Expecting Again

Heading into my last week of general medicine in-patient work as an intern, with one more block of labor and delivery in-patient medicine in June.  In-patient rotations are the most taxing simply because they require one to work 6 days a week.  I find that generally I end up working 10-12 hours/day during the more chill, out-patient rotations, and 12-13 hours/day during the strenuous in-patient rotations, but the big difference in having a life is that the out patient (aka clinic) rotations are 5 days instead of 6 days per week, which just makes for a happier person.  The in-patient rotations however have their perks.  I feel more of a sense of control, every morning has a loosely structured schedule, and I get to accomplish my work however I want, I get sign-out (the low-down on what happened for my patients overnight and who got admitted to the team) from the night team, chart review, see my patients, start my notes, while chowing down on some breakfast; all this gets done in the first 3 hours of the day.  Then rounding (usually a sitting session – thank GOODNESS! Which is where we discuss the patients, their new labs or radiology reports, and their plan of care with the other team intern, the senior resident, and the attending… and sometimes our awesome clinical pharmacologist and a medical student or two), which takes a pretty variable amount of time depending on how much teaching or tangential talking we do … and the rest of the day disappears in a flurry of random tasks, some big some small, like running up to check an EKG or having a family meeting with the patient and their loved ones, or admitting a new patient from the emergency room, all which I must prioritize to ensure good patient care … and to ensure I don’t stay there till well after my 12 hour allotted shift time, which thankfully really doesn’t happen too often, usually only about once per week by about 1 hour.  The day is so busy and usually I do get some time to read or discuss learning points on my own or with my team, and those learning points are always so interesting because they are immediately relevant to what I’m doing and the decisions I have to make (or think I have to make but in reality, the real doctor, the attending, ultimately makes them, but hey I do have some say).

This is in contrast to clinic where I feel I have no control, I have to wait usually at least 20 minutes to see my first patient because it always takes that long for the medical assistant (MA) to screen them, and usually, since I am an intern, I have not even worked with the MA but once or twice so we are not used to each other and things do not flow very efficiently.  Then the day goes by quickly, yes, however I continue to feel I have no control over the day’s events, as each patient is a complete mystery, someone new I’ve never seen before, and who may or may not have a host of medical questions for me to address at our 40 minute appointment, which may seem like adequate time, but when you start by taking the first 20 minutes away, then add on trying to have a 5-10 min conversation with your attending in between interviewing, examining and wrapping up with the patient, which may at times require several iterations depending on the attending and how many things they want you to go back into the room to recheck, you are running behind by 30 minutes at a minimum at the end of the day and still have at least an hour’s worth of medical record documentation to do.  It’s far more draining than the in-patient work.  Perhaps spending more time in the clinic over the next few months will allow me to become more efficient and master the art of clinic flow.  Additionally, when second year officially starts, I’ll no longer have to take the extra step of precepting (or presenting my patient and the plan to an attending) except for patients in which I have questions or uncertainties.

Anyway, that about sums up the intern year schedule dynamics.  Somehow keeping sane most of the time, Andy-man and Mr. Darcy are ever a source of joy… and then there’s the excitement of expecting…


Yes we’re having another baby!  I just passed the big week number 24, also known as “vitality week” since it supposedly marks a statically significant difference in vitality between those who are born prior to verses after this date of gestation.  So I suppose I can worry a little less now.  I don’t know how to not worry, there is always something new on which to ruminate.  Did my water just break, or did i just pee myself?  Am I going into labor or is this just what running is going to feel like from now until I give birth? Knowledge on the subject of medicine and health only makes a person paranoid.

But anyway, there is a lot of excitement in the coming July, going to be finished with intern year, and Andy is going to be a big brother!  Also, another 3 minutes and it’s Easter, He is RISEN, he is RISEN INDEED, HALLELUJAH !



Nights Are Awesome!

I’m surprised to find myself saying this but I’m actually in love with the night-shift inpatient rotation so far! Granted, it’s been very very slow on the ward (things you’re not allowed to say out loud but I don’t believe in that vudo shenanigans) and after that first night, which was much more busy and crazy, things have been pretty much going at just the right pace for me to keep up and have a little extra time to do some reading on the side. Tonight’s topic was gastric outlet obstruction since I got to experience that diagnosis for the first time tonight! Which was pretty neat, …though of course not for the patient… praying for them!
Getting to and from work on nights takes about half as much time, that alone is a huge relief. I hate traffic with a vengeance! 

