I heart my boss... and my job

So, the video below is a year and a half old, but I just saw it again yesterday, while I was at the groundbreaking ceremony for our new facility at 333 North Arch St., slated to open in July. This expansion is more than exciting. It's phenomenal! We'll be adding 24 exam rooms to our current 18... and more than doubling our patient visits per year. The expansion will mean new job responsibilities for me, as I'll be taking on more of a leadership role. I'm looking forward to the new phase of my professional career, but also know that it's easy to become overwhelmed by the need that faces us at SouthEast each and every day.

Lots of days at the health center are emotionally draining and tiring. My patients not only have complicated health problems, but their social, mental, economic, relational and emotional problems are incredibly overwhelming. Tuesdays are the worst. They always seems to be the longest days with the craziest things happening. I always walk away from the clinic amazed at how my patients survive in the worlds they live in AND how blessed I am to have a stable, wholesome home to live in with a wonderful, faithful and loving husband, a healthy son and family and friends that surround us, support us and care for us.

I know God has me in Lancaster for a reason, and I feel that I'm answering His call by going to work everyday at SouthEast. Sometimes the things I see and experience are awful, downright painful. And sometimes work is just plain hard. I always thought that I would go to medical school, finish residency, pay off my loans, and leave the country to work full time in missions. I've come to realize that, for now, I'm in the heart of my mission, and there's nowhere else I'd rather be. I don't know if the calling will be the same in 5 or 10 years from now. But for NOW, it is what it is. And that feels good; I'm at peace.

I'm honored to work with AMAZING people. They're giving, selfless, caring and serving individuals. And they're humble. They're great partners and they go the extra mile. My job (and my life) wouldn't be the same without them. When I'm overwhelmed with the messed up systems at the clinic, inefficiencies that occasionally occur, paperwork that never ends, and the sadness of my patients' lives, it's my partners - my dear friends - who are encouraging and keep me going. We're in the trenches together. I have an awesome boss, too, whom I heart in a big, big, big way. I know we all heart him. He's one of the main reasons I landed at SouthEast in the first place. I'm pretty darn sure I don't know anyone in my professional circles as dedicated, optimistic, brilliant, kind, patient, humble, energetic (and so much more) as this guy. He rocks. This United Way video from last year features him...and some of our nursing staff and our patients. Check out the video. It will make you smile and warm your heart.

a little holiday diversion

Since we got back from vacation, life has felt a little rough.  Sebastian hasn't been himself and has been very clingy, not sleeping well, occasionally refusing to eat - we're wondering if this is just an adjustment from being back from vacation or something else - illness lurking, teething, etc.  His poor sleeping patterns have been trying on us physically and emotionally - we've both been exhausted, and I seemed to manage to mess up my neck royally by sleeping in a very akward position several nights in a row so as to protect my little babe - who would only sleep if sleeping with us. 
I also began a new schedule at work which includes multiple double bookings in order to increase productivity by accounting for our no-show rate.  I was the last provider to move to this schedule, because they were waiting for Sebastian to start solids.  For that, I'm so very thankful... but it was a difficult transition to go back to work after a week of vacation.  The mommy guilt was at a high level - I almost felt like I was going back to work after maternity leave all over again - and I had this new schedule to deal with... 
In the midst of it all, I have not felt like I was in the Christmas mood or spirit at all... it's barely crossed my mind, and I recognize that it's fast approaching.  We don't have any decorations, I have no gifts (let alone ideas!), and I haven't been in church for almost a month because of being on call and then vacation... so the concept of Advent floats around in my head, but doesn't yet seem a reality.  Sigh... Not exactly how I'd like to feel or be around Advent... especially for Sebastian's first go-around with Christmas.
In an effort to relax a bit this afternoon (I had a very early meeting that I was NOT looking forward to this morning, followed by a long day of rounding at the hospital), I decided to play around a bit with the Jib Jab Elf videos to get some comic relief and work towards some holiday cheer. 
So, here you have it - live and for the first time - the Johnsen Martin Elves performing a holiday disco dance.  There were five options, but I chose to post this one, because it seemed to be Sebastian's favorite.  He squealed in delight and flapped his little arms and legs when he saw this video. 
So enjoy!  Here's to the holiday season... may it find its way into our home and hearts very soon! 

