happy new year!

here in the emergency department, it's about 2 hours until 2011, and i'm sipping on some delicious hamakua coast coffee trying to stay awake. (thanks, buzz and michelle!) i'm sure that after folks begin ringing in the new year at the local bars, we'll get a little busier.

we got back from a magical trip to california five days ago, and i've been working most days since then. liv did a great job summarizing the trip, so i won't go into extreme detail about it.

it goes without saying that the best part of our little adventure was a very special hike in the marin headlands with livvie.

other highlights of the trip include: christmas with john and katrina, our yuba river hike, running with liv around the presidio,  walking around japantown and soaking in the kabuki baths.

so happy 2011 everyone! cards will be sent out starting next week. i used to be so good about writing letters to folks. it's exciting to reconnect with folks who i haven't seen in a long time, especially now that we have some good news to share. 

lunch at milltown

our holiday card: better late than never

goodbye san francisco

christmas with john, katrina & zosia mae, oakland

lunch at small shed flatbreads, mill valley, calif.

breakfast with july

big thanks to rebecca and ian for opening up their home to us!

i asked. she said, "yes!"

christmas eve, san francisco

yuba river gorge hike

breakfast at the ashram

door to our cabin at the sivananda yoga farm

yuba state park warnings

thoughts of bringing my kayak to the yuba

livvie at the yuba river

japantown, san francisco

our spot

sushi ran, sausalito, calif.

tennessee beach

lunch at joe's taco lounge. mill valley, calif.

peek-a-boo

breakfast with zosia mae

if you're going . . .

on our way to san francisco, blogging at 34k ft (courtesy of delta airlines). we can't wait to see john, katrina, zosia mae, and nelson.

working like crazy this past week, but more than ever before, i'm having fun doing my job.

oh, and i found out that i am graduating in december, 2 years from now, which is 6 months early. this will give liv and i six months of quality time together before she graduates and i start a new job. life doesn't get much better.

stay tuned. i hope to post regular updates while we're in california.

overheard in the ED

my posting as of late has gotten spotty, to say the least. i've been busy, and when time is at a premium, it seems like i have more important things to do than detailing my life for everyone to read on the internet. this blog has been a great tool for reflection and for keeping my writing skills sharp (outside of documenting the medical encounter, which i do daily).

i also have enjoyed knowing that my widely scattered friends and family can get a little gimpse into my daily doings, as it seems like my capacity for phone or written communication isn't what it used to be. so thanks for reading. posting should be more frequent in the coming weeks.

one reason for the lack of posts: in preparation for going away for the holidays, i've been working a string of 12-hour night shifts the past week. here, on my 4th of 5 night shifts, i feel like i'm getting into a nice rythym. work / sleep / putter around the house and eat breakfast / run / work.

there are some enormous snowflakes falling outside my window, which reminds me that it's time to run so i can get to work on time this evening. hope everyone is having a lovely holiday season!

overheard last night in the ED:

"i'm going to eat real fast, then i'm going to disimpact this dude."

getting cold

it's cold outside, which means that the ED is pretty quiet (and i finally have some time to blog).
starting a long string of nights for the next 5 days before our california vacation. we'll be going to hanging out in the city, going for a hike in the marin headlands, and checking out  japan town (with a visit to kabuki springs planned). after a few days in the city, we're going to hit the yoga farm for a little yoga retreat.

in medical news, this website has rocked my world. it presents the data for several common medical interventions in a straightforward fashion. as a friend of mine and i have been saying for years, we should be smarter about what therapies we use. it might save us a few lives as well as money.

in health policy news the ACA was challenged successfully in federal district court in VA. the justice dept has already said that it will appeal this decision. so what does this mean?

the recent court decision wasn't a ruling on the entire ACA. rather, it specifically addressed the question of the individual mandate to purchase health insurance. the problem is that repealing the individual mandate spells disaster for many of the big (moneyed) players in healthcare, when you consider that insurance companies now are forbidden from excluding individuals with pre-existing conditions or  dropping subscribers when they get sick. trying to muck with these provisions of the ACA would be politically disasterous. if insurers aren't happy about the idea of having to cover sick folks while healthy people aren't required to purchase insurance.

