Screaming Inside

Wednesday, September 30, 2009

The last couple days have reminded me why I blog.

My thoughts have been running through my head so fast that I'm being whisked along behind them right onto the express towards crazy. They bounce around against my skull, getting louder and louder that I'm not entirely sure people around me can't hear them.

When Hubster and I were dating, I'd often ask him what he was thinking. Turns out, guys don't like to be asked this. And without fail, he would say "Nothing."

I don't ask he what he is thinking anymore. I can read his mood better than the TV menu. And as our relationship has grown, he shares more and more.

But I always wondered about the "Nothing" response. Is it the same as when someone asks me what's wrong, and I say, "Nothing." Because I don't what you to know. Or is it really "Nothing."

How could anyone be thinking "Nothing" when my mind is constantly going. When I'm not thinking about what's for dinner and did anyone get the clothes out of the dryer, and we still need to get plastic bins for the things in the garage before winter, I'm thinking do I really want to fellowship in Pain Management or should I just stick to general anesthesia, and how long would it take to tile around the fireplace, and does Monkey like his new daycare and why haven't I started saving for retirement, and it's been a long time since I've painted, maybe I should try to work in some time.

It's like this ALL THE TIME.

So I blog. I'm not always to get everything out, but at least a little. A pressure valve. At least to thin out the internal crowd.


I'm never sure how much to share about work. Because I work in medicine. I feel that I can't just talk about my feelings and experiences, because I'm "representing my field." Can I talk about depression rates and the horrific grind of residency without you wondering if your doctor is depressed and therefore should they be taking care of you?

If I talk about doubts and mistakes I make in my training, does that make you trust medicine less? If I were to say that I felt 100% my senior was wrong about something, and so I went ahead and did what I thought was right and practically saved a patient, is that good or bad? Interns shouldn't be acting without supervision. What I did would not have hurt the patient, and definitely helped her, while doing nothing may have been devastating. But should I have acted of my own accord? Or should I have listened to my senior? Telling you this, do you trust the system less?

I believe in medicine.

I don't think we always make the right decisions. I know that people are hurt by poor decision making. Bad things happen, both due to unavoidable side effects or due to blatant over sight or negligence. It is one thing when your mail is delivered to the wrong address. It is another thing entirely when medicine is delivered to the wrong patient. Or procedures are done incorrectly.

But I still believe in medicine.

Western medicine doesn't have all the answers. I've seen more patients' pain managed with massage and acupuncture than I have with pain medicine and invasive procedures. I've seen patients defy all odds. I've seen families and patients alike get more benefit from prayer, blessings, meditation, and even withdrawal of care, than they would have from ongoing treatment.

But I still believe in medicine.

I may not agree with my training. I don't prescribe to the old school thinking of complete dedication to the exclusion of the rest of your life. I disagree with the hierarchy that's been created in the system. Training shouldn't involve humiliation, degradation, and exhaustion until mental breakdown.

But I still believe in medicine.

I've seen children walk who shouldn't have, because of surgery. I've seen women hold children they never otherwise would have had, because of medicine. I've seen people get a new lease on life after a heart transplant. I've seen infections cured, pain treated, bones set, and lives saved. Because of medicine.

I believe in medicine.

What I write is my own experience. I have bad days and heart-breaking moments. I battle egos as frequently as I do fevers and low blood pressure. I have been through bitterness, depression, and fatigue.

But none of that will change how I treat you in the hospital, with the best care I can provide.

Play Space

Saturday, September 26, 2009

I have a day off today, and am doing my best to not think about what happened at work this week.

So I'm going to get back to what's gone on at home. Because my life involves just as much paint, plaster, and finish nails as it does IV fluids, blood, and lab results.

Probably the biggest change in our house has been our family room.

When we first moved in, this room was terrible. Damp carpet, with moldy tack strips and carpet pad underneath. Seriously disgusting.

Now, it is probably the most used room in the house. Which is funny, considering it doesn't have any furniture.

The first thing to do was remove the disgusting carpet and seal the walls to prevent any more water from coming in. The last thing I ever want to see is more of this...

Worst new home owner surprise: Water damage and mold!

Then Hubster showed his brilliant construction skills and installed a new raised subfloor and the same Pergo that we have since installed in the kitchen. How fast this all happened was mind boggling. Less than two days from carpet out to Pergo in. Amazing.

The walls are the same creamy color as the kitchen. I thought about doing a darker accent wall on the fireplace wall. But when I mentioned it, Hubster gave me that look. So no accent wall.

However, the ceiling is blue. I love the blue ceiling. At first, you almost don't notice it, but when you do, it's hard not to smile. It adds such a playful, fun touch.