Send your own ElfYourself eCards

And yes, we ALL can dance like that in real life. Ha!

For the first time

Sebastian got a taste of something other than good ol' mother's milk. His smart daddy thought to grab my BlackBerry to capture this moment on video. He's still not entirely convinced, but we're getting there, poco a poco.  Mostly, he just wants to chew on his spoon or grab it like a big boy.  We're already convinced that he's going to want to feed himself sooner rather than later.


I was anxious to try some rice cereal with him, because he seemed to be very interested in watching Tim & me while we're eating these days. He doesn't want to miss a beat, and he's been grabbing for everything in sight. But, at the same time I felt a little bit guilty, because he's two weeks shy of the six month mark...which is the new-ish recommended time to wait for any type of solids.
My doctor mommy guilt was kicking in..., til the next day when I saw an 8 week old for a well child check, whose mother told me she started rice cereal a couple of weeks ago (insert YIKES here) and her son just LOVES it...and she did it because her mom told her to... you know, he'd sleep better! And that was right before she told me that she always puts him on his belly to sleep, because he LOVES to sleep on his belly and sleeps so well that way! Ugh... sigh... wiped away any feeling of guilt I was having pretty darn quick. And guess what - my word over her mom's? Not a stinkin' chance. Sigh... (again).
And yes, I did tell her that she was giving me chest pain.

Burned

My skin, that is... right in the middle of my abdomen, just to the right of my belly button. Silly me.... a patient told me she had a "wart" that she wanted me to burn, so before I examined her, I went to get the TCA (trichloroacetic acid). Seems like someone prior to me must have had a little spill or leak, or didn't put the cap on tightly, because when I pulled the plastic box down from the shelf that houses the TCA, liquid splashed onto my new (only have worn it twice) blouse... and subsequently thru the blouse and onto my skin. I flushed my belly with water and went about my day sulking a little bit because of the new shirt likely being ruined - I anticipate a big hole in it as the TCA eats it away when I wash it. But when I got home and put my PJs on, I found that what had been just a little red before is now a lot red and about 2 inches by 2 inches, in the shape of a heart of sorts. How ironic. A burn, on my belly, in the shape of a heart. And you know what the real kicker of it is? I didn't even burn a wart today. Sigh... The joys -and hazards- of doctoring.
Interestingly, when you google TCA burn, you get all sorts of information on chemical peels using TCA for cosmetic purposes. So maybe the TCA will wipe away a few unwanted blemishes left over from a pregnant belly after all. I'll keep you posted. It's a good experiment, since it only fell on one side. It seems almost a little too high up on the belly to make a really good experiment, though.
You'll also find a video of a cheerleading championship dance... I'm not sure I can come up with any explanation for how that fits with "TCA Burn" though. I guess I'm just missing something. Huh.