for this reason, it seems as if the individual mandate is here to stay.

in other ridiculousness, try out this toilet. one of our hospitalists has one in his house. as you approach the toilet, the seat rises, anticipating your arrival. upon sitting upon this thrown, you are greeted by a pre-warmed cushion, pre-programmed by remote control, to your exact temperature specification. as you take care of business, a fan propels air aftward, bypassing your nose and keeping the room air fresh. (ordinary fans direct air upward, which causes foul air to pass by one's nose) after your mission is complete, an oscilator comes out spraying you with cleansing water applied in either a direct or oscilating fashion, followed by blow dry. lastly, the lid closes automatically after you stand up.

polar bear cookie

apparently, our hospital has the largest starbucks in the world. (it really isn't that big, but the patio is enormous, which apparently counts in the calculation of size)

go home WBC

westboro baptist church is coming to pay north carolina a visit. they will be protesting at elizabeth edwards' funeral.

nova scotia

this was taken at liz's wedding last summer. they have a baby on the way that i can't wait to meet.

remembering

our thoughts are with the family of elizabeth edwards.

good night

we had a great applicant dinner for the residency tonight. i feel hopeful about who might end up at our program next year.

winter

after a beautiful snowfall last weekend, it finally feels like winter here in NC. i just got back from an awesome run with ulysses in the cold night air. wow, he's like a different dog now! this summer, he could barely make it two miles with me. in tonight's sub 32-degree weather, we were doing under 7-minute miles x six miles without any difficulty.

i had an discouraging meeting with my program director today regarding the possibility of me getting that extra six months of credit towards completing my residency. it looks like the board is going to deny me (and everyone else that started last year) those 6 months off. of course, before all this happened, i overjoyed at completing my training in 2.5 years instead of 3. so i guess it's all a matter of perspective.

the meeting also gave me a chance to talk about how frustrating it can be sometimes to not get the respect that i used to enjoy as an attending. this won't be the first time i've mentioned this, but it's way harder than i had imagined it would be. it has been a lesson in humility if nothing else.

returning

it seemed like i've been busy for the last week, although objectively, i didn't do much. this week marks my first week back in the ED after two fairly easy months. i haven't acutely felt any kind of stress at going back, but obviously, a few things (like blog posting) have fallen by the wayside.

one interesting little piece of news that has kept me preoccupied: the american board of emergency medicine just changed its standards for people training in emergency medicine that have previously trained in other specialties (ie, me). whereas before, they had granted six months of credit, now they are saying that folks like me can have one entire year of credit toward emergency medicine residency training. this means, in effect, that i could finish my residency in two years instead of three.

at this point, there's no word on whether this will apply to me, as the policy is written oddly. they say they won't grant "retroactive" credit. what does that mean? in any case, i'm working with my program director to see if i can take advantage of the new rules. stay tuned for more information.

we got a tree two days ago, and the house is filled with holiday cheer. this pic was taken with the hipstamatic app for the iphone. it's got myriad funky lenses and settings that make taking photos way more interesting.

i ran an easy six miles yesterday. i ran my marathon two weeks ago, but somehow now i'm feeling a little slow. i don't think i could be still recovering from the race, and i don't think that in two weeks would have had time to get out of shape. maybe i was just having a lazy day.

more tomorrow on the calm of the radiology suite.

congrats

congrats to sarah shanks on her 2nd place age group finish at the gallop and gorge last thursday! overall results aren't back yet, so i have no idea how i did in the race.

how could i forget!? i got to use IV caffeine yesterday at work for a patient with post-lp headache.

messy night

actually, last night was the truly messy night. wednesday, liv and i had a lovely evening with our friends erin and jeff at our house. i made a baked polenta gratin from deborah madison's greens cookbook. i love deborah madison's stuff, especially vegetarian cooking for everyone.  the greens cookbook can wax a bit fancy at times, but overall, i find it extremely accessible. i consider vegetarian cooking for everyone an indispensable volume in the kitchen, alongside joy of cooking.