And I get to stop and notice the beauty around me a little more as I’m not so consumed with the sweltering heat and insanely crushingly long lines of cars and stop and go traffic! Also the weather has been fantastic in the morning drive homes – been rolling down the windows, taking in the fresh air. 
Course I do miss my Andy man… he gave me the oh so sweet present of his attention and joy when I awoke and emerged from my hybernation yesterday afternoon, greeting me with a huge smile and jumping down from his chair to hug me and the preceded  to sit on my lap and smile up at me. The little sucker! 

I miss him and the hubby loads and the in-laws- whom I am barely getting to see while they visit… yes these are the down sides. 

But I am mostly struck by how pleasant it’s been… I suppose I waisted so much dread over it, only to find it’s not so bad when the nights not busy! You get to run around the hospital, not confined to one little space or area, pretty much do completely random and new and interesting things all night! I so feared not knowing things and being ridiculed for it, I was totally wrong to fear that because the peeps I’m working with are so awesome about giving you pointers and help figuring out how to manage the ward! So I feel very blessed… and hope that this post may put to rest fears in new intern to be’s in the future or interns about to start on nights!

Starting Residency – on Nights

I’m only two shifts in, so I can not speak in great depth about the adventures of being a new intern on nights.  But wanted to post a short update anywhoooo…


Getting on the correct sleep schedule wasn’t too too bad, I slept in later than usual on my first day (went from getting up around 5:30/6 to getting up at about 8am) and then I took a quick nap in the afternoon while Andy was out for his nap.  But I must say, I was quite fuzzy and drunk feeling by the end of that first shift.  By the time I hit the hay – it was 8am and I had stayed up about 24 hours total, because I got off work a little later than I was supposed to – worked for 14 hours and it was only supposed to be a 13 hour shift (many programs, even to this day, have something more like 18 or 24 hour-long shifts for the resident, and yeah I’ve been told countless times that it was even worse, “back in the day” before duty hour restrictions! Oy, I can only imagine!).  I mean I do remember everything that happened, I wasn’t that out of it, and I remember feeling pretty coherent, however, it was a very slow and cumbersome version of myself I was having to work with.  In addition, I was trying a lot of new stuff and running into countless strange road blocks/new challenges along the way and my brain was ever so reluctant to confront them!


I extremely was blessed to work with a very kind, thorough, methodical, and organized senior resident, who not only offered support in every challenge I faced but showed me both by example and by walking me through the various new tasks residents must accomplish – such as how to properly admit patients, how to address nursing concerns on patients experiencing short runs of V-tach, or fevers, or fussy sick babies, as well as other night-shift-type duties.  This helped immensely!


Among my new tasks, one of the first was answering calls from the nursing staff.  Unsure of myself initially, I answered with a, “Hello, this is Captain Bier?”  And gradually throughout the night I started to remember to answer with a slightly more confident version of that phrase, making sure to call myself Doctor instead of Captain, as no one really goes by rank when doing any kind of patient care!  I got calls about critical lab values, about patients needing sleep aids, or antipyretics… I learned to make a couple decisions on my own, and a bunch with the second opinion of my senior resident, and even one where I did a quick exam of the patient and called the attending to get his input on a decision.  It felt really good knowing I wasn’t on my own to deal with things with which I wasn’t comfortable flying solo.  I was just a little concerned, because I didn’t feel like I knew when it was ok for me to decide something on my own – as a result, I would always go back to my senior and tell him what had happened whenever I had made a decision, kind of my way of asking/testing him out to see if what I did was appropriate.  He never gave me the impression I was doing too much on my own, so I supposed that’s a good thing.  Hopefully I will get better at this…


As I said, I only worked two shifts – and then I got two days off!  Was a glorious little “weekend,” especially as it was the 4th of July in D.C.!  Got to spend some marvelous quality time with the fam, which was great… sad that tomorrow it all must come to an end and despite the fact I now have my in-laws in town visiting, I’m sure I’ll hardly see them, as I have to work!

