I sing because I'm happy, I sing because I'm free

My time in rural town, USA is rapidly coming to a close.

I'm excited to be back home again. I'm excited to get to spend time every single day with my beloved husband and daughter (!), to get to sleep in my own bed, to not have to pack a suitcase anymore, to not have to struggle to stay awake at the wheel during early morning drives with beautiful, but monotonous scenery, and to get to cook again, rather than being at the mercy of the hospital kitchen ;-).

But, it's been a good month in a lot of ways. I told Meghan this evening that I was surprised to have some bittersweet feelings that this month is ending, in addition to the predominant happy feelings, but they're there.

It was a good month for me professionally. I was excited to get to see a lot of children this month, which helped confirm the decision I finally made last month to hopefully pursue a residency in pediatrics (hooray!) after medical school. I also feel like a lot of my training really gelled this month. I felt the most confident I've ever felt, both with my ability to take a thorough yet efficient history and physical, and my ability to accurately diagnose and come up with a comprehensive management plan. I found myself thinking a lot of time, "Wow. I know exactly what that is. And I know exactly what to do about it.  W :-O W. When did that happen??"

My improved comfort level in my technical abilities also made it easier for me to relax and enjoy my patient encounters and to work on developing my own unique style of bedside manner. Instead of just being satisfied to have gotten through a patient encounter successfully, I was able to reflect critically on the encounter, trying to integrate these reflections into the next encounter, consciously trying to improve with each patient. You have to know the notes and rhythm of a piece of music before you can work on the dynamics, articulation, more subtle aspects of musical development, and I felt like I was able to work on actually making a beautiful song this month much more than past months. It was exciting!

It was also a good month for me on a personal level. I had to relearn an important lesson that I'd learned last summer:

When I first started rotations last July, I looked calm on the outside, but inside I felt very anxious. It was the most I'd been apart from Julia, and I felt frantic to get to her as soon as possible, even though I knew she was being well taken care of and loved on by my parents, and, ultimately, by God. I finally had to realize that I was torturing myself missing her, worrying about her, and feeling guilty about not being with her. I had to let go and let God. I had to give myself permission to enjoy my rotations, to enjoy spending time learning and helping patients. That it was okay for me to be okay apart from her. That my worrying about having time together, did not, in fact, add a single moment to our time together. That my making myself miserable did nothing for Julia. Nothing. That she was happy and that she would want me to be happy. I pray Julia will look back on her childhood and understand that I felt called by God to be both a mother and a doctor, and that I believe God has a plan for me to do His work through my vocation and through my profession. But, I don't think Julia would look back on her childhood and feel as understanding of my demanding professional road if I was miserable all the while. At that point, what would the point even be? If I felt called to be a mom and a doctor, I was going to have to do both with joy. And I wanted to... I just had to give myself permission that it was okay to be joyful. Not only okay, really, but my calling as a Christian. There are many difficult sacrifices to be made on this path I'm on, and it's natural to miss Julia, but I can do something more constructive with these feelings than dwelling on them and getting upset and grumpy. Namely, I can offer up my prayers, joys, and sacrifices of the day to God out of love for Him and love for my family, and do so with a cheerful heart.


So, I went from being so uptight inside and smiling on the outside, to smiling on the outside AND on the inside. It made my life so much better, and I think it helped shed some light in darkness.  A few people commented to me or Aaron that I was one of the most joyful (or "sparkly," according to one resident ;-) ) people in the hospital. On some of our most difficult rotations, some classmates and I made a habit of positive thinking and affirming, every day, that it was a great day. Because every day is a great day. Every day is a gift. I am so blessed to be alive, to be a daughter of God, to be a wife, to be a mother, to be a sister, to be a friend, to be a student doctor.

Anyhow, apparently, I'm not the best at extrapolating lessons I've learned. It would have been logical to extend that good attitude to this month of having to be far from home, but, instead, I was obtuse and ended up being rather negative going into the month, resenting the fact that I had to be away from Julia. So, I had to realize anew that my negativity does nothing for Julia. Nothing. To realize that I do much more good for her by being positive and cheerful and prayerful, even from far away, than frustrated and bitter and sad. To realize anew that she was well-taken care of while I was away, by her father and grandparents who love her, and, especially, by her Father who loves her. And give myself permission to enjoy the present, the day that God has given, regardless of where I am or who I'm with.

