everyone the best story of our wedding day.

Going into the wedding I had heard many people say that despite the best planning something will go wrong on your wedding day. I believed them but wasn't worried because I would like to think that I was appropriately laid back and could roll with it.

On our wedding morning I was quite emotional and trying to just hold it together-they were good emotions but as a surgery resident I guess I'm not used to dealing with really strong emotions anymore. I got ready at my house with bridesmaids, my parents, Leslie and Sam Petersen, and then our photographer and her entourage. At the time what I didn't know was that Leslie and my dad had seen the limo driver pull up, strip down from the waist up and change into clean clothes in our cul-de-sac. They were horrified but didn't want to tell me. When he walked into the house he wasn't quite what I expected in a limo driver but I didn't care. I was just excited to go see Kerwyn (we were taking pictures beforehand).

So mom, dad, Christy (our photographer) and myself climbed into the limo. I was immediately struck by how hot the inside was since the engine was "running". The limo man also pulled my dad aside to get his credit card from him and clarify that he would take any additional tip that my dad would like to give him (he already had Kerwyn's card). As he started driving I was immediately alarmed by the fact that he went in a very circuitous route to the meeting place down a road riddled with construction in a raunchy part of town. We sputtered down the road with cars honking and restarted the engine several times. Eventually the engine wouldn't restart. I asked the driver what Plan B was. At first he wouldn't respond to me and so I spoke louder. He didn't have a plan because his "company" wasn't answering their phones. We sat in our personal sauna for a few minutes with cars honking before mom noticed the heat rash spreading across my body. At that point I knew I was getting out of the limo. So we climbed out into busy traffic (I wish you could have seen the moment people realized a bride was getting out of the limo). The tone changed as people shouted condolences about our situation. I was laughing as this seemed hilarious. I then realized that we couldn't just sit in the sun baking and the only building nearby was a porn shop.

So mom, dad, myself and the photographer wandered into the porn shop to cool off on my wedding day. We laughed a lot. The workers were very nice and even offered us water if we wanted it. I just needed to go to the bathroom so in my wedding dress mom helped me use one of the nastier bathrooms I've been in in a long time.

I used my parents phone and with the photographer's help we were able to redirect a couple of cars to come pick us up (thanks Tara!).

Had he gone the route that I expected/wanted him to take we would have likely broken down on the interstate so it all worked out wonderfully.

It was a very eventful start to the day. What it did that I am so grateful for was change the entire tone of the day from one of nerves to one of pure joy. It was a hilarious situation that helped us all to relax and just enjoy the day knowing that we had pretty much seen it all at that point (no pun intended). An extra bonus was having our photographer there to capture it all on camera. The pictures are hilarious!

I'm Back!

Sorry for the horrible delay for those of you still following this blog. Planning a wedding and being a surgical resident were pretty much all I could handle for the past few months. The wedding is over and Kerwyn and I are adjusting to life as newlyweds. I've got some funny stories to post in the coming days. I'm back. I promise.

An open letter

Dear violent people of Indianapolis,

Please just get along today. You see, I'm very tired and I'm on call. But if you must, please be nice to me. I don't like it when you swear at me as I try and stop your bleeding. It isn't nice. But maybe that's what put you in the situation you're in. Also, telling me (with a police officer over my shoulder) to let you go so you can go and "put a cap in their *&!%$" is just stupid. Thirdly, I know you weren't minding your own business so stop telling me that. I don't care how it happened. My job is just to fix you and leave the detective work for others. Either way, I'm tired so just stop fighting.

Trauma call

Just to give you a glimpse into what call is like...I was on call last night at our large county hospital with dozens and dozens of physicians on call on any given night. I had a fairly busy night but I've had much worse. This morning one of my friends called the operator to get my pager number to get in touch with me and the operator didn't even hesitate to recite my pager number from memory. Maybe she has a photographic memory but either way we got a good laugh out of the misery that is our current call schedule.

The beating

I recently performed a surgery that is the "holy grail" of general surgery. It is usually reserved for chief residents or fellows but I had the fortune of scrubbing in when no one else was available last week. Lest you think the patient pays the price for my inexperience please know the staff was in complete control of the surgery. He told me that he wouldn't accept anything other than perfection and I assure you that to the best of human abilities that is what the patient received.

Here are some of the quotes from the case directed at me:

• I don't know how I can be any more descript with what I want you to do
• Terrible
• Horrible
• Amateur move
• Are you sure you're up for this case?
• How can you not know how to do that?
• You've got to think
• Unbelievable
• STOP DOING THAT!
• What a rookie move
• I don't like that. Take it out.
• If you mess this tie up she is going to bleed 1 liter per minute so don't screw this up
• Countless expletives
• Your left hand is doing nothing to help- get it involved in the surgery

Lest you think I'm a complete hack he did comment that I have surprisingly good control of the needle for a second year resident and that overall I did a really good job. If the beating I took was with a "good job" I would hate to be there when I'm doing a bad job.

I post all this to keep a balance to all of my happy posts about my surgical training. While I have loved the majority of my residency and have had overall very positive feedback I have had moments and days that just suck. This was one of them. The good news is that starting July 1st I have a year to regroup and enjoy being a newlywed.

I knew what I was signing up for in becoming a surgeon and this is part of it. Lives are on the line and they know I have to be able to perform under pressure. I have to master my adrenaline while I have staff as a safety net before I'm on my own.

By the way the patient is doing very well.

Why I love Indianapolis...