I can say that going from medical student to intern has been pretty exciting!  Walking in on day one was yes of course very intimidating, but it was crazy the difference between how I felt walking in that first day and walking in the second!  So much more confidence and excitement for the shift to come!  Don’t get me wrong, I was still in a state of being constantly slightly terrified haha, but it’s just so cool to finally be able to say that I’m a doctor and I can finally sign stuff and get things moving.  Yes, there are people above me, who are still signing on that bottom line of a lot of what I do, but it’s definitely different, and more engaging than it used to be as a student.  Also, I feel like I can be myself more because I’m not in a perpetual state of interviewing for a job anymore, feeling like I need to always be searching for what they want me to say or do.  Instead I’m thinking more independently and making more sincere friendships with those around me.  So that’s exciting!

Well I’ve accomplished my goal to stay up until 1am, now it’s time to climb in bed, and tomorrow twill be: nights – day number three!

Quick Summary of How the Match Went!

For those of you who don’t know, I am now heading into the final week of this month long orientation to the Family Medicine Residency of …my top choice program! Fort Belvoir!  I was talking to a med student the other day (oh haha, I remember what it was like to be a med student…), just one year behind me in the process, and realized that I was already forgetting many of the interview trail details and tips I would have offered up just 6 months ago!

So before it’s all gone, here’s a “brief” synopsis…

RANK LIST: I wanted to be in Family Medicine, no 2nd choice specialties.  I wanted a military residency but also wanted to be in the D.C. area (as my hubby was there) so my rank list on the military application, which I had drafted up sometime in August, but was officially due by Oct 1st, looked like this…

#1. Fort Belvoir

#2. Civilian Deferred

#3-11? or so… Other military bases

My civilian/

SCHEDULING “auditions”/”Acting Internships”/”Sub-I’s”: I wanted to do my audition rotations as soon as I could, but also planned to do them after taking step 2 of the board exams, which I took end of May with just one week of scheduled exclusive study time, and I got a 608 (COMLEX, Level 2), think it went pretty well.  I chose to do them back-to-back so it would interfere with my school’s curriculum as little as possible and less flying around in theory AND some less jumping around for daycare for Andy.  I rotated at Eglin Air Force base in July and Fort Belvoir in August.  After scheduling these (which I did so in December the year prior), I also stuck an extremely stressful but extremely useful audition with the Georgetown Family Medicine Residency program in my schedule immediately before the one in Eglin – so I did that one in June.  I had to schedule that one through VSAS (visiting student application system) I believe.  If it wasn’t VSAS, then I must have done it by simply communicating with the Program Coordinator.  You can search for that information sometimes by just googling it, of course, but also on https://services.aamc.org/eras/erasstats/par/, ERAS (https://apps.aamc.org/myeras-web/#/landing … but your school must give you your application token to utilize this site), NMS (https://www.natmatch.com/aoairp/instdirp/aboutproglist.html) and http://opportunities.osteopathic.org/search/search.cfm.

CIVILIAN ONLINE APPLICATION: I applied to 34 allopathic residencies via ERAS, and eventually I also submitted an application for the osteopathic residencies via NMS, even though I applied for only 2 programs.  Applying to so many programs cost me a lot of money, probably about $500 total.  But I had no idea how many interviews I would get, and I wanted to have at least 10, with 3 of them being my top choice programs.  I started with fewer and gradually added some programs to my list as I did further research, and many of the programs in which I submitted very late applications, like all of the University of Pennsylvania ones that I randomly decided I wanted to apply to, never got interviews at, and they had like 3 different sites to which I applied.  I perhaps wouldn’t have applied for so many if I had done further research, and you can use sites like Doximity or the program’s website if often a good resource, but then again some programs have very limited info online, and sometimes you really have to go there and meet the people to understand what it’s like.  I submitted my finalized applications for both systems rather late – but I think did receive offers for a lot of interviews – 16 total, including all but 1 of my top tier programs!  So there is a tip for you – make sure you are aware of the soonest date you can submit your application so you can be first in line to get interview spots.  Although I will note that it kind of worked out for me, because by submitting my application later, I got the later interview spots which I was able to later cancel because after December 7th, I had my military match results, and knew I got Fort Belvoir.  Within about 2 weeks after submitting, I wrote emails to the programs that were among the top half in my list in which I didn’t get interviews, and this worked about 50%.  Just a note saying hey, I’m applying and really interested in your program, a couple tidbits about why that program specifically.  I know that one of the programs (University of Maryland) has a very allopathic-only type attitude, at least their faculty/residency selection would attest to this, also they don’t allow osteopathic students to audition, so this was a big clue to me to not bother applying, but I had to give it a try.