well, i was about to make my beautiful gratin, but i realized that the cheese that liv had picked up at the store was gone. i searched the kitchen high and low but couldn't find it. finally, i saw the leavings of a wrapper in the living room. bubba had eaten $25 worth of cheese (valle d'aosta fontina and gorgonzola) while we weren't looking.

this is not good, least of all because i had to go back to the store for the cheese which delayed dinner. the worst sequela of this incident has been the constant doggy diarrhea for the past 24 hours. liv and i were woken up several times to clean up liquid doggy stool / soiled crate or to let bubba out to relieve himself. we would have been totally hosed if it hadn't been for deb. i had to work all day and bubba would have been stuck in his crate, except that deb graciously agreed to let him out today while i was at work.

today was also messy in that i tried to pick up too many patients at work tonight. the day after a holiday is notorious for being high volume. (people don't waste their holiday in the ER; they wait until the day after) today didn't disapoint.

in the ER, the ostensible goal is to see as many patients as possible while providing good care. it can be a fine balance. today, in walking the line between attention and volume, i strayed a bit too far towards the latter. i ended up signing out a bunch of loose ends and generally putting too much on my plate. all this in the name of trying to look like a stud. needless to say, it didn't work out like that, at least in my mind.

this isn't so much a defeat as a lesson to take things a little slower next time. sometimes, i can work through a ton of patients and do a good job. this just wasn't one of those nights.

switching gears entirely, here's a nice pic that liv took in philly with her iphone:

riding my bicycle home from work this evening, i was grateful for a few moments to collect my thoughts and take a few deep breaths after my shift.

gallop and gorge

today started off with the gallop and gorge, an 8k through downtown carrboro. last year, i ran it with livvie's sister, which was awesome. this year didn't disappoint either. i saw what seemed like almost everyone i know in my little town. it was great to catch up with folks that i hadn't seen in a while.

liv and i spent the afternoon watching the kids are alright. i loved it. liv not so much. 

thanksgiving with my class

results

i'm a bit disappointed with my marathon results. i shaved about 30 seconds off my previous PR, so it's a new best for me. but i was so hoping to break that 3:11 to get my boston qualifying time. for this year, it won't matter anyway (since the race is closed). so there wasn't a ton of pressure here.

on the bright side, i ran a more even-paced race. i never hit any signifcant wall of tiredness, and i even had some juice left over for the last two miles.

one thing that was lacking from this training cycle and every previous one has been the speed work. each time i train for a marathon, i go out there and do some piddly runs during the week and then usually one decent long-run on the weekend. that's fine, but it's obviously not going to get me any faster at these distances.

if i don't end up making it into the ironman lottery for next summer, i'm going to really train for chicago in october 2011 to get my time below 3:10.

Bib	First	Last	City	State	ChipTime	ClockTime	Half	30K
798	Stephen	Gamboa	Carrboro	NC	03:12:17	03:13:36

there were a few things that slowed me down, most notably, that i didn't make it to the start in time and the crowd i started with had to be fought through. the taxi cab we called the previous night failed to show up, and we had to walk toward the start until we could find a cab to hail. but i'm not going to make excuses here. i think if i had been sufficiently trained, i could have ran faster.

liv was, of course, awesome at supporting me. from getting up at 5 AM to get ready for the start until the finish line where she fed me and helped me pull on some warm clothes, i had the best [one woman] support  crew i could have asked for. thanks, baby!

despite the semi-disapointing finish time, we did have a big fun time in philly this weekend. we got to spend an entire day with ben and dawn and their new baby, julia skyke.

julia skye was the highlight of the day, but we were also quite taken with their chocolate lab, hercules.

philly was a good race, but i don't think i'll do it again. after chicago, it seemed pretty small and low-enery. i'm also not a huge fan of the out-and-back loop type courses.

although we had a very limited time to be tourists, we did see a few of the sights. we mostly walked around downtown and the penn campus.