I survived

My first day back to work, after three months off... so much has happened in the past three months, and my life has changed in ways I never before understood or imagined. Sebastian is an incredible gift, and I love him more than I believed was humanly possible. He has stolen such a huge chunk of my heart... and he also makes me love my wonderful husband more and more each day. Being a mother is truly amazing, and sharing this journey with Tim is even more amazing.
Last night I cried myself to sleep... not because I don't like my job (in fact, I normally love my job); not because Sebastian wasn't going to be extremely well cared for (he's being taken care of by his two grandmas and an aunt, who are all fabulous and love him to pieces); not because I didn't think I could do this thing of being a mom and a professional at the same time; not because I was afraid he wouldn't love me anymore; not because I'm afraid that I'll miss him rolling over for the first time (he's oh.so.close!)... simply because it's sad. And I was (am) mourning. And I have the mom guilt thing going on.
But I survived. My first day back was OK. I felt awful about leaving Sebastian. I hated to think about all the bottles he would get instead of the time I normally spend nursing him. I felt like my brain was mush, and I couldn't remember things - I had to ask my partners what you called this or that test, diagnosis or medication on several occasions. I was anxious about not getting my "pumping time." And I was frustrated to be running behind schedule. Oh, and I was not excited about having to do a two hour customer service training on my first day back. Seriously? The staff at work were compassionate, oohhhed and aahhhed over my pictures, tried to help me out to get to my pumping time promptly, and kept telling me that I was doing just fine (thanks, Julie ;)). My patients were very understanding, even when I entered their rooms sometimes 30-40 minutes late... and they all wanted to know about my little boy - his name, how big he was, who was taking care of him, where the pictures were, etc. Plus, throughout the day, I had hugs and notes from partners (who have made it very clear that they're thrilled that I'm back), smiles and words of the most sincere empathy from my boss (well, maybe it was really the most sincere sympathy, cuz he's a man...), and kisses and caresses from my husband, who wiped the tears off my cheeks last night and reassured me as he left carrying Sebastian out the door this morning, leaving me behind...with one of the emptiest feelings I recall ever experiencing. And then at the end of the day, when my little boy came home to me, he still smiled at me, loved me and nursed right away as if I had never left him (the bottle hasn't destroyed him, thank goodness!). He laughed and cooed, was content to have me hold him and smother him with kisses, and he followed his regular nighttime routine like such a good little boy. And to top it all off, I had ice cream with some friends to decompress a bit. So, so yummy...! And they all love my baby and fight over who gets to hold him, which is such a special gift. Of course, Sebastian eats it up - the spoiling and fussing over him that is, not the ice cream (yet!).
So, all in all, it was OK. I certainly could never say I love this transition. But it is what it is for now. And we're all surviving. And now both my boys are fast asleep, the diapers are hung and drying (thanks, Timmy), the bottles are washed, and the diaper bag and milk bag are packed for the morning. Tomorrow (today) will come soon, and we'll do it all over again. I know each day will get a little bit easier, and I'm thankful that it's only the first day once.
Sebastian has changed my priorities forever. That means a lot of things; but today that means doing the best I can for my patients while I'm at work, all the while being the most efficient I can be, so I can finish on time and race home to see my precious little babe. It means saying "no" sometimes. And it means soaking up every opportunity to love on him that I can get.
I was blessed to have three months at home with Sebastian; some women have far less time. I count it a privilege to have partners who understand the value of family and children. It's a blessing beyond belief to have family helping to care for Sebastian. And I know God will continue to use me powerfully in the service I provide to patients who are "the least of these."
Today I pray for balance, patience and rest... so off to bed I go.

A post-dates pregger doctor takes the day off

This past weekend, I was really struggling emotionally with the fact that I was almost a week past my due date and my doctor was starting to talk more about the "I"* word, which was making me not healthy and happy...
So yesterday after church, Tim & I spent some time with a friend of ours who is one of our support persons planning to come to the house while I'm in labor. She's been doing this baby stuff for a long time, and just knew exactly what to say to me yesterday to bring a great sense of peace over me, my baby and my body. She gave me some great advice. She said that this will happen, and reminded me that I know down deep that it will; she said that I should stop going to work! and that I should enjoy the next few days doing things I like and emotionally preparing myself for labor and being a new mom, instead of trying to fix others' medical problems and getting really frustrated every morning when I walk into the clinic and everyone says: "You're here again today? We didn't expect to see you here. No baby yet? When are you going to have that baby? Still pregnant, eh?" and on and on and on... Grrr!! I know that they ask because they're interested, excited, concerned, and such, but so not helpful...
Our friend also recommended that I do things like go to the park, read a trashy novel (not a pregnancy book) or a fun book, buy some flowers, have a hot date with my husband, go to market, get a pedicure (did that last week), buy some sexy lingerie, take a long walk in the sun, sit by the river, just enjoy being me and celebrate being pregnant, feeling the baby move and getting ready for his or her arrival.
So, today I heeded her advice... and I didn't go to work! It felt good! And this is how my day has gone so far:

