The Shack

I just read this book in the past few days. I found it hard to put down because it truly challenged my perspective on tragedy, the reality of God, and how God works through tragedy. Of course it needs to be read as fiction, but I think there are some figurative truths that it makes easier to grasp. Is it the Bible? No, but it conveys some unique aspects of God in a way that is thought-provoking. I would recommend it to anyone and everyone! This quote at the end sums it up,

Earth's crammed with heaven,
And every common bush afire with God,
But only He who sees takes off his shoes;
The rest sit round it and pick blackberries.

-Elizabeth Barrett Browning

Oh that we would have eyes to see!

Story Side B- Be Still

I heard this song yesterday and love it. Enjoy!

Insomnia

I can't sleep right now. I'm on call and have been for 60 of the last 72 or so hours. Despite the relative sleep deprivation I am unable to even consider lying down because I am so energized by taking care of patients. It's crazy. I LOVE what I am doing. Being a doctor is pretty much the most incredible privilege. Some wise person said, "Do what you need to do so someday you can do what you want to do." I have thought about that often through college and medical school and I am much closer to the end goal and it is much better than I could have imagined.

Tonight I discussed "code status" with a family whose mom is likely to die tonight. I get to spend the night walking through this with them. What an honor! After speaking with them the well-experienced nurse gave me a hug and said, "Once again you are my hero." I said, "Why?". She said, "I just love the way you do business. You have a really great way of relating to patients." I don't rely on the affirmation of those around me, but it is really encouraging and energizing to be reminded that I am doing exactly what I was made to do.

While I wouldn't mind getting some sleep tonight after a very long week, I know that in 5 days I will be flying to Palm Springs, CA for a week of fun and rest. So tonight I will lean in and help this family walk through one of their darkest nights.

What do you need to do so you can do what you want to do? I've still got a long way to go to be a staff surgeon able to go abroad and teach others, but I'm taking steps and know that that day will come much faster than I expect.

Voices

I'm sitting in one of the call rooms (no, this doesn't happen often it's just a very slow day)at the hospital thinking over the weekend. I am blessed to have some incredible mentors speaking into my life and in the past week I have interacted with all of them. These aren't the only people I listen to, but their words to me have increased weight because of the respect and admiration I have for them.

Sarah Kolasa Bouma formally mentored me in my last year of high school and through college. She walked with me through the hardest period in my short life and alongside God, counselors, family and friends helped me come out much stronger and more balanced. She called me to be a great leader and helped develop some early leadership gifts in my life. I have always looked up to her and consider her friendship to be an incredible blessing in my life. She might be the only friend who shares my appreciation for Dumb and Dumber and Night at the Roxbury.

Michelle Wegner is someone I have looked up to since middle school when I first met her. She has always been one to challenge and encourage me and in the past year we've taken that up a notch. I am so thankful that she takes time out of her busy schedule to email and get together to talk. I love hearing about her life, her incredible marriage and family, books she is reading, and her vision for what we can do to take the Kingdom of God all over the world.

Arch and Connie Nevins are the leaders of our House Church. They lead our group with love and wisdom. They are a blast to hang out with and it is phenomenal to dive deeper alongside them. I am so blessed to get to share life with them. Arch is writing a book that I can't wait to read. I'll let you know when it is available.

Dr. P is a surgeon who has been very intentional about mentoring me. He actually paged me one afternoon after I was done working on his service to ask if he could mentor me. It wasn't a hard decision. He's one of the leaders of the trauma/critical care program and he sees something in me that he wants to develop and help guide. He's a great man who treats me to good food and is helping plan my career.

Alison is a surgeon I connected with this year who is teaching me the ins and outs of surviving and thriving in a surgical residency. She has helped me work on my technical skills, patient management, presenting at M&Ms, and has also been a great model for blending marriage/motherhood and a surgical career (I'm not married or pregnant, just aware that someday I might be). A week into working together she said, "look I'm mentoring you whether you like it or not...". It was pretty funny.

There are many other individuals who have spoken into my life in ways I will never forget. I feel so honored to have friends and mentors to share life with. I wish I was mentoring someone formally but for now I spend a few focused weeks at a time with medical students. It is a great opportunity to get to know them, challenge them, encourage them, and model what a caring surgeon can look like. Who is your mentor? Who are you mentoring?

A quick update

Just wanted to check in and let everyone know that I am still not only alive, but doing really well. Residency is insane. There are times when I just walk around the hospital laughing at the obsurdity of everything. Here are some of the highpoints/lowpoints that are so awkward I can't not tell them:

• After operating with a surgeon I hadn't previously worked with he stopped and shook my hand and said, "welcome to the team". I didn't realize this but apparently he is really critical and tends to yell and swear a lot. He never even appeared remotely upset or bothered by me. Of course he gave me pointers but I made every cut, threw every stitch, and tied every knot myself. As I walked out of the OR I smiled and said a quiet, "booyah".
  
• When finishing my transplant rotation the secretary on the organ transplant unit gave me a huge hug. They kept telling me that they weren't going to let me leave the rotation because they're not used to residents actually enjoying the rotation and having fun with them. I tried to get them to organize a flag football game for the unit. They're hoping I go into transplant surgery and become the fellow for 2 years.
  
