that time of year when we push ourselves ahead

*deep breath*

So, it's been, um, a while since I was here. Things that happened/were accomplished since July:
- I've applied for residencies (in family medicine, of course) and scheduled my interviews. So that feels good. I'm really looking forward to the interview thing, actually, even though it's going to be tiring and all that, but I'm excited to meet the people I'll be working with for the next 3-4 years, whomever they are. (For the record, in case anyone is interested, I applied to UH here in Cleveland; Montefiore, Beth Israel and Columbia in NYC' Tufts, Boston Univ Medical Center and Lawrence in the greater Boston area; Brown in Rhode Island; and Middlesex and UCONN in Connecticut.)
- Did rotations in emergency medicine and geriatrics, did my acting internship in pediatrics, and am now chilling in musculoskeletal radiology. And kind of scrambling to figure out what rotation I'm doing for the next two weeks, but that's another story.
- Took Step 2 CS! Our clinical skills exam, part of our licensing boards, is a big pain in the butt (expensive, offered in only 5 cities, long and tiring) but I took it in Houston on Monday and now I am done with standardized testing! Until Step 3 in, like, a year or two, but whatever.
- Attended some lovely weddings of family (my cousin Lisa) and friends (my childhood friend Christine). Discovered that yes, it is possible to drive to Connecticut and back to Ohio for a weekend. Thanked God and good fortune that I have a life partner willing to actually do all that driving, so all I had to do was sit and knit and be conversational and not get a DVT.
- I've also been knitting a ton, although, as Ben is quick to point out, I haven't actually finished a project since, like, May or something. However, I believe firmly in the utility of parallel knitting projects and many of them are nearing completion, so stay tuned. I've been working on:

- a shawl of my own design (ran out of (discontinued) yarn on the edging, need to devote some time to emailing Ravelers to see if they'll part with a skein)
- a scarf for my mom's birthday (in May) that I, um, still haven't finished. (There's beading. It's driving me crazy. It will be done by the time I go home in November.)
- a Pi shawl that may or may not be wedding material (halfway through the edging, it started to get not-fun; I'll be picking it up again soon when I'm ready for more finicky knitting)
- a pair of socks that exist solely for portable knitting, which I started during the AAFP conference in August. They'll get finished while I'm interviewing.
- the Luna Moth shawl (ran out of yarn doing the bind-off. This was even more annoying as I purchased three skeins of this yarn, but could not find the third skein anywhere in the house. Since it's only $2.99 a skein, KnitPicks got an emergency order from me.)
- another shawl (noticing a trend?) that may be a gift so I'm not going to say more about it. But I got a lot done while I flew to Houston and back earlier this week, with connections both ways.

However, as it gets colder (and these projects get finished), I think I'm going to transitioning to winter knitting. I appreciate a lapful of wool in November in a way that's just not possible in August. I have yarn and patterns for the Urban Aran, cardigan version (Cascade Ecological Wool in beige) and the Sayuri sweater (Rowan RYC Soft Lux in amethyst or green - I lost it a little when I found it for $1.99/skein, so I bought two sweaters' worth. This is how that excessive stash thing starts, isn't it?), so those will probably be my next projects.

In other news, I'm thinking very seriously about doing NaNoWriMo. (Since their site has been very slow, the short version: November, National Novel Writing Month, write 50,000 words in 30 days. Go.) Except I think I'm going to skip the "novel" business and just try to write 50,000 words of more-or-less non-fictional essays. I've had a few medically-related essays percolating for a while, and this might be a good way to actually get them down on paper. And interview season might be just the right time to reflect on the practice of medicine. And writing ten 5,000 word essays seems a lot more possible at this point than 50,000 words of plot. So we'll see.

