Chicago

     A few weeks ago, we made a trip to Chicago to visit a couple of residency programs and see the city.  It is taking me a little while to get pictures on the blog because Mark takes about 1000 (literally) in each city we visit, so there are quite a few to choose from!

     Our first stop was for some Chicago deep dish pizza, and it was so yummy!  On the other side of that pizza was our good friend Matt Lapine.   He and his wife Molly, who was back at the hotel with their precious daughter Bella for nap time, were able to meet us for the weekend and it was so good to see them!  We met Matt and Molly pretty soon after we were married when we were in the same church small group, and we became fast friends.  We have missed them dearly since they moved last July, but have been excited for them as Matt enjoys a new job in Toledo, Ohio.  It was so fun to spend time with them again!

     Molly and sweet Bella.

     Bella loves leaves.  She would be perfectly content to sit in her stroller with a leaf in each hand.  She is such a laid back kid and smiles more than any little one I've ever met!

     A pretty view from our walk along the water toward Navy Pier, which is in the background if you can see it.  Mark and I realized that every city we are looking at is on a body of water, which we are so excited about because it is so pretty!

     This one was taken from Navy pier.  I love the silhouette of the city and the bird in mid-flight.  Mark is such a great photographer!

     The Art Institute of Chicago, where Mark's aunt studied.

     Running Bella up a ramp.  She was pretty unfazed by the excitement.

     Can you spot the two people in the center of the bean, one is much taller than the other?

     There they are.  I didn't realize the last time I saw this structure how cool the reflection of the city looks.  I'm guessing I was missing the main point of it.

     Another thing you learn when you are married to an artist with a background in art history and architecture is to appreciate buildings.  An interesting little tidbit Mark brought up is that we've seen a Frank Gehry building in each city we've visited.  In Seattle it was the Experience Music Project, in Chicago the Pritzker Pavilion (below), in LA the Walt Disney Concert Hall, and in NYC the 8 Spruce Street building.

     The "L."  Mark and I are really excited about living in a place that has good public transportation.  We are looking forward to selling our cars and spending more time walking outside.

     You don't have to know Mark very well to know that he has been a lifelong Cubs fan.  So, of course we had to make the pilgrimage to Wrigley Field!  He was such a happy guy.

     After we left Wrigley field, we walked around the Lincoln Park area which is a neat more-residential neighborhood.  We were walking by this park and I said, "Um, I think that's a rhino."  Apparently, there is a free zoo in Lincoln Park!  So, of course we walked through.  I did not wake up that morning thinking I'd see lions and tigers and rhinos!

     The tiger was roaring.  Mark started to make some comment about how he was probably roaring because he was miserable, but I stopped him mid-sentence because there was a 5 year old boy standing next to us.

     The lions were taking a rest.  They were right up next to a window, so we could see them up close.  The picture doesn't do justice to how massive they were.  Their paws were the size of my face.  We talked about how powerful and majestic they are, and got a better picture of our God's power and majesty as he is often described as a lion in the Bible.

     Overall, we had a great time in Chicago.  It is such a neat city with a lot of natural beauty paired with the excitement that a big city brings.  Mark was with me for a three day weekend and then he flew home to get back to work and my mom joined me for the rest of the week.  We had a lot of fun walking, shopping, and of course, eating.  I interviewed with 2 programs and we left feeling like Chicago will be a definite possibility for our next destination!

Seattle

Our first stop on the interview trail was Seattle.  My brother has lived there for the past 5 years, so I've been there before but it was Mark's first visit to the Pacific Northwest.  It is such a pretty part of the country and has a great mix of city life and natural beauty.  Shortly after we arrived, we took a ferry boat over to Bainbridge Island, which is where the next three pictures are from.  It was a very quaint little town and we had some amazing coffee, lunch, and probably the best ice cream I've ever had.

