Saturday, July 26, 2014

the i-don't-knows

i have answered "i don't know" no less than 286 times this month when asked details about moving.

some have been logistical questions that finally have answers:
where will you be living?
monterey hills (east of downtown LA)
have you packed?
finally, yes.
what will you be doing?
it's an HIV corrections fellowship.
i'll be at LA County Hospital's HIV clinic, the LA county jail, and a clinic on Skid Row.
yes, Skid Row is a real place.
yes, I said the jail.
yes, my mom is nervous.
will you miss pittsburgh?

a lot of questions are more complex, and i don't have answers. i have no idea what to expect. i don't know what it will be like working in a jail. i don't know what my patients will be like or how i will fill my days. i know data and statistics about hiv and jail and homelessness, but i don't know anyone's stories yet so i feel at a loss.

the good news is, i've done a lot of things before where i haven't known anything other than facts:

i moved to swaziland knowing only the perinatal hiv rate (42.6%) and the number of orphans (100,000 of a national population of one million). what i found were amazing friends like zandi and jabu who taught me what it is to hope.

i worked in alaska for a month at a native alaskan hospital. i knew rates of alcoholism and domestic violence were horribly high, but it wasn't until bruised women shared with me their stories did i start to understand.

so now i start this next adventure with all of my not-knowing, and am waiting for the stories to begin.

"instructions for living a life:
pay attention.
be astonished.
tell about it."
-mary oliver

Tuesday, July 8, 2014

the end of residency

over and over, i'm breathing out thankfulness.
i made it.

3 years ago, i was assigned five patients.
i didn't know how to enter orders in the computer.
my white coat was still white.
i thought i would only do this for a year.
instead, i fell in love with taking care of patients and decided to stay.

i couldn't leave the place of listening to human stories in exchange for shaping global health policy. i know policy touches communities, but i needed to touch the person in front of me. at the time, it seemed like a huge decision to give up hopkins for a general hospital in a post-industrial city. but i knew i had to stay.

being healthly intern  year was grace; without that year of health, i would have left clinical medicine and entered the world of public health.

it has been anything but easy. four hospital admissions. countless infections. monthly infusions. my sister over and over reminded me "just keep swimming."

so i kept swimming, upstream like the salmon, and i've ended up at beautiful over and over: working in alaska for a month. watching a friend get married in india. listening and being humbled by the patients who trust me with their stories.

and the same prayer i have breathed out countless times over the past three years, whispered under my breath in airplanes taking off over delhi and sitka, to cries from hospital beds when planes left without me:

blessed are you, o lord, who has kept us alive and sustained us,
who has brought us whole to this moment.

Wednesday, July 2, 2014

residency in iPhone photos

This is where I have spent the last 3 years:
The views from the hospital aren't that bad:

I spent most my time trying to figure out which pager was beeping and waiting on people to return my pages:

I survived off of cafeteria food and graham crackers stolen from nurse's stations:
I looked at way too many of these:
I rarely saw the call room (note the unused bed):
I made sure the important orders got in first:
Only once did I ever see the emergency room empty:
There were early morning signouts, greasy post-call breakfasts, and rare chances to sit in the resident lounge:

I had lots of opportunites to wear Indian clothes:
I tried my hardest to avoid being a patient: 
And got to I spend a month working in Alaska:

It's been an amazing, exhausting, humbling, tiring, but beautiful 3 years.
Now I'm turning in my pager and my badge because I'm done!
a million thanks and then some to my family and friends
for all the love that has carried me through these past 3 years.


Wednesday, January 1, 2014

hello, 2014

2013 is over.

i finished second year of residency.

i missed a trip to europe.

i learned to paddleboard.

i was a doctor in alaska for a month.

i ran a glorious downhill 10k through pittsburgh, with "spirit indestructible" blasting in my ipod as i crossed the finish line. two weeks later i struggled to breathe in the step-down icu.

i got an hiv fellowship at USC. i'm moving to LA this year.

life keeps spiraling forward, and i struggle to slow down to listen to the hearts of those around me. but i keep trying.

so hello, 2014.

Thursday, September 19, 2013


I've had a weird fascination with salmon swimming upstream since elementary school science. I don't know why. But seeing a salmon swim upstream was on my to-do list in Alaska.

It didn't take long. There are lots of spawning salmon in September. They swim from the ocean and into the rivers where they lay their eggs and then die. When they are dying en-mass, it smells kinda bad. 

One of my patients told me she was praying for rain so the salmon would have enough water to keep swimming. I looked out the window at the downpour. It rains A LOT here.  God must love the salmon, she smiled. 

In Native Alaskan culture, the salmon is a symbol for determination. Something about that resonates with me. This year has been an uphill swim, a fight against sickness. Yet grace continues to rain and makes the swim upstream just a big easier. Sometimes that rain is just enough energy to get through another day, other times it is a glorious downpour like a month in Alaska. 

God must love the salmon.

Friday, July 19, 2013

in memory of her

i knew when i met her she didn't have long to live. it was a sad story, a few months of nausea that was mostly ignored, actually a rare cancer that had spread throughout her belly. 
they decided to start chemo. she was optimistic; she told me she was gonna fight this thing. we talked about how her hair would fall out, and what head scarves she was gonna buy. how she wanted to go to the beach this summer but was scared to be away from her doctors. about how cute her granddaughter was.  
her family was always in the room. her mom drove her crazy, with the fluffing of pillows and the force-feedings of sherbet and ensure. her sisters told stories of what an amazing person she was. her pregnant daughter brought in ultrasound pictures of her soon-to-be baby girl. her three-year old granddaughter ran through the room, making everyone nervous. they made me feel like family.
the chemo was hard on her, but she managed to get discharged, only to come back a couple days later, dehydrated and weak. this time, when her family had left the room, she told me, i know this is gonna kill me. i'm not ready to go.
she kept getting sicker, and her story changed: i know this is gonna kill me, but i'm ready. her mom pulled me in the hall and started crying: i know she doesn't have long. what do you think? i couldn't argue.
there was something about her, her mix of sadness and hope, resilience and resignation, her honesty, and her willingness to just let me sit with her that kept drawing me back to her room long after i had rotated off her team. maybe because i could carry the grief of my own sickness there and sit with it as she sat with hers. she heard my voice weakening as bronchitis set it, saw my mask when i was at risk for infection, but never asked more than how i was feeling that day. so we would both sit there and separately hold our losses, hers greater than mine, and talk about small things. sometimes she would cry. i would bring rita's and cupcakes that she would inevitably throw up.
i knew she was dying fast, but i didn't think it would be only two days after she left the hospital that second time, only six weeks after the cancer was detected, still four months before her second granddaughter takes a breath. 
i went to the viewing, not to say goodbye to her, but so i could hug her daughter and her mom and her sisters, because she made me want to hug my mom and my sisters, because life is just too short sometimes.