but the best thing we saw was the mutter museum, which houses a fascinating collection of medical oddities and history. my favorites were the x-ray shoe fitter, the iron lung, the preserved mega-colon, and the liver of the original siamese twins, chang and eng bunker. turns out, those conjoined twins who settled in mt. airy, nc were only joined by a shared lobe of liver. the entire liver of both men and the shared segment are on view in the museum, bathed in formaldehyde.

across the finish line

powered by what?

this is not exactly correct, as i don't eat any meat. but the national beef council had a booth at the race expo, so i couldn't resist.

julia skye and livvie

back in the department

although i'm officially still on my ultrasound month, yesterday i took a shift in the emergency department for a colleague. i have to admit, it was nice being back: seeing patients, interacting with my fellow residents, learning. one of my favorite seniors was working alongside me for the afternoon, and he gave me a red trauma to run just before i had to leave.

in about two hours, liv and i are headed to philly for a weekend of city exploration and the marathon on sunday. any suggestions for what we should do while we're there? any restaurant recommnedations? we will be staying in west philly with friends (who are out of town), and the race start is in center city, i think.

my feet are ready to go. the weather looks perfect, and i'm very happy with the way my new race shoes feel.

now that this training cycle is over, i'm thinking about getting back to things like paddling (see below) and riding my bicycle. i hope that liv and i will find some time to swim together in the new year too.

i'm a bit sad that to miss the family thanksgiving celebration next week in new orleans. i had thought that i'd have the week free. now turns out that i have to work in the emergency department. i guess that's what i signed up for a year ago when i applied for this job.

on the bright side, liv is spending the actual thanksgiving day with me before she heads to ATL for thanksgiving (one day late) on friday with her folks. i already have a little turkey day menu planned for us (minus the turkey) for after the gallup and gorge 8k thursday morning.

oh, almost forgot: if you haven't seen this guy, i think he's my doppelganger.  filipino, rides bikes, runs, blogs, is a hospitalist MD, and we're exactly the same age. oh, and we happen to be 3rd cousins (i think; please help me with this, aunt vicky). we've never actually met in person, but i hope we do get to hang out together sometime, perhaps when liv and i do our asia trip.

again, any suggestions for cool things to do in philly are welcome.

hello. bubba

liv loves her new iphone. this was taken with the hipstamatic app.

lazy day

well, not really. we had residency conference this morning, and i'm running around this afternoon checking off to-do items.

mostly, i'm trying to rest before the race on sunday.

we're already starting to plan our winter vacation. we fly into san francisco and will be heading up into the sierra foothills mostly, we'll be doing a yoga retreat near grass valley. a visit to see zosia mae is also in the works.

looking good

 

looks like the weather in philly is going to cooperate this weekend. except for my first marathon (charlotte in 2001), all my races have been blessed with good weather. even in chicago last year, with a 32 degree F start,  the temperature felt perfect. it's hard to imagine how bad it would suck to spend months training only to be slowed down by soggy shoes.

ran my last "real" run yesterday: 5 miles. when i headed out the door, i realized that since i'm purposefully running slow, i can take ulysses with me! he does fine at moderate speeds, but usually he slows me down (and consequently doesn't get to come running with me).

my last ultrasound shift is today. at my meeting with our u/s director, bobby, i realized that i've actually made some progress this month with my scans. i'm not a perfect sonographer, but i can do the exams that i need to get done (aortic aneurysm, pelvic, FAST, DVT, and cardiac echo are the biggies).

liv and i are going to be in CH for thanksgiving. anyone want to run gallop and gorge with us? if you haven't heard of the race, it's a fun 8k through downtown carrboro and a great way to get a little exercise before, well, gorging yourself on turkey.

check out these folks from my old residency

ok, you fix the budget

with this nytimes tool, you can give it your best shot.