On our second day, we visited Pike Place Market, the famous farmer's market in downtown Seattle.  We watched the fishmongers throw the gigantic fish, looked at the incredible flowers, and smelled the delicious baked goods.  We tasted some yummy roasted hazelnuts and fresh baked donuts, and got fresh salmon and crab to make dinner that evening.  Mark got some amazing apple cider, but I recently learned he only likes cold cider after I excitedly brought home hot cider k-cups for our Keurig coffee maker which he gently told me tasted like medicine.  

I interviewed with Seattle Children's Hospital and really liked it.  The program had a very warm, welcoming feel and the hospital was a free-standing children's hospital (as opposed to a pediatric ward in a general hospital).  The residents seemed to enjoy their lives, meaning they didn't seem too stressed out, which is also a plus.  There are some neat opportunities for community advocacy projects and global health.  Each resident also spends 2 months in their second year in a rural area of the northwest known as the "WWAMI" region (Washington, Wyoming, Alaska, Montana, Idaho) working with populations like American Indians, migrant farm workers, etc.  So, altogether it sounded like a well-rounded and somewhat unique residency.  It was my first interview, so I don't know where it will land among the rest, but it was a great start!

The Trail

The next few months of our life are pretty unique if you aren't familiar with how medical school/residency works.  I've found that most people's idea is some combination of Grey's Anatomy, Scrubs, and House, which is usually pretty far from reality.

The terminology usually confuses people, but medical school is 4 years and you are only ever known as a medical student or occasionally a sub-intern in the 4th year.  You are officially a doctor when you graduate medical school, but you go on to further training, called residency.  The first year of residents are called "interns."    In Pediatrics, 2nd and 3rd year residents are known as "upper levels," "residents," or "senior residents."  Also unique to Pediatrics and a few other specialties, "chief residents" are doctors who are elected to stay an extra year after 3rd year to serve in an administrative/leadership position.  Beyond residency, doctors are known as "attendings" if they are in an academic setting where they are overseeing residents and medical students, or they are just board certified physicians.  So, this next step is a 3 year training process, but it is a job where I am getting paid, etc.  The climate of residency has changed a lot over the past 10 years, where they used to have no duty hour regulations but now, we are limited to 80 hour weeks with no more than something like 26 consecutive hours of patient care.  New this year, interns are only allowed to do 16 hours in a row, eliminating overnight call.  Most programs I've looked into have gone over to shift work, which a lot of people don't like for some reason, but I enjoy coming home at night so it sounds good to me.  I guess I'll see what I think next year.

A few months ago, Mark and I decided on different parts of the country where we would be willing to move based mainly on places with good job opportunities for him.  We landed on Seattle, Los Angeles, Dallas, Chicago, and New York.  It was pretty easy for me to find some great programs to apply to because they are all big cities with good options.  I sent in my application at the beginning of September, and we've set up all of the interviews between now and Christmas.  After I visit and interview with the programs, I'll enter a list ranking all of the programs where I'd be willing to train into a national ranking website.  All of the programs submit a list ranking their applicants and the computer matches you to one program.  On Friday, March 16, we'll go up to campus and after some anticipatory festivities, everyone in my class along with everyone across the country will open envelopes at the same time and find out where they are going.  Exciting!

So, between now and then, I'm going to try to keep the blog up to date with our travels around the country.  We've already visited Seattle and it was a great start!  It all started to feel real when our plane landed in Seattle and Mark and I started talking about how it could possibly be our next home.  Mark is going to come to each city once with me so we can make a good decision together, and he is trying to network with some companies in each place to feel out the job market.  It is a really exciting time for us, filled with a lot of unknowns but we are looking forward to this next step!

The Bunny Slope

I started my 4th year of medical school in July.  It is kind of hard to believe that my last year of school is finally here!  On one hand, it has been a very long road and I'm ready to move on, but on the other hand, it is a little intimidating to think that I'll have an MD attached to my name in a matter of months.  In the mean time, 4th year is amazing.  Aside from a set of board exams, this year has no tests or grades and is much less stressful than the past three.  There are three required rotations which include a sub-internship which is a general inpatient month where you are treated like a 1st year resident, an acute care month which is an ER or ICU month, and an outpatient clinic rotation.  Other than that, there are 4 elective months for a total of 7 months, leaving a solid 4 months for vacation!  Hooray!