Once I was able to let go, I really did enjoy my time here. I went to the park here several times and was in awe of the beauty of God's creation and how fresh the air is outside of a large city. I got to swing on the playground, to enjoy some new music, to read some great books, to try some local restaurants... to take advantage of a few nights of less responsibility. I was able to get some great blogging done (right? haha ;-) ), I was able to study much more than at home, and I got some good praying and reflecting done.

Enjoying the beauty of the creek's overflow waterfall at the park one day during my lunch break.

Enjoying the beauty one evening.

You gotta swing when the spirit says swing.

Local flavor. I'm always up for an adventure! ;-)

Praise be God for His patience with me. For gently reteaching me lessons when I stubbornly cling to fear and anxiety. For loving me and being so generous with me even when I am ungrateful and blind. And praise God for the freedom and joy that come from trust and surrender. 

Thank you, God, for always giving me exactly what I need, instead of exactly what I think I need. And thank you for a beautiful month.

I sing because I'm happy, I sing because I'm free
For His eye is on the sparrow, His eye is on the sparrow
And I know He's watching me





"He said to [his] disciples, 'Therefore I tell you, do not worry about your life and what you will eat, or about your body and what you will wear. For life is more than food and the body more than clothing. Notice the ravens: they do not sow or reap; they have neither storehouse nor barn, yet God feeds them. How much more important are you than birds! Can any of you by worrying add a moment to your lifespan? If even the smallest things are beyond your control, why are you anxious about the rest?'" - Luke 12:22-26

"And do not fear those who kill the body but cannot kill the soul. But rather fear Him who is able to destroy both soul and body in hell. Are not two sparrows sold for a copper coin? And not one of them falls to the ground apart from your Father’s will. But the very hairs of your head are all numbered." 
- Matthew 10:28

Sweet 16 (months)!

Julia turned 16-months on the 12th! She is growing so fast! (I know I say that every month... but it's true!)

Cheese!

Mischievous!

Another photo in this little rocker? Really, mom?

Highlights of this past month include:

• Hugs! Julia has gotten so affectionate lately! She loves giving hugs and love pats and kisses. It absolutely melts my heart. She has learned to blow kisses. She opens her arms wide and asks for hugs all the time. Julia especially loves asking for hugs during dinner, of course, when she's covered in food.
• "Hi!" Julia loves saying "hi" and waving to everyone and everything she encounters...whether the person or animal or object is in a store, at church, in a book, decorating the wall, etc. She is a very friendly girl.
•  Julia is a master imitator. You have to watch what you say because she loves to repeat it! We try not to say "no" too much, allowing her to explore within reason and saying "hot" or "yucky" or some other descriptive term that explains why we don't want her to do something if we have to refuse her. However, when I do say "no," she latches onto it and starts wagging her finger and saying, in her singsong little voice, "No, no, no!" It's pretty hilarious.
• Speaking of watching what you say around Julia...Some of Julia's lispy words sound like curse words... specifically "frog" and "sit" (I'm sure you can guess what they sound like). I made the mistake of telling Uncle Erik that yesterday because, in his own words, he is "too immature to handle that knowledge." So, if you are startled sometime before realizing that Julia is talking about frogs a lot, I blame him. Just kidding ;-)
• Speaking of family, Julia loves hers. A lot. She knows everyone in both Aaron's and my immediate families really well and often asks for them. We show her photos of them and she gets really excited and kisses them. She'll even say "love you" ("la ya") when prompted and is very generous with her hugs and kisses.
• Julia is getting so sophisticated in her movement. She can easily climb up her little slide now, she scales the playground at the park, she does a hilarious "jump" which is more of an energetic fall than an actual up, she is getting close to being able to somersault, and she twirls and moves her feet while dancing. Watch out world!
• Julia loves to learn! She's got a good chunk of the alphabet song down and can count to 10. She knows the names of colors and manages to guess the correct color at least 30% of the time when asked ;-)
• She's starting to be able to sort things, too. Lately, she's enjoyed lining up her plastic animals or her puzzle pieces on the fireplace or on Aaron's desk, and then putting them back. The other day, she had all the animals lined up, and then she sorted the farm animals back into her barn and the Noah's ark animals back into the ark all by herself.  
• Julia has been singing a lot lately and knows the words to a lot of songs. She's also gotten picky about her beloved music videos. She'll beg and beg for "minah" (music) and then we'll sometimes oblige her, but if we choose the "wrong" one she gets upset and starts crying and saying "no!" very forcefully over and over until we find the specific one she wanted all along. This is why we often hide our laptops from her ! ;-)
• Julia still has some funny suffixes. Avocado is "Ahh-deedo-deedo." Isley is "Eyes-lee-lee" and Ernie is "Er-nee-lee-lee." Cracks me up.
• Julia gets a better sense of humor every month. She thinks a lot of things are "fun-nee!" and loves to laugh. One of her favorite games lately is for us to chase her with her Fisher Price corn popper. She hands us stuffed animals and wants them to "chase" her... so we hold them near the handle of the popper and run after her. Sometimes, we'll be holding her dog, Violet, and all four Sesame Street characters, wearing a bead crown on our head, and running around after Julia, who is laughing wildly. It's a pretty crazy scene.
• We still use the stroller quite a bit, but we also sometimes take Julia out on a walk without it. She tolerates having to hold hands (since we threaten to "pick up" if she doesn't) and she loves plodding along in her little sneakers and also loves "jumping" when Aaron and I simultaneously gently swing her forward in a given step. It's a lot of fun.