racing flats! (one week to go)

ran a very slow 7 miles yesterday in my new shoes. they feel fast and have just about the right amount of support. (ie, i don't expect my feet to be completely ravaged at mile 20) 

just got back from a very short bike ride. for me, it was about an hour. liv continued on with the team for about a 45 mile, 3-hour loop. today is supposed to be a rest day, and i'm trying my hardest to not push hard AT ALL this week on my runs. i'm still pessimistic about reaching my goal of 3:10. i'll run as fast as i can, and we'll see what happens.

had the nice surprise of meeting up with officer kitty and his west-coast fiance for dinner last night. we all just happened to be at the same restaurant, one of my favorites in carrboro. they're probably the only place in town with a decent selection of wines. they even seem to have picked my 2 favorite sonoma zins: seghesio and a few of the ridge zin blends. both these wineries were a short bike ride from my house in healdsburg five years ago.

autonomy

i've spent the last two nights working 12-hour shifts at a very rural hospital in the eastern part of the state. it has been awesome: exciting but not too exciting. (read: no scary patients trying too hard to die on me) crazy how being a resident can sometime take the fun out of an otherwise satisfying job. whatever it is about working on my own in the ED and being responsible for my own decisions, it seems to suit me well.

i left my shift yesterday tired but happy. drove 30 minutes to lumberton where i had a hotel for that day to sleep between shifts. at first, i was feeling guilty about spending the money for the hotel. the hospital has a little room that i could have slept in, but there are no windows, the bed is a little cot right below a jet-blast air conditioning vent, and it is insanely noisy.

instead, i was treated with a really nice place for pretty cheap. i ate a delicious breakfast, soaked in a hot bath (very important after a night shift) and then settled into a soft, comfortable bed around 9 am. i had planned to get to sleep immediately, but invictus was on HBO, and i stayed awake to watch the whole thing. initially, i had just planned to watch a few minutes, but i couldn't turn it off. great movie, if you haven't seen it.

i can't believe i was apprehensive about coming out here! don't know when i'll have a chance to come back, but i hope it'll be soon.

looking forward to a weekend off with liv then the marathon in one week!

my survival gear

gum elastic bougie, oxford accident & emergency handbook, and my new tintinalli.

thanks, vitalink

just saw some of the great folks from costal hospital critical care transport team. there are no bougies here at this hospital, and i forgot to bring mine! one of the transport medics was nice enough to gift me a bougie from their ambulance. i used to keep one in my timbuk2 bag, but somehow it disappeared. there's no wifi here but tomorrow i'll post a pic.

remembering the prom

borrowing from a post from liv:

had a great time at the med school prom last year with liv. this pic brings back nice memories of a fun night out, so it seemed worth re-posting.

i have my first shift tomorrow moonlighting at an extremely rural hospital in the eastern part of the state. for the last few weeks, i've been a bit nervous about going out there.  it's pretty much the opposite of university hospital. they have few resources and NO consultants. hell, they don't even have an ultrasound or an optical airway device in the emergency department.

but then tonight i realized: wait a sec, i did this for two years before i went back to residency.  pretty much the same type of set-up with almost no support in an isolated setting. tonight, riding my bicycle home from the hospital, i actually started to feel excited about the chance to work by myself with a little autonomy, away from the ultra-supervised setting of the u.

so off i go tomorrow. two 12-hour shifts separated by a short hotel stay. i'll let you know how it goes.

tapering

my 12 mile run yesterday turned into a 10-miler because i was feeling pretty ill. not terrible, just a little tiredness and malaise. (i've been battling a little cold for a few days now) when i told this to liv, she thought it was pretty funny that i would run 10 miles whilst feeling ill.  i think she's right.

either way, i'm in the taper portion of my training now. fewer miles, less time, and supposedly more energy.  those last few long runs took a lot out of me, so i'm glad to be decreasing the training intensity for a bit.

i'm very excited not only to run philly but also to have a chance to explore the city. liv accompanied me to chicago last year for the marathon, and we had a spectacular time wandering around chicago, based at my friend annie's house. (although she and her husband were out of town that weekend. we had the whole place to ourselves!)

again this year, we're staying my friend kristin, who i met last year at ian and rebecca's wedding. and again, kristin and her man will be out of town.

a little less than two weeks to go!