This room is truly a family room, meaning a place for the boys to play. So toy storage is a priority. The storage shelf is from IKEA. And I love the red accents.



Notice the blue ceiling?

We plan on adding more red accents. Some red bean bag chairs for the boys. A row of Mondrian prints to the wall.

I love the idea of Modrian prints,
because of the primary colors and
the linear lines echoing the storage unit.

Oh, and a couch. We've already found one we love. A comfy chocolate brown one that even Hubster loves. Now we just have to wait for the red maple in the front yard to start growing money.

We've installed new oak plank stairs that (nearly) match the Pergo.

We are going to tile around the fireplace, hopefully next month. And add a big beautiful white mantle, perfect for Christmas stockings.

I wish I could say that the room is still clean, and organized, and full of simple lines and red accents. But like I said before, it is a true family room. A true play room. So it spends most of its time looking like two boys and no parents live here.


Wednesday, September 23, 2009

As a medical student, I never had a patient that I was taking care of die.

Patients I had taken care of died, but I had transferred off service, days, months, before that happened.

This last month has been pushed and pulled at me more than I thought possible. I have had three patients die this month.

Every single time, I could have kept them alive. Their blood pressure had been stabilized, they were breathing easily on the ventilator. But every single time, despite the fact that I had done my best, despite the fact the patient was "stable," despite the fact that my attending, myself, and the rest of the ICU team had gone over every possibility and treatment plan, the patient was not going to get better. They were lying in the ICU bed with tubes and wires snaking off their body, surrounded by monitors with multicolored blips and beeping fluid pumps. They had everything medicine could give them. And it wasn't going to make a difference.

Every single time, the families requested that we withdraw care.

Devastating strokes that happened in the middle of the night. Traumas that left the families angry and confused. A combination of a million little things that left the patient and the family with no way out.

When it is just me, a handful of ICU nurses, and the patient, I'm fine. The patient, a middle age woman with a non-functioning brain stem, or a young man with a traumatic brain injury, is quiet, sedated, breathing rhythmically with the ventilator. I adjust medications, watch clear fluid and dark blood flow through tubing to the patient. I listen to breath sounds, feel pulses, watch as the medications slow the heart rate and raise the blood pressure. It is quiet, the patient is stable, and I am fine.

Then the family comes in.

They must have just talked to the surgeon, or the neurologist, or the trauma physician. They are crying, some loudly, some silently. Occasionally, there is yelling at the bedside and someone is asked to leave. There is more crying down the hall, because patients can only have a few visitors at a time.

It is no longer quiet, and I am no longer fine.

The nurses are talking to the family, to the weeping mother, the pale sister, the blank-faced son, so I slip away to the back hall, between the linen carts.

I did my job, and it doesn't matter. I can't fix the brain, I can't save the kidneys or heart. I can keep breathing for them, but they will never breath on their own again. I am crying. I approach a breakdown of my own. And it isn't my grief. Everyone I know and love is still alive and healthy at home, and I will go home to them when I am done with this terribleness. I will finish my shift and leave their grief behind me. It isn't my grief, but still I am crying.

I can only allow myself seconds for the wave of sadness. I return to the silent patient and the aching family.

They wouldn't want this, everyone tells me. The surgeon says there is nothing more they can do, they say to me. Yes, they told me the same.

Two at a time, they say their goodbyes. It takes a very long time, yet not nearly long enough.

Three times, we have taken the breathing tube out, turned off the monitors, pulled the curtains around the bed.

Three times, I've watched someone die. It is never my grief, but still I am crying.

The High Point

Friday, September 18, 2009

I'm approaching the point in residency I've been dreading.

The point where I'm constantly fatigued. I'm so tired that I can't think about doing dishes, or helping prepare meals, or managing the boys school papers. The point where I'm away from home too much, taking overnight in-hospital call every third night. The point where I feel like I will never know enough, never be able to study enough.

I've known this time was coming. I'm not sure if knowing helps me be more prepared or if it just becomes a self-fulfilling prophecy.

During intern orientation, we are shown a graph of rates of depression during intern year. The rate in June is near zero. By January, the rate is near 75%. Everyone looks at this graph and points to the high point in January. We are then given talks about how to cope during the midpoint of the year, the increasing stress, higher expectations combined with the lack of sunshine.

I am scheduled to be on Trauma service at that point.

Although impressive and terrifying, the peak in January isn't what concerned me most about the graph. The red line we were shown never went back to baseline. The rate of depression, so low among incoming residents, so happy after completing four grueling years of medical school, never returned to zero. The lowest it got was 20%.