My sub-I was in July and I was on an inpatient team at Children's that was half general pediatrics and half endocrine patients.  I worked hard that month, but it was so exciting to finally take real responsibility for my patients.  During 3rd year, there is always an intern (1st year resident) seeing the patient along with you, and they are the ones who are responsible for the patient.  Often there are things going on with a patient that you don't know about because you aren't the primary physician.  As a fourth year, you make decisions, write orders, call consults, answer nursing questions, and generally take full responsibility for the patients and although it is much more work, it is so much more fulfilling.  There were some real challenges that came with those responsibilities, including dealing with a stressed out Mom who vented all of her frustrations on me in the middle of the hallway one day, but I learned so much from even that unpleasant experience.  The fact that I enjoyed my sub-I so much was real confirmation that I chose the right career path!

August was my outpatient clinic month, and I did 1 week in the pedi endocrine clinic, 2 weeks in the pedi rheumatology clinic, and they let me spend 1 week out at Camp John Marc for Camp Joint Adventure!  It was so awesome to spend time at camp again.  I worked mainly with the horses, which was a totally new experience for me and I have a new appreciation for the hard work it takes to work out there.  It was really refreshing to spend time outside and get out of the hospital/clinic for a while.  I hope there is a time in the future when I can be in a camp setting again, it is such a neat place.

September was a dermatology elective, affectionately known as derma-holiday because I averaged 2 days of work per week with a few lectures here and there.  I learned a little bit, but mostly enjoyed some free time and studied for my boards which I took at the end of the month.  No more tests for the year!

October was my acute care month which I spent in the neonatal ICU.  It was a completely different world.  For the first week and a half, I had only the lower-level care patients, but by the second week, I started taking care of a baby who was born at 27 weeks.  That translates to a little over 3 months early, and he weighed 1 lb 12 oz.  Tiny.  Unbelievably tiny.  The first day, it was scary to even touch him, but I got to know my little friend pretty well by the end of the month.  He had a lot of major issues to face in the first few weeks of his life and he was by no means through the worst of it when my time in the NICU was over.  There were a lot of babies who had a pretty rough start to life and there were some difficult times, but I'm so thankful for the experience.  I got to know a few mothers well, spending time with them daily at a point in their life that held so much uncertainty.

This month is Radiology, and the start of interview season.  I'm missing a little over 1/2 of this rotation for interviews, and the rest of it is super easy.  I go to lectures from 10-2 some days, and other days (like today, where I'm drinking coffee and watching Let's Make a Deal as I blog) I have nothing!  I've spent some time thinking about what I'm going to do with my free time over the coming months.  I've decided to pick back up with the Rosetta Stone and get better at Spanish, which was basically decided for me when I became a Lopez.  I also became a member of Pinterest, which I'm hoping will inspire some fun crafting and delicious new recipes, but so far I've just spent a lot of time browsing.  I grew up playing the piano, but when I realized that may not be the easiest instrument to always have around, I got a guitar.  I took lessons for a little while in college, but haven't played in a while so I have big dreams to self-teach, but we'll see how that goes.  Other than that, I'm open to ideas for new hobbies!

Next month I have off, and then in January I'm taking "Philosophy of Medicine" which has some interesting reading/discussion topics.  I won't lie though, I was also attracted to the elective due to the schedule....Tuesday/Thursday for 2 hours.  Yep.  I'm about to live life.  I'm hoping in February to be able to take a Public Policy elective where I'll spend 2 weeks in Austin learning about Medicare/CHIP/WIC

Psychiatry

Last rotation of 3rd year was Psychiatry.  To be honest, that was on purpose because Psychiatry was known for being a little more laid back than the rest.  It did not disappoint.