12 miler and insanity. texas style.

hey partners, saddle up for a little crazy talk, texas style. texas republicans, reveling in their political gains last week, are talking about pulling out of the medicaid program to protest the patient protection and affordable care act.

in the words of my friend heidi sinclair, "how on earth do they think would SAVE them money in the long run? it's not like children and disabled poor folks are suddenly going to stop being sick or needing preventative care - they'll just end up in the emergency departments ... or really sick ... or dead."

it must just be blowing smoke - can they are really so short sighted? maybe. but maybe they realize how important the ACA is. this piece of legislation was probably the most significant since i was born.

had a nice visit with my folks this weekend. just said goodbye to them, and i'm heading out for a 12-miler now.

keep your government hands off my medicare!

for those of you riding the t-party tsunami, just remember that taxes pay for your roads, bridges, schools, trash collection, and yes, your medicare. so if anyone needs to stay away from medicare, it's you.  also, consider that "obamacare" will result in tremendous cost-savings. if you truly believe in thriftiness, don't mess with it.

the parents are coming to town this weekend, which should be fun. dinner tonight then fences tomorrow.

got some great news today: i'll be doing OB as my off-service rotation this year with one of my fellow ER interns. this is awesome because there will be lots of people to share call, which means fewer call nights. also, i get to deliver babies again! maybe my future career won't involve OB, but i'll definitely use these skills next time i'm working abroad. having this month of high volume obstetrics will allow me to keep my skills fresh.

the papoose

 

to a child, it's a torture device. to me, it's a godsend. it's the papoose board. basically, when you have a procedure (eg, repair of a laceration) to do on a child, you strap the kid to this device, and they can't move a muscle. the cartoon pretty much illustrates how this works. 

if you don't read the comments on this blog, officer kitty dropped a fascinating story on marathons. i've come down with a cold, and my training has really suffered (ie, non existent) for the past few days. but i've also let go of qualifying for boston at this race. i would like to run boston some day, but it doesn't have to be this year. i just want to enjoy running for now.

in other news, i visited the family medicine center today to keep up some contacts there. i love family docs. i love emergency medicine and working in the ED, but i will always be a family doc at heart. hopefully, i'll find a way to stay involved in the department in the coming years.

great day

just got back from work today at capital, and MAN i am jazzed. i had a great shift with an awesome attending.

although there are certain parameters that most doctors stay within, emergency medicine is extremely variable in practice. it's probably because i trained originally in family medicine, but my practice tends to fall on the minimalist side of things.

\sometimes, this is what happens when i run a case by my attendings:  i propose what i believe to be a reasonable battery of tests for patients. attending looks at me funny. attending tells me that i need to order this or that scan or test and if i don't i'll be sued so watch my backside or else.

not so today. i had the best day i've had in a long time working with dr. c, who, i felt, was just about the most reasonable attending i've worked with so far. no unnecessary blood tests, no needless irradiation (which, we recently have learned, significantly increases our patients' cancer risks). what a breath of fresh air.

not only that, i'm off "jeopardy call," which means i can't get called into the hospital this week. sweet! now off for a recovery run and a relaxing evening. oh, and i'm not even sore from yesterday, which is a double bonus.

long run

today was my last long run of this training cycle.  thank the lord. that was REALLY tiring. 20 miles in ideal weather conditions, and it was still slow and painful. i wasn't very well rested, so i don't feel too bad about running it extremely slow.

worked at capital hospital north [read: wealthy area; wonder why they built that hospital there?] yesterday, and it reminded me of why i like working in the ER. well, not exactly because of the experience there. i really love the idea that anyone that comes into the ED will get care, no matter their ability to pay. no insurance? i don't care. i don't even know if you have insurance or not. if you're my patient, you're going to get the best care, whether you're rich or poor.

i realize that this is nuanced issue. medical bankruptcy is a huge problem. people without insurance can rack up some pretty horrendous bills in the ER. if you don't have some help paying, there are very few folks that won't be hurting after paying their ED tab.