The funny thing is that even as I approach that January peak, and boy, can I ever feel myself rushing towards it as my confidence and ability to stay awake while standing are every tried...the funny thing is that this is still better than medical school ever was.

Room For Boys

Tuesday, September 15, 2009

One of the things I felt I missed out on raising the boys in apartments was the chance to decorate an nursery. Bug's "nursery" consisted of his crib at the foot of our bed in our first one bedroom apartment.

I did give in once, and painted a beautiful room at one of the places we lived when he was nearly three years old.

Bug's 2 year old bedroom, at apartment #3

It was promptly painted over the minute we moved out. (I knew it would happen...but still...)

So the chance to create an amazing boys room at our new home was exciting. For everyone. Bug had no shortage of ideas.

I want my walls painted like a tiger. I want really, really, really dark green. I want a Batman room. Can I paint one wall orange?

I'm all for letting children have input into the design on their own room. But some of these ideas were just a little too bold for me.

Then one day, Bug announced he wanted a red room. Once he decided that, there was no changing his mind. Although I wasn't sure I wanted an entirely red room.

So I told Bug we would do a red stripe in his room. At first, he was incredibly disappointed. He'd been counting on floor to ceiling, all four walls type of red. Even trying to sell the stripes as "racing know like race cars have" didn't make him happy.

Until we found the bunk bed. We weren't even looking for one, although we had discussed it, since Bug and Monkey were going to share a room. We walked into a wholesale furniture store, looking for a coffee table. And there it was. A red bunk bed. It was beautiful. I fell in love with it immediately. So did Bug. I said that we couldn't have red walls and a red bunk bed, because then we couldn't see the bunk bed very well. "That's okay. Maybe we could just do a red stripe instead."

Just like it was his idea all along.

The BEFORE: Just a typical bedroom

The AFTER (part 1):
We used the same warm tan in all the bedrooms. The trim got the same antique white color as found in the living room and kitchen. We installed new darker brown (clean!) carpet. And then, of course, there are the stripes.

The red bunk bed makes its appearance.

A home for Monkey's entourage

Bug's art desk

The boys' room is the most finished in the house. I think it is a style that works well for two little boys now. And hopefully for two bigger boys in the year to come. And while the walls are not head to toe red, the room definitely is Bug's much wanted red room.

First Signs

Monday, September 14, 2009

Fall comes slowly here. It has been creeping up on me for weeks now. The hint of yellow between the green. The droop of flowers. The tinge of red along the river.

Fall in Utah was so different. First the trees would change, nearly overnight, on the mountain sides. The frost and snow would come soon after. Suddenly the color and crispness of fall would be gone, sidewalks covered in the crunch of brown leaves, trees bare against the sky. And I always felt like I missed it.

Here, it has a slow gradual pace, as if autumn is enjoying itself. Flowers change from purple and blue variety to a yellow and red. Trees take their time, trying to be inconspicuous about the small piles of leaves forming underneath them.

Fall has not yet descended in all her glory. But every day I see more of her.

An Entry Way

Saturday, September 12, 2009

The entry way to a home sets the stage for what else is to come. It is just a taste, an introduction to the rest of the story.

I'm not exactly sure what ours is saying, but I like listening.

I don't have any good "before" pictures, because who thinks to take pictures of their unpainted front door before hand?

I have always wanted a red front door. And it's not (just) the Feng Shui tradition of a red door bringing luck. A red door says home, welcome, and happiness lives behind there. I'm sure other door colors could say the same thing, but a red door just seems to say them a little bit louder.

I found the mirror at an antique store years ago, and it appeals to my Jane Austen shabby chic side. It was dark brown when I bought it, and I repainted it white and then antiqued it with a raw umber glaze.

The shelf came from IKEA (custom fit courtesy of Hubster) and appeals to my clean, simple side.

The pears...well pears make me happy. They are such a pretty, artistic fruit.

(All the pears are turned with bite marks towards the wall. Because sometimes, three year old little boys just can't help themselves.)

I still imagine a large turqouise vase with tall curly willow branches in it on the shelf. And maybe a apple green and blue glass bowl for keys and spare change.

(I found this one on Etsy, here
The turquoise vase was also on Etsy,
but it is sadly sold out)

But since currently everything in the entry way is unbreakable, we may just leave things how they are. For now.

The World We Know

Friday, September 11, 2009

Everyone I know remembers where they were when they heard that an airplane had hit the World Trade Towers.

It will be the question that our children ask us when they have homework to interview their parents about growing up. Just like how I asked my parents where they were and what they were doing when they heard JFK had been shot.

We talk a lot about how our lives changed that Tuesday. About the war waged since the following March. About the more complicated security in airports. About level yellow and orange security levels. About How America changed in the view of the rest of the world. About how we came together for a moment.