Hooray for 16 months and for Julia's beautiful personality shining through more and more each month!

One Year Blogiversary!

I've been blogging since last April, so it's been more than a full year now of blog fun!

Woo hoo!

I set out on this labor of love with the primary purpose of creating an online memory book of sorts, building something to remember special moments. I feel I've put together something my family will treasure, and that has made me very happy. I had other hopes for this blog, too, and my expectations have been greatly exceeded.

It's been a true joy to organize, write, and preserve my thoughts, prayers, photos, and recollections. When I'm working on this blog, I have a smile on my face and a feeling of peace. It's been a wonderful outlet for my need for reflection, expression, and creativity.

I've also really loved the feedback. If no one read this blog, I would still enjoy working on it... but it truly wouldn't be quite as meaningful or as fun for me. I've never been one to like a monologue as much as a dialogue! Though this conversation may be lopsided ;-), I do greatly enjoy the dialogue that comments, both online and in person, and even that silent readership provide.

Posting something I've written is like sending out a message in a bottle. Writing the message can be fulfilling, but there's something extra exciting about casting it into the sea, wondering who might see it. Wondering if God might use something I've written to touch someone's heart. Or to make someone think. Or to give someone a needed smile or laugh. Or to proclaim the gospel. Or to brighten someone's day. The possibility of doing some good in this world, however small, through my writing gives me a thrill, and gives me extra motivation to keep writing.

If this bottle has washed up along your beach, thanks for taking the time to open it and discover what's inside. I truly appreciate you. Thank you for reading, for being such a beautiful part of a wonderful year! You are all in my prayers and are very much loved.

Kaitlin


"So whether you eat or drink, or whatever you do, do everything for the glory of God." 
- 1 Corinthians 10:31

The original masthead. Now the "new" one badly needs updating... how time flies!

(By the way, I just discovered the term "blogiversary" tonight! I thought I was being clever, but then google graciously let me know that there are over half a million hits for other websites already using the term. What can I say... I'm behind the times! ;-) )

Easter 2012

Finally, the long-awaited Easter post! Pathetic, I know, that I couldn't be bothered to write about the resurrection of God's son yet, but I made sure to write and photograph scalloped potatoes. ;-) I'll do better. Here's the scoop, starting with the Triduum...