Some random tips –

  1. Always write your thank you notes! I also wrote some personalized follow up notes after the military match day, just saying that I’m so sorry to be withdrawing my ERAS application, and how much I enjoyed the program-just of course to my favorite programs/programs I really got close with like Georgetown and Grant Medical Center.
  2. Always go to the dinner/meal with the residents that are often included with the interview.  Unless you really cannot make it, in which case write them a nice email explaining why you are declining.
  3. Communicate with your school/home program because they may be assuming you’re planning to interview/apply there – I had an awkward encounter because I communicated in a rather delayed manor, but in my defense it wasn’t intentional and I was taking my time in getting my application/list of programs finalized… anyway it was frowned upon.

Some things I didn’t know until going into the interview season –

  1. You can’t rank a program that you didn’t interview with
  2. You can add programs to your ERAS application after you’ve submitted your first finalized version

So anyway, hopefully this helps a few medical students out there! Please post questions, I’d be glad to help you out!

IMG_5307 2

Before my Wright State interview at Good Samaritan Hospital

Snorkeling in Oahu

This past Sunday was tragically our last day in Oahu (during my post med-school/pre-residency sabbatical, part 2 – Hawai’i), but before we were to leave, we had plans to dip into the ocean one last time, along with some snorkeling gear, guided by James’ long-time friend, Jeff!  I was ever so excited for this, as the last time I had snorkeled was with some kiddy-gear in the Kennedy pool back-in-the-day during my childhood (looking back, that was an awesome toy!).  We met up at Kahe Beach Park, selected by our snorkeling-savvy friend.  It’s strategically located adjacent to an electricity plant, from which flows a large pipe of clean, heated water, about 40 feet below the ocean’s surface, thus creating a unique ecosystem, harboring an abundant and diverse gathering of fish and other wildlife for many-a snorkelers and divers to enjoy alike!


As I prepared for the day, packing and plunging into my bathing suit, I recalled Jeff’s words, “you guys are ok with going over 40-foot drop-offs?” and “when we get out there, the important thing is to breathe normal, don’t freak out!”  …I was starting to freak out…  a little anyway.  I couldn’t help but think about what I always think about now-a-days when I go off and do something semi-adventurous/risky, what will happen to Andy if James and/or I die (lovely imagination we parents have…)?  Jeff’s wife, Christina, so graciously offered to watch the now 16 month-old Andy for us.  Fortunately Jeff and Christina are close family friends and have all the contact info for James’ family… and at least James has a living will… mine is still on the to-do list… oops… need to work on that, I thought to myself.


Looking over the ocean, you could see its surface, over the spot to which we were aiming to snorkel, a small ripple of turbulent water created by the gush of warm water spewing from the pipe below.  Kinda freaky…. but I trusted Jeff’s advice to go there and was also comforted by the number of others snorkeling and diving around the area.


After all of this anticipation plus what I think was 4 trips from our spot on the beach back to the car to retrieve Andy-snacks, diapers, and other forgotten or unanticipated items, we finally grabbed our gear and headed for sea.  Wait, no, I had to go to the bathroom one more time!  Jeff had us wipe the inside of our goggles with a special solution for the fog.  We rinsed everything off, then slipped on the flippers, next pulled on the goggles.  We made sure the goggles were nice and snug… Then we were off!  Finally!  I was somewhat nervous about setting out, as I knew there were shallow rocks and coral, but the flippers provided great foot protection to walk or stand on the coral if needed, the waves were very small, and the coral was not really very sharp if you are just walking on it anyways.  Soon we were cruising atop the water, looking down at the fishies!  As we were new to the practice, Jeff had James and I practice our snorkel “dives” a couple times before heading out to deeper waters.  Mildly distracted by our GoPro camera as we attempted to document the adventure, we were a bit slow at first, but in short time caught on to the breathing and swimming patterns we needed to use.  We didn’t even have to travel 20 feet seaward before we encountered tons of beautiful fish and coral.  I began to feel my fears melt away as I dove down, over and over, getting up-close and personal with some of the breath-takingly exquisitely vivid wild life.