• Kissed my husband goodbye and sent him off to work
• Had a cup of tea and biscotti
• Lounged around and read a bit
• Went to my postdates testing appointment and had a beautiful, reactive non-stress test and an ultrasound that showed my AFI (amniotic fluid index) was 13.9 - that's good, by the way (means the baby has plenty of fluid to swim in still). No peaking during the ultrasound either. ;)
• Had lunch with my mom
• Picked rhubarb in my parent's backyard
• Went to the grocery store
• Bought some flowers
• Came home and baked - super yummy Chewy Chocolate Chip Oatmeal Cookies - found the recipe here
• Also baked one of Timmy's favorites - Rhubarb Strawberry Crisp
• Made my sister-in-law's famous Penne with Vodka Sauce for dinner, which we ate with roasted garlic bread...
• And I'm about to take a walk with the best hubby ever, then come home to relax on the couch with him over some of that Crisp and perhaps a cup of hot tea...
• Then to bed we'll go, not knowing what the night or tomorrow will bring!

Although I was busy doing "stuff," it was stuff that makes me happy, that I enjoy, and that I might not get to do for a long time. Besides, I was really craving chocolate chip cookies!

*"I" stands for induction, in case you didn't know... and I'm really hoping and praying that we won't need to talk much more about it! (Hint: So don't ask ;)!)

The week in review...

So I realized that it's been a very long time since I've done much posting - almost a month, as a matter of fact! Except for the pictures of my jewelry that I posted yesterday before the power outage (lasting 4 hours) and the -even worse- cable outage, lasting almost 24 hours. I'm as happy as a clam to have internet back, and figured it was time to do some blogging. It's crazy to realize how dependent we are on the internet, at least in this household, in 2008. We don't have TV, so this is our source for all things informative, not to mention how I check on the jewelry business, communicate with friends and family and follow things at the hospital while I'm on call (like right now!). Anyways, the internet is back, and so am I!

Since it's been so long, I just thought I'd post some updates...

First, we have a wonderful new outdoors patio set, which we just assembled last night. Check out the picture (a view from above on our balcony) - it was made from tropical woods (maybe acacia?!?) in Indonesia, and we were ever-so-pleased to purchase it, knowing that it was Forest Stewardship Council certified, which means sustainable and responsible methods of forestry were used to get the wood to make our super sweet table. The best news is that I ordered the table, chairs and benches on clearance, and when I ordered them, it said that there were only three chairs left, so, I ordered three chairs and two benches to have seating the whole way around our 7 foot table. When they arrived, the cartons for the chairs said "two chairs per carton." What a surprise! No where did it say that on the website nor the order form... so it seems like we got 2 for the price of 1! And we thought they were a bargain when they were the price for just one! So now we have a table, six chairs and two benches. We put the extra bench on the front porch for now, to create a sitting area out there to watch the cars and people go by on our quiet city street. Isn't our furniture lovely?!? Now you'll all have to come over and have dinner with us! We're starting with my parents tonight to break in the new table and chairs.

While having new patio furniture is exciting, it was a bit of a sad week, because I went to my third-ever funeral of a patient. This funeral was particularly sad, because it was a baby that I had delivered the week before, that was born still-born. Everything seemed fine up until the day the baby was born, when the teenage mom developed belly pain and all of a sudden didn't feel the baby move anymore. We still don't know what happened, and likely never will. My patient is doing as well as can be expected, but this is incredibly difficult for her and her family. Some things are so hard to understand no matter how old you are, but especially when you've just finished 9th grade. I was glad to be able to get coverage during my office hours to make it to the funeral - my patient and her family were all very appreciative.