Julia was cranky to the max on Holy Thursday, so we sadly missed out on that mass, but my mom watched Julia on Good Friday so Aaron and I could join my dad and Sarah for the service that evening. The reading of the passion never fails to move me, especially as I have to shout out, "Crucify him! Crucify him!" and realize anew that, through my sin, I really am a part of that crowd. That reminds me of one of the verses from one of my favorite songs, How Deep the Father's Love for Us.

Behold the Man upon a cross
My sin upon His shoulders
Ashamed I hear my mocking voice
Call out among the scoffers

It was my sin that left Him there
Until it was accomplished
His dying breath has brought me life
I know that it is finished 

 Hopefully next year, Julia will be better able to join us for the long Good Friday service, because I think she'd enjoy the veneration of the cross. She always loves giving a goodnight kiss to the Jesus on my Guatemalan crucifix hanging in her bathroom after she brushes her teeth before bed.

For the first time since seventh grade, I didn't make it to the Easter Vigil. It felt strange not going, but Julia simply couldn't have handled it. Easter morning, Julia was all dressed up and ready to go, but she got mad that we didn't let her watch the Sesame Street music video she was clammering for... so she expressed her displeasure by ramming her head into the back of the couch, splitting her upper lip and getting blood on her Easter dress. Luckily, I'd had the good sense to get some Easter photos of her the day before, so the staining of her dress wasn't too sad. And, fortunately, too, Julia was okay and the bleeding and crying stopped quickly. I promise you, I cared much, much more about Julia than her dress when it happened, even if I just typed about them in an order that makes me look like a horrible mother. Below are some of those pictures... compare them to last year's Easter photo shoot if you want your mind to be blown by how big Julia has gotten!

The unblemished dress on Holy Saturday.

So busy throwing eggs.

We love to laugh!

Beautiful girl.

So happy together!

It's amazing how old Julia is looking these days, isn't it?!?

My favorite.

Easter morning mass was beautiful, and Julia was very well behaved, even after having such a rough start to the morning. It is such a gift to be able to worship God together! Christ is risen, Alleluia! I've been listening to Matt Maher's album, Alive Again, a lot in the car lately, especially with the commuting I'm doing this month, so the song, Christ is Risen, has become my Easter anthem this year. Take a listen if you haven't heard it (or even if you have). It expresses the Easter joy in my heart better than I can right now, I think.

We spent some quality skype time with Aaron's family, and then spent some quality time with my family at Meghan and Erik's house that afternoon. Julia enjoyed playing with plastic eggs, and we all enjoyed a wonderful dinner.

Aaron and I never got around to giving Julia her Easter basket until later in the Easter octave... Friday, to be specific. She got a couple "Melmo" (her word for Elmo) books and a pair of bunny ears from the Target $1 bin, some coloring books, some fat crayons, a set of 4 different pastel colors of Play-Dough, and six plastic eggs "filled" with one chocolate chip each (her beloved "coco"). She really seemed to enjoy her basket, especially the coco! ;-) Of course, her grandmothers both spoiled her with Easter gifts as well! I got some cute photos of Julia discovering her Easter goodies but my SD card is not in rural Oklahoma with me, so I'll try to update the post soon with those.

We took Julia to an Easter egg hunt at a local park on the Saturday before Easter. We were about 3-5 minutes late arriving, and, I kid you not, it was already over. Children in search of candy are vultures. It's probably good we missed it, because Julia likely would have gotten trampled in the stampede. She still had fun, though, wandering around the park and waving hi to the other children (or "babies," according to her), who just ignored her and continued rifling through their bags of newly acquired sugary treasure.

Staring at all the babies.

Another favorite.

Loving being outside!

She didn't find any eggs or candy, but did find a heavy stick to tote around.

I pray you are having a blessed Easter season, celebrating the resurrection!

Regina cæli, lætare, alleluia:

Quia quem meruisti portare, alleluia,

Resurrexit, sicut dixit, alleluia,

Ora pro nobis Deum, alleluia.