We talk about a pre 9/11 world and a post 9/11 world.

For my children, their entire lives are post 9/11.

They will never have any other context than a world without the Trade Towers. A world with a war in Iraq. A world where people continue to be afraid of Muslims and Middle Eastern men.

I will never be able to give them the world before.

Just like they will never know a world before Columbine, where parents sent their children to school without worrying if that school would be the next one in the headlines.

While our world and our world view changed forever 8 years ago, the world for my children did not. The change we live in and still feel every day, is the only world they will ever know.

One Year Later

Saturday, September 5, 2009

I will get back to posting about my exhausting, long drawn out home renovation. Promise.

But another thing has come up.

My blog is one year old today.

I actually started blogging about one month before that, one what I now call my "family blog." Because that's what it is. It is all about my boys, and Hubster, and family activities and get-togethers. It is a stereotypical mommy blog.

I started blogging because I thought it was the best way to keep my family up to date with our lives. The grandparents could see darling photos, my friends could see what we were up to.

But soon, I realized that I wanted to write, and not just about my boys, or the latest trip to the lake. Those things, while still important to share, did not fulfill my desire to share my thoughts. My opinions about books and photos I loves and the complete randomness that is my thought process sometimes felt out of place on an otherwise linear family blog.

So I created this place.

One year ago, I never could have imagined how much this blog would come to mean to me. Many times I've turned to here as a safety valve. I've been able to express, maybe not the darkest, most intimate inner working, but definitely parts of me I felt were worth sharing.

Above all, I never expected anyone to ever read it. Especially not 21 someones, and the occasional wanderer who shows up looking for someone who hated Wuthering Heights. Every single reader has meant so much. Every single comment makes my day.

So, for the little celebration I'm having for my blog, I would like to introduce myself to you. In a much more succinct way than you've been introduced in the past, which has been wandering, rambling "getting to know" process.

But in exchange, you must let me know something about you. I don't care if you are a family member I've known my entire life, a friend I've known for years, a reader who leaves comments, or someone who has just stumbled for the first time across my attempt to be optimistic. I want you to introduce yourself to me. Because it's polite.

And fun.

So here we go.

Hello. I'm Katherine. I'm a 27 year old mother of two. I spent some of the happiest years of my childhood growing up across California, tagging along with my Navy father and my ever growing family. When I was 11 years old, my family moved to Utah. I lived in Utah for most of my life. In fact, when I turned 23, Hubster told me I had to stop telling people I was from California, because I had lived in Utah for longer than I had ever lived in California. I met my husband when I was still in high school. Nearly two years and one year of college later, we got married.

In the eight years that have followed, my life has been a mixture of happiness, chaos, hard work, and magic. We have two darling boys, Bug, age 7, and Monkey, age 3. Not their real names, obviously. But for all intents and purposes, they might as well be.

During the time that Hubster and I were raising two darling boys, I also applied to medical school, got accepted, went to medical school, threatened to drop out of medical school, and then one year ago, graduated medical school.

3 months ago, my family of four packed up our 2 bedroom apartment life and moved 1200 miles away from the mountains of Utah to the corn fields of Iowa, so I could start my anesthesiology residency training.

So, if you're keeping track, I'm a 27 year old, happily married, mother of 2 boys, first time home owner, anesthesia resident-physician.

I also have a serious age complex. I haven't determined whether I'm too young to have all those titles, or too old to still experience the emotions that come with those titles. Or just crazy. A lot of days, we just go with that one.

So now it's your turn. I don't care if it is one line or an entire paragraph.

I've been here a year and I would love to get to know the landscape a little better.

Game Day

Friday, September 4, 2009

I must interrupt my regular programming for a very important update.

I've already mentioned my sadness about the passing of summer. Even now, looking out my office window, the flowers across the street are looking slightly wilted and there are now, not just yellow leaves, but red leaves too in the trees around the school yard.

Someone else out there must have felt the same pain that summer was over. Because they did the very best they could to ease the transition between warm, carefree summer days and the nip and chill of autumn.

They invented college football.

Last night, watching Boise State beat up on Oregon while checking the progress of the Utes game on the computer (Oh, the sadness of leaving our beloved Mountain West conference and living in the land of the Big Ten) I once again realized how much I love football.

Image "borrowed" from ESPN

I'll be honest here. Before I met Hubster, I didn't know a pick from a fumble, a tight end from a running back, a play action pass from the option. But then, just as I introduced Hubster to the wonderful world of Harry Potter and Lord of the Rings, he introduced me to the beauty of college football.