• One day I was rounding with the nation's leading transplant surgeon (in quantity and outcomes) for a certain organ and he mentioned a certain study and I was miraculously familiar with it and was able to discuss it intelligently (it just might be the only study I could have talked about). He said, " I can't believe you have even heard of that trial. It is incredible that you are able to have a conversation about it." I told him I was seriously considering transplant surgery and he exclaimed, "That would be great. I would really like that." It's good to have allies in the field you are considering pursuing!
• A resident pulled me aside at the end of my transplant rotation and said, "I know you feel abused and like they are giving you too much responsibility but you should take it as a huge complement. They are doing it because they trust you. Look at you, you are rounding by yourself on all of these patients in the ICU and writing orders while the other intern literally isn't allowed in the ICU unless he is with another resident. You are an awesome intern."
• While on call (about 25 hours into the shift) a nurse paged me and said, "I think this patient's trach (tube in the neck to help with breathing) fell out." I said, "What makes you think that?" She said, "I walked into the room and it was lying on his belly." This is the point where I wanted to joke around and say, "You think it fell out? If it's on his chest it's not in his neck-of course it is out." Instead since it was an emergency and she didn't know me enough to appreciate my sarcasm I just hung up and ran to the room to find a morbidly obese (around 500lbs) man lying there with a hole in his neck. If only you could have seen the rest. Trust me this job is really glamorous. FYI- he's ok now.
  
• I was told I needed to mark the site (write "yes" on the area of the body we were going to operate on) on a kidney donor and since I had no idea where specifically they make their incisions in that surgery I just put a large "yes" on the proper side and she freaked out. It wasn't where she thought the incision would be and I told her that I wasn't sure where the incision would be made. At that point she lost all confidence in our surgery team and was seeming to regret her decision to give up a kidney. It was a hilariously awkward situation where I tried to convince her that indeed I would not be the one cutting on her, I was just making a vague marking to get the right side of the body. In the end we got the kidney and so far it is working well. It is experiences like these that keep me very humble and remind me of how much I have to learn.
  
  

I am considering transplant as a career. Regardless what is becoming clear is that I do best with critically ill patients. I find myself naturally migrating to the ICUs and that is where I am most comfortable. Who knows what the future holds, but I'm getting more excited to pick a field and pursue it all out!
P.S. if you find yourself needing a liver, kidney, pancreas, small intestine, or stomach I would recommend IU very highly! They are one of the top programs in the country. People come from all over the world to have transplants done here. Who knew???

Meet Mbali

I wish I had a picture to show you, but I don't. However, Mbali is a beautiful 3 year old girl in Swaziland that I am sponsoring through World Vision. She lives in a country where 26.1% of the population has HIV/AIDS- the highest prevalence in the world. Her birthday is the same as two of my closest friends- October 1st. She turns four this year and is already responsible for carrying clean water for their family every day. She lives with her parents and two sisters. Her dad works in construction and is not surprisingly struggling to provide for their family. My $35/month will provide her with clean water, food, healthcare, education, clothing and other basic necessities.

Why did I decide to sponsor a child? Because children matter to God and I believe the HIV/AIDS crisis is breaking the heart of God. We are blessed to be a blessing and while I am a tad bit busy with residency, I can't ignore the extreme disparity between what I have and all that so many lack. I long for the day when I can go and operate on the sick and provide them with healthcare that they otherwise wouldn't have, but in the mean time I have to do something. Maybe I can even meet Mbali next time I travel to southern Africa.

Why World Vision? 86% of the money I give goes directly towards those in need. Their overhead is very small compared to many nonprofit organizations. They also give the option of sponsoring children in conflict areas (Columbia, Uganda...), areas with extreme health crises, children being exploited, etc.... Children all over the world have extreme needs, but my greatest interest is in those areas with rampant health crises.

Why Swaziland? I knew they had the highest HIV/AIDS prevalence and that sealed the deal.

It's fun to have an income and to be creative with other ways I can leverage my resources for bigger purposes. Mostly, I'm planning to pay off loans, but it's exciting to have some discretionary funds for other causes!

The question, "Is our community and world any different because our Church exists?" has been banging around in my head quite a bit. I'm still processing, but more and more convinced that if I'm not intentional about this the answer will be "no".

We are blessed to be a blessing. Who are you blessing?

Just another day

Here is a typical day in my life as a surgery intern on call:
Get to the hospital by 5 or 6am (sometimes 4am depending on the service)
Round on all of our patients with residents/fellows/med students- for us right now we have 23 patients, most of whom are critically ill so this takes a couple of hours
Meet with attending to round again
Write orders on all patients, schedule tests and procedures, contact consultants and discuss plans
Go to OR (this isn't happening much yet for me, but it will on other rotations)
Inhale food
See patients, follow up on tests, write more orders
Go back to OR
Admit new patients to hospital
Meet with intern from every other surgical service when they go home to get my "to-do list" from them on their patients
Answer unending pages (literally 100-200/night) from trivial questions to emergencies
Do post-op checks on everyone's patients
Admit new patients
Put out fires/crises
Eat
See more new patients
Try and lay down for a bit- get interrupted by a page every 5-15 minutes
Get up and talk with every other intern when they show up in the morning to tell them what I did with their patients overnight
Go see all of my patients again
Round with other residents/fellows on my team
Go to morbidity and mortality conference and resident education hours
Round with our attending
Write orders, call consultants, ensure tests and procedures are still happening
Take sutures out of patients, pull drains and tubes
Go home after 32 nearly non-stop hours
Go for a long bike ride to unwind- still answering pages while biking down the road
Continue to get pages every hour for the rest of the day
Go to sleep early to start it all over again the next day

It's been pretty wild, but I love what I am doing!