Jeff pointed to the itty-bitty little bubble shaped sacks in the water, “these are, blah-blah-blah’s, tiny little harmless jellyfish,” he shared (he told us their name, but of course my brain has long since discarded that info).  As the swim progressed, I began to doubt his claim to total harmlessness, as I felt all over my body tiny little stinging zaps throughout my swim.  They weren’t anything to cry about, and left no mark, so I carried on, not worrying about it too much.  Later during the swim, Jeff did say that he was getting stung too, and admitted he had spied several other tiny jellies with their tiny stingers out and about (some other species that of course Jeff knew the name of and yes I instantly forgot it as well) most likely encountered in such high frequency due to the nearing of the next full moon.


We soon approached the great pipe.  From the water’s surface, we gazed down what Jeff had said was 40 feet to the bottom of the ocean.  Dotting it’s surface were several divers sauntering around.  I could feel the sudden change of water temperature and my fears came creeping back to stifle my child-like mermaid-mode-joy, as I now imagined the possibility of rip tides and other scary current-things.  We converged at the water’s surface, “you can really feel that gush of warm water!” James said.  “Yeah, it’s kinda freaky!” I chimed in.  Jeff nodded, “Some snorkelers will dive all the way down to entrance of that pipe, but I prefer to kind of keep my distance.”  I was relieved to hear this.


giant outflow pipe from the electric plant

After maybe 60 seconds of discussion, we went back to take some pictures around the pipe only to find we had drifted nearly 30 feet from the pipe we were just looking over.  Oh boy.  But we swam back, took some pictures, took a minute to enjoyed the dense cloud of fish surrounding the entire area, and then headed south to look for sea turtles.  After maybe twenty more minutes of swimming and photographing around in the ocean with various beautiful golden, white, blue, and pink fishies, Jeff stopped to ask us if we thought we wanted to go on.  I responded to my motherly instincts, always tugging at me now, and said I was a little concerned about Andy, so we started to head back.


Those brief moments while we were kicking it back in were the fleeing moments of completely and total joy that I enjoyed during this swim, as I felt like I was really freed from all worry and could just savor everything.  I had already discarded the GoPro, so I didn’t have to worry about that, James and Jeff were no longer swimming off in separate directions that I had to keep track of, and Andy was soon to be back in my arms.  I savored the water rushing through my hair, the dawdling groups of fishies letting me join their little schools for a second, the speed and depth I could go with those powerful fins attached to my feet, and the clarity through which I could view everything!  I didn’t want it to end!  But at the same time by virtue it had to.  I can’t wait to go back again!

We never did bump into any sea turtles, unfortunately.  Jeff was much more dismayed at this, however, than I was, as the whole experience was awesome enough to write home about ;).  We followed up this glorious experience with some glorious sushi, and reluctantly said goodbye to our friends as we headed for our next flight: to Maui!

My Life Is Baby Land

Today I fly out to D.C. to interview for the second time at a civilian family medicine residency program. It has been such a horribly long time since writing – I am utterly ashamed! However, I will attempt to fill you in…

So Andy, my darling, lovely son is now almost 1-year-old. He has grown and grown each day, despite my best efforts to freeze his cuteness in time. I keep telling him each day, “this quite possibly is your cutest day ever, it’s all down-hill from here!” but he just laughs and with a smirk turns back to his block-banging, kitchen-drawer-picking, glad-ware-tossing, outlet-searching activity.

The boy is now a clapping, blabbering, crawling-almost-walking 11-month and one week old, he’s been missing his Daddy now for about 3.5 months, as he was deployed to Qatar, a land so seemingly far away that I almost feel as though he’s in a different universe all together. He is to return in about 3 months from now, and I cannot wait for that moment! I just wish I could have a date so I could book a flight to meet him when he gets back to this continent!


Andy watching Daddy’s bed-time story-telling, missing him, but still get to see him!