1. It has the benefits of a big city without the traffic and hassles of a big city. For instance- Friday night I went downtown to enjoy the final four hysteria and despite the thousands of people downtown it didn't take me any longer than normal to get downtown. We just don't have traffic problems. I'm not sure how but it's amazing.

2. We host some fantastic events. We have the men's final four every 5 years, the women's every 5, big ten championships, national swimming and diving championships, our first super bowl in a couple of years, and unending conferences and other tournaments.

3. I have some phenomenal friends in Indy.

4. IU medical center is where I've become a surgeon and there's something sentimental about that.

5. It's very affordable for a larger city.

6. I met my soon-to-be husband here and that will make me forever grateful for the city.

7. Maxine's chicken and waffles. Trust me. Next time you come to Indy we should eat there. It really is chicken and waffles and so much better than the name can convey.

8. I live in a neighborhood where my neighbor has done all of my yard work and snow shoveling for two years now. That is a pretty friendly city.

9. Patachou- best breakfast food in the city. I love this place. We can go there too when you come visit.

10. Indianapolis Colts- need I say more?

Career update

In the midst of deciding to get married and planning a wedding I have had a major shift in career focus. It is not because I am getting married that my plans are changing but simply due to the timing of the rotations I have been on and several ways God has been hitting me over the head with the obvious.



For the past year and a half I have been pursuing transplant surgery and have been incredibly excited about the opportunities in that field. Due to my interest in transplant surgery I scheduled as many vascular surgery rotations this year as possible since they have a lot of similar surgical technique. As a result, for the past 18 weeks I have been immersed in as much vascular surgery as possible.



Little did I know how much I would enjoy vascular surgery and that it is actually an area I excel in. During my rotations as I got to know the staff and gained their trust I was doing larger and larger portions of surgeries to the point that prior to completing the 18 weeks I did as much or more than most chief residents do. The feedback I received from staff was unanimously complimentary but escalated to the point that they were discussing why I should become a vascular surgeon and all the many reasons I shouldn't go into transplant surgery nearly every day with me. At first I thought they were just being funny and then I realized how serious they were. It all culminated on the last day of my vascular surgery rotations when a staff gave me even more independence and when he saw how well I did with it he sighed and said, "There is room for you in vascular surgery. There isn't room for you in transplant. When you decide that you want to be a vascular surgeon you just let us know and we will make it happen."

I have received a lot of positive feedback throughout residency that I was progressing well and ahead of my expected level technically, but I've never had so many staff absolutely insist that I have an exceptional talent for their field. I love vascular surgery. It is insanely fun. One staff told me, "It's the most fun you'll ever have with your pants on."

Yesterday I met with one of the head vascular surgeons to talk about my future. It was an incredibly affirming meeting and has left no doubt that vascular surgery will not only be a great career but it is a dynamic field where I can practice anywhere in the world and have a great lifestyle (for a surgeon). I will complete my general surgery residency as planned with 1 year of transplant research beginning this July 1st. Seriously it is going to be the best year of my life up to this point. Wedding, honeymoon, complete flexibility with a job I will do from home... what more can I ask for?

After the research year I will have 3 more clinical years until I can become board certified as a general surgeon. From there I will do a 2 year vascular surgery fellowship. This could be at IU but likely will happen elsewhere. From there the sky is the limit. They have made it clear that I could likely have a job on staff at IU if I want to or I can go to any small or large city in the country or head overseas depending on where God leads Kerwyn and I.

While I won't be doing tummy tucks and face lifts like several relatives have hoped and I won't be putting new kidneys into patients on dialysis I will be involved in emergency life-or-death ruptured aneurysm repairs, restoring bloodflow to extremities that will otherwise become gangrenous, preventing debilitating strokes, providing access for patients who need dialysis and amputating limbs when a diseased limb is actually limiting the quality of one's life.


I am so excited about all that is to come with my surgical career.

In the meantime I'm off to Puerto Vallarta for a wonderful week with my fiance and parents. God is good!

Curling

Last night (thanks to my moms recommendation) I took Kerwyn curling. It was a blast. Neither of us fell but we are both a little tired from the constant effort to stay vertical. We went from minimal understanding of the game to throwing out phrases like, "hog line" and "hurry hard" within 2 hours. I would highly recommend it as a "sport" to try. Even if I never play again I now understand how it really works. I see visions of curling with my house church, other surgery residents and anyone else crazy enough to join us in the future. Sorry for the last picture Kerwyn, but it was too hilarious to not post.

Upgrade

My parents are taking Kerwyn and I to Puerto Vallarta for a week in March. We've had an amazing villa picked out with our own pool and hot tub that we've all been really excited about. It was a splurge but not exorbitant. I just found out tonight that the villa we've all been anticipating is closed for major renovations unexpectedly.

As a result we are getting the most massive upgrade in accomodations that I've ever experienced. We are going from a villa that cost a few hundred a night to one that costs $2200 per night at no extra cost to us. It is obscene. We went from having a cook and a housekeeper (which we were amazed to have) to having a chef and 4other employees working for just us. We have a cliffside villa (yes it's the entire property on the cliff in the pictures below) with an infinity pool overlooking the ocean (with a swim-up bar), a gym, 5 bedrooms with full ensuite bathrooms and individual sun terraces....

It should be an amazing week! And no, you can't come. Part of the deal is that we keep with our original party size. We'll be thinking of you while we gaze out into the ocean from our heated infinity pool.