We had a lovely surprise in our front yard! Which was a wonderful reminder of growth and new life (even when there are sad times and death). My sister-in-law, Lydia, had done landscaping for us in the front yard (which is gorgeous!), and somehow snuck in a surprise. About two weeks ago, I noticed leaves that didn't seem like anything else in our yard, yet strangely familiar to me. Sure enough, out popped my favorite flower, a calla lilly, and then more and more. They keep coming, one at a time! They're beautiful, and in MY yard (as opposed to some garden or alongside the road in Mexico). Thanks, Lydia.

Tim and a friend, Jason, spent the day doing the prep work to re-do the electrical work in our master bedroom. We only have two outlets, as it stands now, but soon we'll have a total of 6, plus lights in the closet, that don't currently exist. One step at a time, the master bedroom will become a wonderful retreat! Can't wait to have lots of zzzz's in that space. :)

Tim and I both must have been distracted this week, because three days in a row, we did a load of laundry and forgot that it was there! Of course, with the dampness and the hot, steamy days of July, by the next day when we remembered, the items were asking to PLEASE be washed again! At least we use eco-friendly laundry detergent, but so much for doing our deed in terms of minimizing our carbon foot print this week!

I guess we didn't do too badly, now that I think about it - we dry all of our clothes on drying racks or on the line (some day I'll have a wonderful pully system to dry our clothes on, but for now it's been added to the "list"), Tim has upped our rain barrel count to 10 (I told him that I bet no one else in Lancaster City owns so many rain barrels), and I ride my bike to work while Tim car pools with two other guys.

We're coming up on our 1st anniversary very, very soon! Just three days away! So hard to believe that we've been married now for one whole year. When I think about what the year has brought, I'm overwhelmed with joy and blessings. I have a wonderful husband, a great house (with lots of projects to keep us all busy for a long time), a fabulous group of partners to work with (go SELHS!), family and friends close by, and wonderful vegetables to eat everynight from our local CSA. Yum!

Speaking of vegetables, it's time to get on with dinner - chard cheese bake (delicious recipe from Simply in Season), grilled corn on the cob, beets, sweet potatoes, and pineapple (not from the CSA, sadly, but every now and then we break down and go with the splurges beyond what our local produce can offer), fresh baked bread from Ric's Bread at Central Market, something to do with cucumbers, and surely blueberries for dessert... all at our new table! Summer is great!

Life is Precious

This week has been a tough week - not just because I've had a more demanding schedule, but also because I'm reminded that life is precious. Working as a physician can sometimes lend itself to becoming callous, because we experience so much sickness, death, trauma, etc., and it's often a way to subconsciously protect ourselves from becoming overwhelmed. This week, there was too much sorrow in my path, and I think I was too tired to shrug it off.

• On Monday, I told a very sweet 70 year old man that he had cancer - it doesn't look good - and he could only ask me, in his broken English - "Is it bad?"
• On Tuesday, I told a young woman, who very much desired to be pregnant, that she was having a miscarriage.
• On Wednesday, I sent one of my prenatal patients who's 33 weeks pregnant to the ER Crisis Center because she struggles from severe depression and told me she had thoughts about hurting herself.
• My grandmother went back into hospice care, and she's experiencing a lot of pain and is fearful and anxious. We're hoping hospice will get her back to a point where she's comfortable.
• My friend's mother "coded" after she had surgery for colon cancer. Fortunately she's much better now, but I can't imagine watching my mom go through that. My friend was sitting by her mother's side when it happened.

In the midst of all these very sad things, I also experienced the precious gift of life in the miracle of birth, as I delivered a beautiful baby boy to a mom who was amazing, valiant, and made childbirth look like something easy. It's not always that easy! She had no medications, and labored like a champ with grace and beauty.

It's an honor to be a physician, but sometimes it's a big responsibility and certainly not all that glorious.

It's the little reminders of how precious life is that helps to keep me humble.