For the first 3 weeks, I was on Parkland Consults, meaning anywhere in the hospital that a team felt a Psychiatrist was needed for a patient, we went to see them.  Sometimes, this meant a team was trying to cover their own tails and it wasn't very interesting/necessary to get Psychiatry on board, but most of the time it was really (I found myself starting to type "crazy" here, but that's not PC, but now I can't think of a better word...) ...wild.  The second half of the rotation I spent on inpatient Psychiatry in Parkland which is a locked-down ward.  I also went to mental illness court which is where patients go who are trying to get out of the hospital when the doctors don't think they should leave.  Finally, I spent 3 shifts in the Psych ER, which was the most intense experience of all.  I'll sum up this rotation with a couple of good stories:

A woman with underlying dementia who became delirious (there is a big difference between delirium and dementia and if you learn that, you learn a very important Psychiatry topic) who told me stories about her maggot friends and how they walked in a line and she saw them on the ceiling and it was strange how they walked together because, everyone knows maggots don't walk in a line, just ask science and they'll tell you.  She also told me I looked like "one of them girls on the shows who is always hanging out with the boys" and to tell my husband to keep me in line.  I'm pretty sure she was calling me a floozy, but I tried not to read into it.

Another woman had the most beautiful singing voice, but the problem was she would sing gospel music at the top of her lungs early in the morning which aggravated all the other patients on the ward.  One day I walked in and told her good morning and she stopped me to tell me she had a revelation.  When I asked what it was about, she said it came in the version of a song and started belting out Steve Miller's "Fly Like an Eagle."

In all seriousness though, I think mental illness can be one of the most difficult things a patient and their family can face.  It is different from other medical illnesses both in how it is approached and how the public receives it.  There are so many challenges to coping with, treating, and handling mental illness.  I think the Church went through a period of time where it failed to see psychiatric illness as a true medical problem and people were often ashamed of it and saw it as spiritual failure when it is often just as organic as a heart attack.  There is a fine line between recognizing that a medication is necessary and relying on it, but I firmly believe that medication for mental illness has a place along with faith, community, and prayer.

Obstetrics & Gynecology

OB/GYN was my second to last rotation of 3rd year and I was starting to feel like it was the home stretch.  I did gynecology first and it was not my favorite.  I spent a lot of time in the OR watching hysterectomies and other surgeries that would make a person cringe if I described them.  If there is one thing I figured out early on, the OR is not my favorite place to be.  I think I might enjoy it more if I wasn't so freaked out the whole time that I was going to touch the wrong thing and contaminate it and have the wrath of a scrub nurse fall on me.  But even besides that, gynecology surgeries are in a particularly difficult place to watch if more than 2 people are standing around the patient, so I spent hours pretending to be attentive when all I could see was the back of people's heads.  I made to-do lists in my head, memorized the order of advertisements on the computer screensaver in the room, and basically tried to save myself from a death caused by boredom.  Gynecology clinic was OK, a better learning experience but mostly a little gross in my opinion.  Then I did a week of urogynecology where I learned everything there is to know about urinary incontinence and basically learned to fear the consequences of child bearing.  I'm mostly kidding...

The second half of the rotation was the obstetrics part which I enjoyed a lot more.  Being a part of delivering a baby was an unforgettable experience.  I had a hard time not getting choked up everytime I was in a delivery because it was just such an amazing sight to see the faces of the mothers and fathers as they saw their little one for the first time.  It was at this point that I realized Pediatrics was it for me, because I always found myself wishing I could go with the baby over to the warmer instead of finishing up with the mom.  After a while, you also start to recognize the personality types that certain fields of medicine attract, and I am not quite the ob/gyn type.  Not really sure how to explain it, but it is just a feeling you get I guess.

Zihuatanejo

Over spring break this year, Mark and I went to Zihuatanejo, Mexico.  Mark did about 8 posts on his blog: Bongos and Peaches last April, so I won't put all the pictures on this one, but check it out of you're interested.  Mark takes some seriously awesome pictures, I'm always impressed by what he captures.