"Blessed be the God and Father of our Lord Jesus Christ, who in his great mercy gave us a new birth to a living hope through the resurrection of Jesus Christ from the dead..." - 1 Peter 1:3

Christ is risen from the dead
Trampling over death by death
Come awake, come awake
Come and rise up from the grave

Christ is risen from the dead
We are one with Him again
Come awake, come awake
Come and rise up from the grave

Rural Town, USA, Part III

I promise you, contrary to what you might think by reading this blog, I do have more exciting things going on in my life than my rural hospital dinners. But, I've always had a weakness for documenting food (just ask Aaron about the food sketches in my Italy journal or any of my travel buddies about my daily dinner photos [my old camera had a food setting!])... and the food here is just getting more pathetic (read: hilarious) by the day. I can't resist posting. Too delicious (the pleasure of posting, not the food).

Don't scroll forward just yet... what do you think is in the box???

Scalloped potatoes!

That's right. A box with nothing in it besides a huge helping of scalloped potatoes. And I had the audacity to think that some of the previous meals were carb heavy.. silly me! Surely the patients got something else to eat, right?? Otherwise, they're going to start faking seizures to be transferred to a bigger hospital with better food. Maybe I'll finally post about Easter after I get back from buying some protein (I've seen cows around here... I know they exist!).

Over and out from rural town, USA.

Rural Town, USA, Part II

I figured I should take advantage of my last night in rural town, USA for the week (Hallelujah!) to get a little blogging done! I am currently reading The Hunger Games though (I know, I know... that is so March of me!), which makes it hard to blog, or, you know, work or study or sleep... or eat (just kidding on that last one... I know there's a terrible pun to be made involving the title, but I will resist).

I video chatted with my loves earlier this evening. If anyone can hear me outside of my hospital room, (which they almost certainly can, because I can easily hear noises and voices coming from the hall), they may think I'm crazy. How often do you hear a grown woman alone in a hospital room repeatedly and excitedly singing "The Itsy Bitsy Spider," "If You're Happy and You Know It," or the ever-popular Laurie Berkner hit, "Moon, Moon, Moon"*? I wonder if the people in the hospital think that this room, set off by itself, with a sturdy, metal key pad is actually the world's tiniest psych ward? And that I am a patient in this hospital, dutifully eating the hospital's cold ham and Kraft single sandwiches for dinner**, trudging around in the evenings in baggy gray sweatpants because I got vinegar on the only pair of jeans I brought to Sallisaw (don't ask)***, and singing children's songs. They must be terrified, though, if they do think this, to see me in the early mornings and late afternoons, because I pull a pretty impressive Frank Abagnale, "playing doctor" just down the hall from my room! For several days this month, my attending physician is the town's hospitalist...which means I am seeing my own hospital patients, writing my own orders, and dictating my own history and physicals. Truth be told, hooray for rural medicine! It's been a great experience getting to dictate and write orders. My preceptor has already shown a lot of faith in me, and, while still overseeing my work, has allowed me a lot of responsibility and autonomy, which has been very educational and empowering.

I have also been blown away, yet again, by how nicely students are treated out here. This one middle-aged woman, who's the charge nurse (supervising everything), and knows much more medicine than me at this point, I'm sure, insists on giving me her seat and workspace every morning. I always try to refuse, but she is adamant. After I was done working on notes this morning, I tried to give it back to her.

"I'm not even working anymore! Please take it back!" I said, rising.

"No, no," she said, "You just sit and visit (with the attending physician, who was sitting at that same work area) and learn. I'm old school. Nurses should show respect to doctors."

"But I'm not even a doctor yet!" I protested, "Please sit!" as I pleadingly motioned to the now vacant chair.

"Well, you are almost a doctor!" she said, "And you'll stay right in that seat!"

I wanted to tell her I was old school, in a way, too, because I respect age and experience... but her mind was made up, and, let's face it, no woman likes hearing about her age ;-)


Umm... this post was supposed to be about Easter, but now that I got distracted and blogged about randomness, I just want to get back to my book. It is the octave of Easter, after all, so I should probably celebrate by indulging myself in my fiction, don't you think? I will write an Easter post soon... the book is a quick read. In the meanwhile, happy Easter and God bless you with joy during this celebration of Jesus' glorious resurrection!

Warning: if you thought the above was random (read: pointless), it only gets worse. Read on at your own risk.

