the pet awesome

so a friend just introduced me to the concept of pet awesomes.

what is a pet awesome, you might ask -

well, it's like the opposite of a pet peeve.  It's something pretty non-significant that makes you pretty happy.

For example, for this friend it was watching guys who clearly work out their upper body in the gym so that each of their six triceps are defined - but can't run to save their lives - try to run and look really, really unathletic (despite their ripped arms).

One reason I like the concept is that it's really easy to come up with pet peeves, but usually just makes you focus on them more and get more and more irritated.

why not focus on pet awesomes and instead, get more appreciative?
(or at least smile more)

some pet awesomes of mine this week include:
*when attendings (the head doctors) take their shoes off under the table during meetings or lectures
*walking in to see one of my patients in the morning when they are deeply asleep and have a really awesome snore going on.  you know the kind that actually sounds like someone sawing wood?
*this older irish man whose medical condition I know nothing about, but as part of his physical therapy, walks laps around our floor using his cane when I'm on night float singing irish folk songs.
yessssss.....

what are your pet awesomes?

for more awesome things, check out this blog that another friend recommended to me called 1000 awesome things.  It's pretty spectacular.



~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"All difficult things have their origin in that which is easy and great things in that which is small"
- Lao-Tzu

photo source

home | How to Live as a (temporary) Nomad

because I like to think I've mastered it a little...

1. yoga podcasts & yoga mat

(it's good exercise and good relaxation at the same time, AND portable)

 I've had a lot of requests for good podcasts and here are my two favorites to check out:

Dave Farmar

Kindii McCollum

for extra awesomenss, play epic music in the background - I like either the Lord of the Rings pandora station or James Taylor (so similar, I know)

2. keep some things constant - like breakfast

I read somewhere that if you don't have to think about your morning routine, you feel much more relaxed going into the day and I think it's absolutely true.
My routine is making coffee in my french press, oatmeal with walnuts, seasonal fruit, and maple syrup, and reading for at least ten minutes.  If I have to wake up 20 minutes earlier to make this happen, I've found that it's worth it.   Things that make this tradition better? Other morning people to share it with, like my friend Lizzie (with popovers, below):

Burlington, VT

3. have something you can "decorate" wherever you are
my mom gave me a teeny vase that I take and put one flower in everywhere I go
I also have a framed photo from my last birthday with me and my tribe of women, and a little one of me and my family.  I just pull them out and put them on the dresser wherever I am and it feels just a little bit more like home.

from anthropologie home

4. get a cell phone charger for your car

I know it seems ridiculous, but I am finally one of those people who needs my phone to operate efficiently.  and because I spend too much time in my car moving from place to place, the car phone charger has let me not worry about using up battery playing surgery podcasts (lectures) on long commutes while also GPS-ing directions to and from new places; boring, maybe, but seriously life changing.

5. stay in touch
I do this by a combo of calling people (especially in between things), making dates whenever I'm in town, email and this blog

Pittsburgh, PA

Pittsburgh, PA

Burlington, VT

Santa Cruz, California

6. reflect often
get a journal, start a blog, go on long walks and 
just think about where you are and where you're headed

Scarsborough, ME

7. get oriented (aka bring your running shoes)
or, if it's more your style, walking shoes.  Nothing like jogging around to get oriented to new places

Wildwood, NJ

8. know your belly
this way when you go somewhere new and make the inevitably crazy first grocery store run, you don't spend a million bucks on things you won't actually eat.  some of my staples include breakfast food (see #2) veggie burgers, beans, tortillas, cheese, salsa, fresh spinach, frozen broccoli
(and of course the assorted local cuisine, as seen below)

Santa Cruz, California

9.  create a tradition
not forever, but just for that place.  Find a coffee shop you like and make it your study spot, go for a long run every Thursday in the park, do yoga on the tennis court on sunday mornings, watch old movies in bed on Wednesday afternoons when everyone else is working and you're post-call, grab coffee with a specific friend every Saturday morning (or mimosas, as seen below)

Burlington, VT

10. figure out what you can control and what you have to let go
for example, I have pretty little control over my schedule these days (hello call until 10pm last night and working 16 days straight) but some of the things I can control is wearing compression socks on long call days/nights so that my feet don't hurt or swell as much or that I always have almonds in my pocket in case I have to miss a meal.