Tangentially, I'm loving Genius, iTunes' version of Pandora: you pick a song, and it builds a playlist from your library based on that song. I've been actually listening to music again, and enjoying a lot of the stuff I'd forgotten I had. (If I end up doing the NaNoWriMo thing, I have a feeling it will come in handy.)


title from "The End of Summer" by Dar Williams. Because it's snowing here today.

to break the still of day

Just popping in here to say that I'm loving family medicine. The patients come into the hospital, they get more or less fixed up, and then the same person follows up with them after their inpatient stay. And, you know, addresses the issues that landed them in the hospital in the first place. Love it. (Additionally, we're only calling consults when we have an actual question for the consultant. My consultant calls are going like this: "We've got a patient who's still having blood in his urine 4 days after his traumatic Foley placement and we've worked him up, done these labs, gotten this imaging and we're thinking it's 60/40 for Diagnosis A vs Diagnosis B but we'd like your input and additionally some recommendations on the current best treatment modalities for either diagnosis" vs "This patient has diabetes and we need endocrine on board. Just because." Incredible.)

I really don't have much else to say, and I'm off to bed in about 5 minutes, but just - *happy sigh* When do I get to go do this full-time for real again?

Also, totally stolen from Ben: go check out Pandora - it's this fantastically fun music streaming site where you enter in one or two of your favorite artists and it builds you a radio station. I've already found 3 new artists whose stuff I love.

title from "Of Angels and Angles," The Decemberists.

poets that we never find time to know

[I think I'll be titling posts with song lyrics from now on, because of all the things that drive me crazy, coming up with subject lines and titles are one of the things that get me there the fastest.]

So this week has consisted mostly of me falling into bed at 11 o'clock and hauling myself out of it at 5:30 am, with lots of internal medicine in between. Which I'm enjoying far more than I expected to, actually - I'm not the biggest fan of the inpatient setting, but I'm learning exponentially more on this service that I have on any other, my team is great, and I have a ton of autonomy. For example, I wrote my first prescriptions this week! Like, on a prescription pad and everything. I wrote scripts at Metro occasionally, but they had the electronic prescription system, which is vastly superior and less error-prone, etc, and I totally appreciate that. But the prescription pad thing is kind of fun. It's almost like I'm a real doctor. :)

So the actually interesting part of my week, though, was our society dinner at my dean's house on Friday. She invited Dr. Joseph Foley to come and speak, who, sadly, does not have a Wikipedia entry, but he's an internist and neurologist who first described asterixis in 1949. He's in his 90s now, but he's still pretty involved in teaching and community activism. He spoke about his early training in Boston in the 30s and 40s, and his time as a medic in WWII. It was a really interesting evening, and his talk sparked some great conversation afterwards.

A few of us were discussing the existence of the "physician-scholar" - you know, those people (often neurologists, it seems) who are incredible clinicians and also experts in Roman architecture or something totally esoteric, and we were wondering if those kind of physicians are perhaps a casualty to the modern face of medicine. Because none of us seem to have much time to even fully study what we're supposed to be learning, much less pursue an avocational interest in something non-medically-oriented. Or do we find the time for that sort of thing later, once we're attendings or have our own practices? (I'm not sure knitting counts, if only because I usually knit while I'm doing something else.)

Anyway. I think part of these musings stem from the shock to the system that is the transition from research to clinical medicine. I managed to forget how intensely time-consuming this whole thing is. What I do appreciate, though, and what I'm not sure I ever heard before I started clerkships, is that the hours really don't seem that bad when you're there. The wards are always (or usually) incredibly busy, and you've got enough coffee and epinephrine to get you through a 16 hour day without much difficulty. It's only once I'm home, I find, that I'll get hit with it - on my way to the shower or something, I'll find myself kind of looking around the apartment and thinking, Oh, yeah, I live here. That's right. It's this bizarre sensation, when you're conscious for less than an hour a day in your own home, how it starts to feel ... less real. I remember this from when I started on OB, and I think I'll be getting more accustomed to the schedule as time goes by, but this first week has been a bit of a readjustment.

But sleep deprivation and dissociation aside, it's actually been really great getting back to clinical medicine again. I was worried that I would have totally lost those skills after research block, but I can still do a decent physical exam and get an assessment and plan together, so that's reassuring. Hopefully I will have some interesting clinical stories to share soon, but so far it's just been heart failure and renal failure and ... heart failure and renal failure. I think internal medicine will be what it takes to get me back to the gym.