* I wanted to share a link since the "ever-popular" part was somewhat tongue in cheek. Julia has loved the Laurie Berkner CD she got from Aaron's uncle, aunt, and cousins when she was really small, and we've enjoyed a lot of the songs along with her. I'd never seen a video of the band, though, until searching for a link. And now I'm officially frightened. I'm also thinking that I may sound even crazier than I'd initially thought I might for singing that song.

**This was my dinner two nights ago (pictured below).

Nothing like a cold sandwich, stale potato chips, and warm Jell-O after a long, hard day of work.**** It reminded me a lot of the graphic below.

Last night, they just set out a huge serving bowl of tuna tetrazzini and a metal vat of cooked carrots. Basically, I got all of the hospital cafeteria's dinner leftovers. I took a large spoonful of each, and confused, left the rest out? For other people to maybe eat, too?? I was conflicted as to whether I should have tried to find a fridge to put it in, but with no message to me (not even a "Student Doctor" label) it was hard to know if the food was even for me, if they wanted it refrigerated, if it was destined for the trash, etc. Tonight, there was nothing for me. Either that, or maybe the large, white tupperware containers of beans and salsa were left open for me? Or were those left out from lunch? So confusing. To make a long story longer, I skipped the suspicious looking ice cream tub of salsa and grabbed some fast food (which looked equally like the government myplate, I assure you).

***I know, I know. By saying "don't ask" about my vinegar jeans, you're just dying to know how it happened. [Or not. But, if not, you certainly didn't have to go to the trouble of finding the set of three asterisks at the very bottom of the page. Just saying.] I washed and dried some green spearmint gum into my white coat pocket last weekend. So, this weekend, I naturally hit up the interwebs to find out how to get it out. Some sites suggested ice and scraping, so I tried it, with only marginal success. Then, I tried the warm vinegar trick, melting it off, which worked better. Meanwhile, I also spent some time with good old soap and water, trying to work on some ink stains I have on my pocket (I think I'm going to have to go geek soon and get a pocket protector). Anyhow, by the time I was ready to put my white coat in the wash, the crotch of the jeans I was wearing was wet. As I thought at the time that it was water from working on the ink stains and as I wear my jeans a few times between washings, I just set them to out to dry before folding them up for my stay in rural town, USA. But, when I went to put them on after work on Monday evening, the smell of the vinegar crotch almost knocked me out. I like pickles, salt and vinegar potato chips, and easter egg dying, but this was a little much... hence the gray sweatpants.

**** Lest anyone think I'm an ingrate, I do want to acknowledge that I'm just kidding around about the food. I am grateful to God for not going to bed hungry, something much of the world rarely experiences. Thanks be to God for the countless blessings in my life!

Rural town, USA

In case I bored you half to death with my last post, I thought I'd gift you with another more lively one to revive you, if at all possible. Or, at least to reestablish readership, after driving away 4 of my 8 followers.

I jest, I jest. But post I will.

The reason I have the aforementioned newfound free time that I do is that I am currently living in rural town, USA, population < 9,000, for my rural clinic rotation. I drove in early this morning, and it took me about an hour and a half to get here. I plan to spend 2-3 weeknights here per week, to save on drive time, gas money, etc. With my lack of responsibility and time not spent taking care of family/house/etc. I should be able to get a lot of studying done. I will spend weekends and 2-3 weeknights per week at home, because I simply cannot stay away from Julia that long. I miss Aaron, too, but at least I can talk to him on the phone... but Julia? Well, I just need to cuddle her. Staying here for an entire week just isn't an option with such a lovey toddler at home.

Anyhow, I am staying at the hospital here in town. It's really small and some of the friendliest people ever work here. The lady who gave me a tour introduced me to everyone we bumped into, and she must have told me at least 14 times that I was to come to her if I needed anything, anything at all. So, so sweet.