The talk of the day is the new president, but I of course wish to avoid all discussions on the matter as I am, like so many, utterly dismayed at the bloodbath that we have witnessed thus far on the subject or anything related. I did vote, via absentee ballot, which I do prefer, as I can avoid the lines and inconveniences of voting in person. I supposed I would like to say that we were little activists this year, about a month ago when my dad asked that my mom and myself support the Miami Valley Women’s Center in some pro-life work: we held up some signs and stood in silence and prayerfulness along County Line Road on a Sunday afternoon – it happened to be gorgeous outside, so that was a pleasant surprise-blessing; in addition, I bumped into a high school acquaintance while participating – the perks of being back in my hometown!


My talk of the day is Family Medicine Residency application! I can’t get over the intricacies of the process! It brings me flash-backs of my medical school application days – different, however, in that I feel (somewhat) more assured in this process. I feel slightly more confident than I felt when in the medical school application days, as I have the military match options open to me in addition to the civilian options, and my board scores are slightly above average. All of this helps, however, I, of course, have found reason to fret despite this. Though it should be enough to get into any residency program, the fact is, that I very much hope I get my top choice, because it would be the best option for our family situation. Everyone in my family and friends circle have been every bit as supportive as a fourth-year medical student and new-mom could ever ask. I can’t give thanks enough! But anyone who wishes to cast a prayer towards the heavens on my behalf is more than welcome 😉

Applying to a military residency is a special beast one has to take on. The good news (for anyone hoping to do so) is that if you schedule your auditions. manage to get to them, and finally manage to do relatively well at them, you’ve already won half the battle! This is because the residency military programs all talk to each other, and your good efforts in one group of people will be talked over to the others. Next, if your application is somewhat competitive (board scores, medical school performance) you’ve won another third of the battle… However, the major downside, the is the mysterious other part of the battle, which you can’t possibly participate in because it’s out of your hands. In the military match, we are told there is a “points” system through which you are ranked and to which your preferences are assigned accordingly, and which is variable from year to year. It is said to take into account your school performance (Dean’s letter, Med School Transcripts, Letters of Recommendation, volunteer hours/leadership roles and other such activities completed during medical school), board scores, interview performance evaluations, any research work, and finally, your prior military service. But there may be other variables and unknown weight is assigned to each item. For most HPSP’ers (medical school scholars, or Health Professional Scholarship Program’ers), you will get no points in that last category, whereas other, more experienced military residency applicants may get a significant number of points, putting them miles ahead of you, meaning if that type of applicant wishes to have the same thing you want, you will not get it, unless of course there are enough spots for both of you to get it. Does that make sense?

Anyway, that’s the military match beast, to which I have applied months ago, and in regards to which I have done just about everything in my power to do. I now await the fruits of these efforts to come to fruition on December 7, a significant day indeed. This is the military match day, and on this day I will know if I have gotten my first choice military location or my second choice, which is the broad category of the civilian residency. I wait on baited breath, though I am attempting to take deep breaths. Pearl Harbor day. This is also the day after Andy’s 1st birthday. This is also a Wednesday…which is a less important fact to note. December 7th. Ugh.

In the mean time I am momm’ing, applying and interviewing for civilian residencies, and yes I’m still doing “school” – which currently involves doing my clerkships at various clinics and hospitals within the Dayton area. My most recent mom-event was yesterday, while taking Andy to daycare (which I usually don’t do, because my parents have so graciously taken that responsibility from me), I was loading him up into the car, had him clicked in, was just about to lock him up and proceed with entering the car myself, when I glanced at his cute little face and noticed the rather ominous symmetrical red rash encircling his mouth. It looked to be certainly allergenic – “oh my goodness,” I panicked, “what if he’s going into anaphylactic shock?” But here he was smiling up and down and giving me this look like “whyyyyyyy are you looking at me like that?” In my head I’m like… It’s nothing… it’s SOMETHING!… it’s nothing … IT’S SOMETHING! … I quickly consulted my mom who was also mid-her morning departure to work… and the panic escalated. After the two of us inspected him for a minute or two, the rash not changing and Andy’s bewilderment at our close study of his face increasing, we decided it was most likely going to be ok, and took him to daycare, explaining to his providers that I wanted to know right away if his condition worsened in the slightest, which it didn’t.


red rash around mouth = panic… but everything turned out ok!