I've tried watching the NFL. While I will admit that I do love the occasional Monday Night game, and that I enjoy a good Super Bowl party as much as anyone, I just never was able to get that into. The NFL is more about super egos, trades, and politics.

College football, on the other hand, is all about the love of the game. Most the boys playing college football will not go on to play professionally. While most of them do get some compensation for their playing in the form of scholarships, it still requires a lot of them. We joke about paid test takers and easy majors, but the truth is that sports gives college opportunities to many who wouldn't have any otherwise. These kids play with their hearts. And you see it with every ecstatic cheer after a win and every look of heartbreak after a loss.

I'm going to miss my Utes something fierce. After two perfect seasons and two BCS appearances I have high expectations and higher loyalty. Because of a poorly thoughtout decision to have a conference TV channel, I will not be able to watch very many Ute football games here in Iowa.

But Iowa is doing its best to ease our pain. College football, depending on who you talk too, comes just after, or just before, God and church out here. During game day, the local university stadium becomes the fifth largest city in Iowa. We hope to make it to a game this year.

Because it doesn't matter if it is your alma mater or not. It doesn't matter if you cheer for the home team or not. It doesn't (always) matter whether you win or lose.

What matters is the game.

Big Reveal, Part 2: The Kitchen

Thursday, September 3, 2009

When we first saw our home, we loved the Pergo that was in the living room.

The adjoining kitchen has blue linoleum, which we imaging being replaced by the same Pergo that was in the living room. We thought it would make the main floor feel more open and light having the same flooring throughout.

However, given our limited budget and time, we were never that serious about replacing the kitchen floor.

Until the home inspection revealed some rot underneath the kitchen floor by the back door. The subfloor needed to be replaced, which meant tearing out the existing kitchen floor. While we knew this would be a labor intensive project, we were still excited, because it gave us the perfect excuse to extend the American Beech Pergo flooring of the living room into the kitchen...just like we had imagined.

But before any of that could happen, the popcorn ceiling had to be removed. That involved days atop ladders and stools, wearing masks, equipped with spray bottles, scrapers, and sanders. We've tried to completey shut that portion of the home renovation out of our mind. It was more miserable that I will ever be able to convey. But worth it. Now, a home that had popcorn ceilings through out (and when I say through out, I'm including closests and bathrooms and every single other surface that could be interpretted as a ceiling.) Like they say, things must get worse before they get better.

Replacing the kitchen floor turned out to be just a slightly bigger project than previously anticipated. Turns out, the previous home owners had installed the blue linoleum right over the old linoleum, which had be installed right over the original linoleum. Between the layer of blue linoleum and tan linoleum, and then again between the layer of tan linoleum and original red, orange, and avacodo green checkered linoleum, was an additional subfloor. So, if you're keeping track, that's five, FIVE, layers of old flooring that needed to be removed before we could reach the damaged original subfloor. We discussed not fixing the subfloor and just laying the Pergo right over the five other layers of flooring. However, the kitchen floor was already raised nearly 1/2 inch compared to the living room floor due to previous homeowners taking this same approach.

So, we gritted our teeth and did it right. Well, Hubster did it right. I mostly watched between naps recovering from night shifts and overbearing senior residents. I will say this. When you come home to scenes like this, it can be slightly overwhelming.

The paint color was another challenge. I had thought about doing a lighter version of the living room color. But because we had to work around the existing countertops, I thought that it would be too much blue-gray in one room. Then we thought yellow. A yellow kitchen is so cheerful and friendly. However, after we starting painting the kitchen yellow, we didn't like how it felt next to the calming blue in the living room. The contrast was too much, and even though we had chosen a very creamy yellow, it felt much too bright.

One evening, as we were sitting there, staring at our very yellow wall, I confessed that I thought it wasn't the right color. Hubster chips in with, "Well, I always thought the yellow was a bad idea." Well, thanks.

After more paint cards stuck to the wall and more discussions, we decided on a warm cream. The color reminds me of antique parchment, comfortable linen, and Florida beaches. While quite neutral, it is warm and welcoming and works so nicely with the antique white trim that we extended in from the living room.

Between the new floors and new paint, our kitchen is mostly done.







This room also suffers from lack of accessories. But just imagine a giant iron clock on the wall behind the table.

And a larger table that would actually have room for guests to sit at it. I love the idea of a table in the same dark espresso wood we used in the living room, surrounded by cross-back chairs in white, to pick up the color of the trim.

But even without those, our kitchen is nice. It is bright with so much light coming in from the large back door over looking the back yard.

It is also a place where extremely competitive games of Phase 10 are played and new attempts at cooking are both enjoyed and, um, declined.