When I was told I would be staying in a hospital room, I pictured the hospital call room from my OB month... and I was dreading it. I figured I'd end up depressed or crazy by the end of the month, driven mad (or sad) by the wind howling through the chink in the window, the sterile tile floor, the paper thin, institutional bedding, and the flickering burnt out fluorescent light. But, wow, this hospital room is posh! It has nicer furniture than my house by a long shot. I'm quite impressed with this rural hospital's mad decorating skills. It's amazing what some color and carpet can do to a room to make it feel more homey. Our training hospital could learn a thing or two from this hospital about call rooms that make students and residents happy (or at least feel less terrified!).

My bed! It's a far cry from a rickety bunk bed or a hospital bed. Luxury!

Side table with alarm clock, coasters, lamp, and tiny plant. Hooray for oxygen!

That leather chair hiding beside the bed is pretty darn comfy.

Note the mini fridge/freezer and the flat screen TV.

Chest of drawers and my desk.

Even the bathroom is decorated! I love the tiles on the wall.

Pretty shower curtain and bookshelf with more fresh towels. Aren't loofahs for exfoliation? Won't be (re)using that.

Non-hospital towels = I actually will get dry after my shower. Hamper = free housekeeping once per week. Heck yeah!

I also think the quality of the room says something about how they feel about medical students, namely that they are valued. It is a strange and refreshing feeling to be so valued, especially at the beginning of the month when I have proven absolutely nothing to anyone here. The woman who introduced me to everyone from the IT guy to the nurses to the custodian introduced me proudly as "our student doctor for the month." Between the room and the introductions, I was feeling the love. Usually, I am a nobody in the world of medicine. But, in rural town, USA, I am somebody. I am, in fact, their student doctor. So cute.

Then, if I wasn't feeling loved enough, the hospital also provides free breakfast, lunch, and dinner to me in the employee break room. Lunch is standard cafeteria fare, served in a hot line (today: mystery meat [pork?], mashed potatoes, mixed veggies) and salad bar for all the employees of the hospital who wish to eat it, but breakfast and dinner are prepared only for the hospital patients and... me. At 7:30 am and 5:30 pm, the dining workers put out a tray in the empty employee break room, specially for me, carefully labeled with a note that says, you guessed it, "Student Doctor." It's pretty adorable.

I went to get my dinner tonight in the empty break room. Don't worry, I studied during dinner so I would feel less lonely. Just ask Belle from Beauty in the Beast: books can be friends.

Please try not to be jealous.

When I first saw the medicine cups of cheese and what I thought was green salsa on my tray, I figured the entree must be Mexican.

 
Wrong.

Okay, try harder not to be jealous. Envy doesn't become you.

It was a single hot dog. With a small bowl of canned chili. The green stuff was relish. I suppose the mustard and saltines made more sense with a chili dog than Mexican (but I wouldn't have been surprised, either if rural "Texican" food was accompanied by saltines and mustard). Also, yes, that is Jell-O and a chocolate chip cookie on my tray. I skipped the former*, not wanting to induce diabetes with my dinner, but I threw it carefully away rather than leaving it on my tray, lest the workers think I was ungrateful for my tiny, sugar-laden feast that they had lovingly prepared for me.

Not being used to the quiet simplicity of rural life, I, of course needed to live it up a bit and get out of the hospital for a little while tonight....despite the fact that there has been a pretty decent thunder storm going on (hey, just because they call me student doctor doesn't mean that I'm smart). I decided to do what anyone does when they first arrive in rural America. Go shop at a little mom and pop store Walmart. Yes, Walmart. I needed some cheap made in China plastic eggs for Julia for Easter. And some peanut butter, because the hot dog already seemed light years away. And some shampoo. And some Easter candy (in case the sugar/carb coffers dry up... duh).

So, there you have it. My day of rural medicine, without even mentioning medicine yet. I guess I could mention that we saw a ton of patients today and that I came to rural town, USA, population <9,000 to finally learn a clinic based EMR (electronic medical record) system. Oh, life, you are funny indeed.

*I accidentally typed "latter" here originally. Horror of horrors. I would never, ever eat Jell-O (of all things) and throw away a chocolate chip cookie. To do so would be to deny my heritage, especially my cookie-baking mother.

Osteopathic Medicine

I thought I'd take advantage of my newfound free time (more on that soon) to look back on my last rotation.