but back to saturday. without getting into any of the specifics, i saw some wealthy, entitled people that day. most of my patients were lovely, but it made me remember how much i love treating folks who are just grateful for their care and don't want to call a plastic surgeon for a scrape on their kid's elbow.

i did love working my shift this weekend. i got to see some interesting cases, learned a fair bit, and got to interact with some terrific staff and very nice patients. in fact, i love the day to day of my job pretty much all the time.

these past few weeks have been a great reminder that work is great. in moderation. my schedule this month is dreamy. normal residency schedule: sometimes very tiring.

one more thing: i just discovered playmakers rep.  i'd known about them for a while, but i'd never seen one of their shows. turns out that this season's line-up looks fantastic. i'm going to see fences this weekend with my folks, and i'm interested in just about everything else they're doing this year: angels in america, big river, the year of magical thinking, exit cuckoo, even shipwrecked! looks good.

new shoes

for my last 20-miler. what a beautiful day!

goodnight ulysses

again, not ours

but ain't she cute! meet julia skye, baby of ben and dawn. congrats folks. can't wait to meet her (maybe in two weeks when liv and i travel to philly).

progress

ran my race pace 12 miler on monday, with ok results:

1	07:17
2	07:05
3	07:13
4	07:12
5	07:16
6	07:10
7	07:10
8	07:06
9	08:02
10	07:44
11	07:10
12	07:08

mile 9 and 10 were big hills. friday is big tempo / interval day. my legs felt like bricks yesterday on my recovery run, so hopefully i'll be recovered by tomorrow.

eats with the neighbors

thanks to lara and brian who had us over last night for a lovely meal of veg chili and homemade cornbread. we all live so close to one-another; it's surprising that we can end up going such long periods without talking. it seemed like we hadn't seen each other in a long time, so it was good to catch up.

back to "work" today. it's my ultrasound month, so although there are 5 or so real ED shifts in there, it's mostly just me running around the department scanning people and learning how to do ultrasound. nice.

my training cycle for the philly marathon is starting to wrap up. one more longish run at marathon pace and one more 20 mile long run. this has been a great way to focus my training over the last few months, but it has meant that running is just a bit less fun. the running regimen has also made less room in my life for other things like yoga and cycling and spending quiet time writing in my journal.

despite having tested INFP a few years ago, i think i've shifted big-time towards ENFP. i love a good evening out on the town or hosting a large party at our house. but i also need some time by myself to recharge. sometimes this can take the form of running, but mostly it means true quiet time, ie being still.

pumpkin carving

pumpkin carving on saturday night at jonas's place. aided by elecric jigsaw.

in other news, ben and dawn's baby was born. yeah! we get to see little bendawn in about 4 weeks when we got to philly for the marathon.

the month that was

even during a month off, i had a terrible time sticking to my daily training schedule. so i'm adopting the "run less, run faster" strategy: each week one long run, one recovery / form run, one speed workout. i think it'll be easier to actually accomplish this even with a crazy schedule.

i'm also sort of glad that boston closed out early this year. so i won't be running in that race come april. just as well, as i'm going to have to learn how to be a triathlete now. DWARP is going to be doing the VA beach marathon in march, so i might have to run too. one thing is for sure: i won't be doing any special training for that one.

this month has been a blessed relief. i had no idea that i was going to feel so tired after just 3 months of residency. i guess that it WAS internship all over again, which is supposed to be hard. i'll also concede that i might have been trying to do too much with the marathon and all. but i keep thinking to myself: well, people have kids during residency- my situation wasn't all that bad.

either way, i'm grateful for this past month. hell, i got to see lots of old friends, hang out in hawaii, go back to LEAF, and have a great fall vacation with liv in the mountains. and yup, i've got another one of these months coming up in march.

 perhaps most significant about this month was the way that it has cemented how i feel about the idea of work. but more about that after i eat some breakfast.

up in the air

taking off

true love

this is not our infant

but she's pretty cute, huh?