what are your tips for living a life on the move?  
I rarely try to elicit comments from readers, but I would love to hear some for this one!
and for my less computer saavy readers (hey grandpa!), how to comment: go to the end of this post and find where it says "0 comments" in purple and click on it.  It should bring up a new window and you can just type in there.  

~~~~~~~~~~~~~
"Adventure is a path. Real adventure - self-determined, self-motivated, often risky - forces you to have firsthand encounters with the world. The world the way it is, not the way you imagine it.  Your body will collide with the earth and you will bear witness.  In this way you will be compelled to grapple with the limitless kindness and bottomless cruelty of humankind - and perhaps realize that you yourself are capable of both.  This will change you.
Nothing will ever again be black-and-white.
-Mark Jenkins

Stereotypes and Tents

A friend of mine just sent me this awesome article written by Mindy Kaling, one of the writers of the office, about female stereotypes in film that are absolutely ridiculous - but we love them, and maybe crazier, start to aspire to be like them or think we are like them.  For example:

The Woman Who Is Obsessed with Her Career and Is No Fun at All

I regularly work sixteen hours a day. Yet, like most people I know who are similarly busy, I’m a pleasant, pretty normal person. But that’s not how working women are depicted in movies. I’m not always barking orders into my hands-free phone device and yelling, “I have no time for this!” Often, a script calls for this uptight career woman to “relearn” how to seduce a man, and she has to do all sorts of crazy degrading crap, like eat a hot dog in a sexy way or something. And since when does holding a job necessitate that a woman pull her hair back in a severe, tight bun? Do screenwriters think that loose hair makes it hard to concentrate?

Other gems include "The forty-year old mother of a thirty-year old male lead", the "ethereal weirdo" (think juno or the female lead in garden state), and "the skinny woman who is beautiful and toned but also gluttonous and disgusting" (think skinny girl stuffing her face with cake).  I've been on my own sort of stereotype smashing spree because, sparing you the details, I've been getting some pretty awful reactions to my telling people that I am strongly considering the field of ob-gyn. 

the consensus generally seems to be that I'm not going to be a very good mother, a very good surgeon, very good at diagnosing things other than pregnancy, surrounded by mean awful people, and overall pretty miserable with my life.  The field itself is sometimes perceived as being "too estrogen heavy" (helllloooo it's birth, it REQUIRES estrogen) which inevitably results in catty gossip, backstabbing, and comparing who has cuter dansko clogs, right?  NO.  From what I've seen, ob-gyn is not a field of just women, and the women and men in the field are serious, smart, competent doctors who went into ob-gyn because the physiology of pregnancy is like nothing else, because we still haven't figured out fertility, or menopause, and the reproductive cycle of a woman is one of the only topics in health vital to the continuance of our species, so it's been pretty fine-tuned by evolution and involves tons of genes, messaging cascades, and signals.  And  while some of my very favorite ob-gyn attendings were men and many of the people I love and respect in my life are men, I feel a different kind of energy in groups of just women.  It's not catty or gossipy or back-stabbing energy, but strong, calm, nurturing power.  Especially with pregnancy, it feels like going back to our tribal roots, when the birthing process was a tent filled of the women of the tribe who each had been through it or would soon, who had felt twinges in their own bodies that resembled this sensation, who empathized with the feeling of looking at your child for the first time, of the power of that bond, the implications of how the rest of your life will change, that's a lot to hold and I think there's something programmed in women to understand that in a different way.

And if we can bring medical knowledge and skills to the tent, well then, all the better.  

Four Agreements

A good friend just told me about her experience with a physician who saw a lot of highly educated patients whose stress was contributing to deteriorating health.

She said that the first thing he would do would be to listen, and then he would recommend this book:

The Four Agreements, by Miguel Angel Ruiz.

I'm going to actually read it (just waiting for it to arrive in the mail!), but in the meantime, I wanted to share his outline of the agreements and start to consider how they apply to all of us being better people, better contributors to our world and to each other:

1. Be impeccable with your word

2. Don't take things personally

3. Don't make assumptions

4. Always do your best

What do you think?

10 things I learned in surgery

1. the enemy of good is better (otherwise known as, doing more isn't always the right move)
2. the art of being a surgeon is first knowing when NOT to do surgery
3. when asked a question that you don't know the answer to, first: say you don't know, then say what you do know (as in, we don't know if she's going to recover fully but we do know that her kidney function has returned to normal more quickly than we would have expected).
4.  the surgeon is the head of the team, act like it. thank your team for what they do, and most importantly, tell your team what's going on so they can do their jobs the best they can.
5. how you do one thing is how you do everything, so make sure your values are reflected in all you do.
6. from one of my vascular attendings to a diabetic man who had already had one below-the-knee amputation due to low blood flow from his arteries not working well due to his extensive smoking behavior and diabetes "hey man, you're smoking your leg off" - (aka surgery isn't always the end of a problem).
7. bad news should always be hard to deliver, no matter how much experience you have.
8. the major causes of fever after surgery all start with W:
1) wind (atelectasis, pulmonary embolism), 2) water (UTIs), 3) walking (DVTs), 4) wound (infections), 5) wires (foleys, NG tubes, J tubes, ventilators), 6) wonder drugs (lots of drugs can cause fever)
9. a pulse is more important than breathing.  CPR guidelines just changed to focus on pulse first, then airway, then breathing.  so #1: feel for a pulse, if it's not there, start chest compressions
10. set yourself up for success - in surgery, 90% of the success of the surgery is deciding the approach.  If you don't feel comfortable - adjust something.