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(P.S. - I totally turned on iTunes just now, solely because my Last.fm widget was showing that the last song I listened to was John Denver's "Take Me Home, Country Roads" over and over. I'm not sure I fully appreciated the fact that I'd be publicly airing my guilty-pleasure music when I stuck that feature on the blog.)

Update, Short Form

Okay, so I've totally given up hope that I will write about all the things I've been up to lately, so I'm going to blog in outline form and call it a day.

- Knitting: working on Henry (and I do mean working.... I think the scarf will be great, but it seriously stresses me out to knit it), made some fingerless mitts with the alpaca yarn that Sarah gave me in August, started this shrug in a purple silk/wool blend. No pictures yet, but the mitts just need their ends woven in, and the shrug is 2/3 finished, so I just may wait and photograph them when they're all done. (I think this new-found obsession with things on size 10 needles is directly related to the fact that I'm knitting a scarf on size 2s.) The unbloggable knitting project has stalled in favor of these, but I'm going to try and get back to it soon-ish. (Christmas knitting? What Christmas knitting?)

- Ben and I were able to go home two weeks ago, which was wonderful - highlights were seeing both sets of parents and my youngest sister, spending time with friends, and finding my wedding dress! All around a great weekend. (Also, I found and acquired dried kiwifruit at a grocery store in Manhattan, which was not a highlight so much as a weird thing I'd never seen before. They're much better fresh, for what it's worth.)

- We also went to Regina Spektor's concert at the Hammerstein, which was fabulous. Go to her site and check out her music videos - she is just as adorable and talented in person. (And she is seriously talented: she's a one-woman show, and there were multiple points at which she was simultaneously singing, playing piano with one hand, drum pad with the other, and stomping on the stage for added percussion. It was like watching someone live inside their music.)

- Research is winding up, which means I am frantically writing two manuscripts simultaneously while endlessly hassling our statistician. I'm sure he's having just as much fun as I am. (EndNote, by the way? Rocks my world. Once it works properly.)

- Ben's parents are visiting this weekend, which is why I have given up hope of really updating the blog this weekend. (A trade I am delighted to make, by the way.) They came in last night, and I'm really looking forward to spending time with them and getting to play tourist at home. (We've already had one culinary adventure, and it's shaping up to be an action-packed weekend.)

- I made pumpkin pie this morning. While wearing a sweater. It really must be fall.

- Also, I really don't have time to do this. I really don't. But I want to - I think it would really interesting to explore the evolution of the concept of a "hospital" historically: start with Islamic medicine c. what, like, 400 AD and the spread of "hospitals" throughout the world. (Because, seriously, there are a lot of ways in which hospitals are structurally and ideologically bad for the administration of health care (and a number of ways in which they do work, of course) but it would be interesting to see how we got to this structure.) Or take a look at the relationship between religion and medicine (ancient temples of healing, hospitals run by religous orders, faith healing, etc) thoughout history. But somehow I don't think I'll be able to crib something together during my surgery rotation. Alas.

On Repeat

Today has consisted mostly of working on my manuscript and, when that stalls, messing around with my iTunes playlists. (There's a reason I haven't posted in a week.) But - sometime in the past few days I have rediscovered Sarah Harmer, which has been delightful. I've listened to Basement Apartment, oh, at least five or six times today, and so wanted to share a link to the music video on YouTube. The perfect song for a kind of cloudy, kind of boring Tuesday. (Although I have to say that the fake leather pants really threw me.)

[Edited to add: Also, for anyone who watched this week's episode of House and is obsessive like me was wondering about the Alanis Morissette song, I did some internet sleuthing: Not As We.]

There's really no new knitting news - I'm slogging along on Henry, which is turning out nicely but is more than a little tedious. 400-plus sts per row! In tiny dark yarn I can't see while watching TV! On the other hand, the pattern really is very easy - you get into a slip 2, knit/purl 2 rhythm pretty quickly. I do enjoy the first four or so rows of each repeat, as the jumbled-looking mess resolves itself into chevron stripes, but there's only so much joy to be had there. (Joy that is counterbalanced, incidentally, by my irrational conviction that it really is a jumbled-looking mess, even though this has played out a couple times now without catastrophe.)