But oh that did give me a fright for a moment there. I did some show-and-tell with some people at the Dermatology clinic at which I was rotating when I arrived that morning; I waved around the photo and explained that the rash cropped up immediately after feeding him oats, with a little bit of pear sauce and a douse of cinnamon. That was when one of the medical assistants chimed in, “oh my daughter used to do the same thing whenever I gave her cinnamon.” Maybe it was that… I did accidentally pour more into his oats than I had intended and hadn’t mixed it in very well and it sat on his skin (as his food often does) during most of his breakfast time (about ten minutes I would guess). The dermatologist took a glance, “you can put a little hydrocortisone cream on that.” What I love about working in medicine!

The rash was completely gone when I went to pick him up.

I am currently working on weaning Andy – it has had its ups and downs so far, he still nurses at night and in the morning, occasionally if he wakes in the middle of the night he nurses for c a minute as well. And I’ve managed to go from pumping twice a day, about 4-6 ounces each time to once per day, about 3-4 ounces. So my body has done a good job adjusting. Now I have to adjust my appetite and self-control with foods! I am currently riding 1st class, thanks to my sweet generous hubby who so sneakily purchased these high-end seats for me when I requested him to reserve my flight for me! As such, the stewardess has just offered me a basket of sweets and of course I grabbed the first chocolate thing I saw – a cookie with chocolate and caramel layers inside – nom nom nom! … MUST RESIST EATING THE SECOND HALF!!!!!

Another change my post-partum physiology has brought about, oh so unfortunately, is migraine reinstatement. I was down to 1-2 mild migraines per month while I was pregnant and even for a few months after Andy was born. But in the last 4 months, my migraines have regained their previous status-quo and I am back up to 4-6 per month, with 1-2 of them being quite debilitating. With the weaning of Andy, I may start to consider prophylactic medications for these horrid things… I just hate the idea of being on a medication every day… and the side effects to most of the choices (tricyclic antidepressants, anti-seizure meds, Beta blockers, muscle relaxants) are not so great (constipation, fatigue, concentration issues… yeah not cool). Oh boy. Guess I just need to get pregnant again haha… ha ha… ha.

Not to lament excessively about life and it’s recent downs, I do know that I have lots to be thankful for and I consider my life and its activities of late to have been pretty adventurous and exciting! But let me describe to you both the good and the ugly. June and July were an incredibly stressful couple of months, whereupon I finished 3rd year clerkships going out with a bang on ObGyn, during which time, James left me as he “PCS’d” (changed work locations in the Air Force) to the D.C. area; in addition to the emotional toll of moving out of our quaint little home apartment and away from my hubby, during this ObGyn rotation, I had to work very long hours and felt extremely misplaced and uncomfortable for much of the time. Next, I joined my hubby in the DC area, to study for and complete my board examinations. After this, I elected to do an “AI” or “Acting Intern” rotation at Georgetown University/Providence Hospital, which was almost totally draining after various respiratory, stomach, and breast infections, long hours, and a crazy long daily commute in and out of D.C. traffic. To top it off, James was deployed to the lands far away during the second to last week of this already stressful rotation, having received a very last-minute notification. This caused not only emotional anxiety of his sudden departure, but also induced some crazy scrambling of phone calls and meetings to arrange rather desperately to revamp the child-care and travel plans for the ensuing months.

I recall the palpitations as I packed up my bags as I wrapped up this rotation, fretting there was something I’d forget. I was preparing for the next step in Andy and my journey: an audition rotation at Eglin Air Force Base in Florida.