Last month, I was on my Osteopathic Manipulative Medicine (OMM) rotation. Three weeks were spent in the clinic and one week in the hospital. I think this a perfect opportunity to expound upon the DO difference, since it seems to be a poorly understood difference in general.

DOs, or Doctors of Osteopathy, are fully licensed physicians with the same rights and responsibilities as MDs. DOs can be board certified in any field of medicine. They can diagnose, prescribe, and treat any illness. Education at osteopathic medical schools is very comparable to education at MD schools.

DOs are unique, though, in their history, philosophy, culture, and treatment. Osteopathy was founded by Andrew Taylor Still, an MD, in the late 1800s. He was frustrated by medical practice because, at the time, much of the work doctors did actually caused more harm than good. He did extensive study of the human body and developed a set of principles that have become the bedrock of osteopathic medicine.

1. The body is an integrated unit of mind, body, and spirit
2. The body possesses self-regulatory mechanisms, having the inherent capacity to defend, repair, and remodel itself.
3. Structure and function are reciprocally inter-related.
4. Rational therapy is based on consideration of the first three principles.

 Dr. Still contended that if there is a problem with the body structurally, it can impede the body functionally, both at the site of the problem, and sometimes elsewhere. The body's structural problem, what DOs call "somatic dysfunction," can also impinge upon the body's natural ability to heal itself.

This is where OMM comes into the picture. OMM is a hands-on approach that DOs use to diagnose and treat somatic dysfunction. DOs use OMM to restore structure and function to the body, helping the body to heal itself, restoring motion, and decreasing pain.

Students at Osteopathic medical schools have extra classes and labs every semester during the first two years of medical school to learn these hands-on diagnostic and treatment skills.  We are trained to identify somatic dysfunction based on assymmetry, restriction of motion, and tissue texture changes. We can then often treat these problems using manipulative medicine. OMM can be used for anything from musculoskeletal pain (i.e. back, neck, knee pain) to headaches to ear infections to asthma.

The mind, body, spirit connection is another important hallmark of osteopathic medicine. DOs are holistic in their approach, striving to always see the patient as a whole person, never just a sum of symptoms. DOs are prepared and able to go into any medical specialty, but osteopathic medical education is great about stressing the importance of and, ultimately, providing a lot of physicians for primary care, especially in rural and underserved areas, which I think is awesome too.

When Aaron and I were applying for medical school, we got in at both M.D. and D.O. schools. We wanted to go DO, though, because we liked osteopathic philosophy, wanted to learn OMM, and felt it was a good fit culture-wise for us. We have been so pleased with decision and feel we've gotten a wonderful education. We love the whole person, compassionate approach that is emphasized in our training. We love bringing healing by laying on hands. The power of touch to heal is powerful. We still learn to prescribe medication, use lab values and imaging, etc. as any MD would, but we feel so grateful to have the extra tool of OMM at our disposal, especially for treating pain and other neuromusculoskeletal complaints.

Anyhow, I've used OMM on many of my rotations, but last month was a month totally dedicated to perfecting the skills we'd learned our first couple years of medical school. I really loved having a lot of time to spend with each patient; it was great having lots of time to talk and get to know the patients as I worked on their back, neck, etc. The feeling of taking away someone's pain, sometimes after years of suffering, is one of the best feelings. There were some tears of joy shed this past month in the clinic, which isn't something you get to see too often in medicine.

In the hospital, I was often the bright spot in the patients' day, so it was fun to feel like a heroine ;-) Most of the other medical personnel coming in and out of the patients' room had to bring them bad news about their need to repeat a colonoscopy due to a poor colon prep or stick them with another needle for yet another blood draw... but I got to just be the girl who came in and helped them breathe more easily and rest more comfortably :-) I got to have some great conversations and pray with some patients, and I saw, more than ever, the power of hands in communication and in healing.

So, all in all, it was a great month. Hooray for osteopathy!

(And no, I did not take the above photo specifically for this blog - the photo is 2 years old and was taken for something else. I don't blame you, though, if you thought I did take a fake OMM picture of me and Aaron... I am pretty nerdy like that ;-) )