"Heaven ain't close in a place like this"

The Killers' concert was indeed delightful - their energy kind of lagged toward the middle third of the set, but the first and last 6 songs or so were phenomenal. I think part of the slowness at mid-show was that the songs from Sam's Town just aren't as high-energy as Hot Fuss and there was some dissonance involved with mixing more ballad-type music with straight-up, drums-and-bass rock. I thought, too, that the front end of the show was pretty heavily weighted with their radio singles, and that the crowd kind of got what they were looking for a little too early. But despite the pacing issues, the concert was a lot of fun, and I'm glad we were able to go.

Tonight Ben and I are going over to Karen and Brandon's for a potluck - Karen's parents are in town, so that will be fun. I'm in the process of making eggplant roll-ups, but while my eggplant slices are cooling, I thought I'd update my book log.

Measuring Time (Helon Habila, 2007). This novel is set in modern-day Nigeria, and is the story of two twin boys living in a largish village, Keti, some distance from Lagos. LaMamo becomes a professional soldier and Mamo, who ends up being the main character, becomes a historian and writer. I enjoyed this immensely - Habila's writing is spare and his words carefully chosen. Now that I've been thinking about pacing above, I realized that the pacing of this novel worked well for me - the chapters are all each only a few pages long, and the tone is well-suited to the story he's telling.

I took a course in Nigerian literature in undergrad, but we focused there on the immediately post-colonial era, and the native fables and folkstories that predated contact with European cultures. It was particularly interesting for me, then, to see a portrait of Nigeria today, reading about the problems with the current government structure and the quotidian experiences of village life. I was used to reading stories set within the traditional family and village structure of Igbo society, and so it was interesting to see how European and Christian influences have changed that society. The first example, of course, was that the twin boys were permitted to survive infancy, and the familial structures in the village seemed to be modeled more on the Christian practice of one wife per husband versus the traditional compound style with several wives in each family. But even beyond my interest in Nigerian literature, the characters were well-crafted and engaging, and I thought the story was interesting.

The Kindness of Strangers (Katrina Kittle, 2005). This book ... basically kicked the crap out of me. I started it yesterday night, and literally could not put it down until I had finished. It's a novel about incestuous sexual abuse, and it's very raw, emotionally. It's told from varying 3rd person limited POV, and it's ... powerful. I've read Kittle's other two novels, and she has this overwhelming talent for putting you right there with a character, which is a heart-wrenching experience when that character is an eleven-year-old boy whose parents have been sexually abusing him for years. And it's not heart-wrenching in an Oprah's book club, tear-jerker bestseller sort of way, but as if you're actually there watching this horrifying situation come to light. It resolves not happily, necessarily, but as well as it could, and the whole novel just feels so incredibly real. I feel about this book as I feel about the movie Traffic, maybe - I can't say I enjoyed reading it, because there's nothing enjoyable about the story she's telling - but I am incredibly glad I read it. It makes you feel exactly what it must be like to be in the middle of a tragedy, right down to the overwhelming anger you'd feel towards nosy Carlotta in the bakery and the it's not true, this can't be happening to me feeling of having something like this unfold right next door. I would wholeheartedly recommend this book to anyone who could stand to read it, but I think you have to be ready to have your feet kicked out from under you. This is a novel I'm going to be thinking about for years.

Clay's Ark (Octavia Butler, 1984). This - I'll have to read again, I think. I liked it, but I kind of blew through it to see how the plot turned out. Part of the problem was that I knew that this novel was part of the Patternist series, but I hadn't known that it was more of an offshoot than a continuation - I kept waiting for the characters I knew to appear, and didn't realize until about halfway through that this was going to be an entirely separate novel from the preceeding ones. I really don't have any concrete thoughts on this yet, so I will definitely be re-reading, but I think I might wait a little while to do so.