To the beautiful beaches of Florida! Getting there was fretful. I had a small break-down when I got to check-in and was told that I would have to check my stroller because it was 1.5 lb over the weight limit for carry-on, thus I would have to cart my 23lb baby throughout the airport, into and out of bathrooms, while also juggling my already bursting-full and heavy backpack and duffle bag. The world seemed so cruel at that moment! Things cleared up though, and setting him precariously down on the family-size bathroom floor (though he didn’t like it one bit) and hoisting him through the Starbucks line wasn’t so bad after all (I know, first world problems, right?). Also, my mom so astutely reminded me that I have access to the all wonderful USO, and I took advantage of this during my layover! A young girl in the marines sat with me there and told me about how she ended up with appendicitis during training and was out of commission for quite some time due to the complications following…crazy! Andy just concerned himself with the abundant toys during this time, and before we knew it, it was time to board our flight to Fort Walton Beach, FL!


shopping at the USO

When we finally arrived, several more things when wrong before the end of the day; I about lost it when I was pulled over for going 15 over on the base, but then I was so very graciously forgiven, maybe it was because I eeked out that I was brand new to the base, but probably more likely it was because of the fact that I had a baby screaming bloody murder in the back. And again, I thought I was at the end of my rope when I got to my hotel at 8pm Florida-time/9pm Andy-time and there was no crib and no one to deliver one to the hotel from the office (a ten minute drive away). So then, I summoned help from a friend from Ohio University, who was also on the base since she too was doing an audition rotation, to ask her to pick up a crib from the office for me. She so kindly did so, only to find the crib was broken. So that night Andy slept on the floor and woke up over and over, once, only to be found screaming after having rolled himself under one of the living room chairs. Poor little guy.

However, the next day, after dropping him off with this amazingly nice provider, who also happened to be a wife of one of the Family Medicine Residents, I was greeted by these warm, friendly people; and within a day, I got an offer from one of the residents to come stay with them instead of at the hotel. I couldn’t believe my good fortune! So for the rest of my stay I was at this completely awesome apartment, with a breath-taking view of the gorgeous Choctawhatchee Bay,


hosted by two of the third-year family medicine residents (married, and apparently 17 or so weeks pregnant at the time!) who happened to love to cook (yay!) and also happened to have two rooms complete with diaper genie (a disposal apparatus, if you haven’t heard of this, it will change your mommy life…) diaper-geniand a crib to spare; they also had an adorable son Wesley who was not yet 2 years old. Andy and myself (and my parents, while they came in town to help me watch Andy during the week in which I had to work on the in-patient service) were well cared for by these people, and had such great company!


Family came to visit… and also help with baby-care!

And I got to stay the night with my best friend Sarah – twice! As she lives just over 2 hours away from the base!

The residents and faculty were so extremely kind and friendly, they functioned so well together, and they held beach volleyball gatherings and went to trivia weekly…it was a dream place to work, I wanted so badly to rank Eglin Air Force Base as my # 1 preferred program, but alas in the end, I concluded after much deliberation that the location was a poor family-life choice; it is not worth the risk of James being stuck in the DC area with Andy and me worlds away for a second year in a row. Oy the despair! But it was glorious while it lasted!

Next, we had some more plane-hopping to do… to get to my audition at Fort Belvoir, which is in the Alexandria/D.C. area. Beautiful campus. On this rotation, I found the residents to also be very warm and friendly. It is a tri-service (meaning navy-army-air force) residency, so it opened my eyes to some differences and interesting things about the other branches. I received many visitors while staying here as well, with many retreats back to the Maryland bungalow (James’ now vacant apartment, as he has left for deployment) on the weekends! It was nice to have the visitors once again, and felt warmly welcomed at this base as well, however, there was also an underlying note of extra stress, as I had to simultaneously attempt to work on my civilian residency application/personal statement/letters of recommendation.

For these reasons, I was exceedingly pleased to head home to Dayton at the end of this rotation, thus marking the end of audition-traveling as a single mom. So much can be said for those who manage to care for their children without the help of a spouse or other family. I don’t know if I couldn’t have retained my sanity without the help that I did get on the weekends and during my in-patent weeks during auditions. (THANKS MOM & DAD!!!)

I am also so very thankful to be done with boards, this too was a very stressful event, and I am so glad to have gotten through it. It is amazing how I always look ahead at these events and trials through a very skeptical lens, and yet, somehow, with so much help and support of course, I still manage to get through it all. As I remind myself so often – I know that I can do all things through Him who gives me strength. I just need to be reminded of this over and over.


And with that I will close this insanely long post even though I feel as though I have so much more to share! Best wishes to everyone in the coming Thanksgiving Holiday, my prayers are with you all!