Wednesday, December 30, 2020

Christmas 2020

Christmas 2020 was unlike any other. It wasn't like the year we were married, when we went on a great American road trip over the winter break. It wasn't like the year we left town on Christmas Day to visit Baltimore, and I had to take a bus back to Pittsburgh 48 hours later in order to work the New Year's shifts. It wasn't like the last two years, when I worked nights over Christmas at the children's hospital (ask me sometime why that was so great!). So what was it like?

Christmas this year was reading The Light of the World: A Beginner's Guide to Advent by Jewish New Testament scholar Amy-Jill Levine with Rosamunda on a quiet Sunday morning. It was our Adult Sunday School book in December. We could debate what "beginners" means, since everyone from the pastors on down learned something new every week, but I'm not complaining. She writes the kind of thoughtful, text- and history-based theological books that you can read and re-read.



I came home from working my first Christmas Eve as an attending to discover that Dear Husband had cooked Montgomery Inn* ribs and Brussels sprouts for dinner, set the table with our good Christmas table linens, AND put on a suit. (*This Cincinnati staple came with Graeter's ice cream from his parents.) The church service on Zoom was very nice and included videos of DH playing the organ for the carols.


Christmas Eve I brought in fresh bagels; and on Christmas Day one of the fellows shared homemade cinnamon rolls. The residency program provided a catered lunch, which I finally enjoyed in "my office," mostly warm, at 2pm, until one of the residents needed me to chaperone a gynecological exam.


Nevertheless, I was able to sneak off in the afternoon to take a walk through the snow in Frick Park with DH while there was still some daylight. It was Pittsburgh's snowiest Christmas on record!

When my 9 straight days of COVID jeopardy and Christmas coverage were over, we finally time to do the baking that was delayed by DH's isolation for not(?)-COVID earlier in the month. We used J.S.'s famous sugar cookie recipe to make reindeer, snowflakes, Christmas trees, candy canes, eighth notes, und unicorns. Most of the 69(!) cookies were packaged up as gifts for the church staff.



Finally, Christmas this year was visiting the 80-foot Duquesne Light Company Christmas tree at the Point. Dear Husband had heard that the state park department had decided to end the 30-year tradition due to concerns about preserving the area and it not fitting into their historical mission, so we figured we had better check it out. Then 9,200 people signed a petition asking them to reconsider, and the last that I heard is they will do something smaller going forward. I can understand why, as everyone who visits has to trek across the muddy grass to get to where the strands of lights and garland are staked into the ground. But it is quite a sight to see from various vantage points along the rivers. After taking some photos, we used a gift card to pick up tacos from täkō to eat for dinner while watching Saturday Night Live sketches.

2020 is practically in the rearview mirror, which means it must be time to write my annual rememberlutions post. Stay tuned...

Saturday, December 26, 2020

I rehabbed my stethoscope!

It was time. My trusty hunter green Littman II stethoscope had seen me through 4 years of medical school and 4 years of residency. (Also 4 years of graduate school, mostly on a shelf.) I bought it from the scrub shop in Champaign with some money from a dear family friend. The sound wasn't as good as the Littman III, but it was pretty good. I had originally planned to treat myself to a pediatric stethoscope when I got to residency, but then I decided the one I had would do well enough. 

In its last year, one of the ear pieces split, so I wrapped it with tape, because you have no idea how painful cracked rubber is when the weight of a metal chest piece is hanging from your ear canals. A friend gave me a replacement ear piece, but that quickly split too. (I don't know whether that was from being thrown in my bookbag or chewed on by a toddler. Oops.)

When I realized the tubing was cracked (below), I decided it was time to replace it. My in-laws gave me the money for Christmas to replace the ear pieces and tubing. Alas, hunter green was no longer available, so I'm sporting a dark blue stethoscope these days. But only after using a utility knife to hack the old tubing off the chest piece--terror, thy name is taking a sharp implement to one's functional if aging stethoscope. Also, I cut myself twice trying to recover the bell. Thankfully, it all fit together at the end. The last two pictures are me trying to auscultate Rosamunda to check the sound. She was suspicious.


Wednesday, December 16, 2020

It's beginning to look a lot like Christmas...


The house is finally decorated for Christmas! We tend to wait until around St. Nicholas' Day (December 6), because Dear Husband likes to keep the tree up until at least Epiphany (January 6).

Again this year we picked out a pre-cut tree from the Trees for Veterans stand in Homewood, where the sales guy makes friendly banter. This time he talked me into accepting a garbage bag full of clippings, some florist's wire, and a large red bow. After we got the tree into its stand upstairs, I made a mess on the kitchen floor fashioning a homemade wreath, to which I added some swag from prior years.

I would show you the handmade vintage Christmas tree skirt to which I treated myself from eBay, but it's stuck somewhere around Columbus. It's red and white with cardinals on it.

Also not pictured: the lights we put up on our porch and that of the abandoned house next door, to make the neighborhood more festive.



Spotted on the mantel next to the grand piano: the pinecone chorister I made in Brownie Girl Scouts.





On the shelf above the shoe caddy: a felt nativity from Palestine, our wedding invitation in stained glass, and steel map cut-outs of Pittsburgh and Baltimore.




On the entertainment center in the dining room: the poinsettia from Third Presbyterian Church, the straw nativity from the Czech Republic, and wedding photos.




In one of the cubbies: the glass nativity S.H. gave me in 8th grade, D. and B.'s wedding photo at the Inner Harbor, and the Kitty Godzilla birthday car DH gave me 2 birthdays ago. When you press the button, it "roars" and rocks back and forth like it's terrorizing the city.


There was a lonely middle section of Advent/Christmas, when DH and I spent 10 days living and sleeping apart after he woke up with COVID symptoms one day. (This was my view from the air mattress in the front room.) We aren't sure whether he got it from Best Buy on Black Friday replacing his laptop or if I brought it home from the clinic, but he tested "negative" and I didn't develop clear symptoms (everyone's a hypochondriac by now, right?).
















Friday, November 27, 2020

Turkey Day, Take 2

The day after Thanksgiving, things were still mostly running as if in holiday mode. Dear Husband picked up individually packed lunches for my team and our sister team, and I smuggled him into the hospital (hey--he's MY support person!) to deliver it. After dropping off the food for the residents, who promptly scattered to different nooks and crannies so they could safely unmask, we went back to my "office" to eat together as a household.

Critic's take: the turkey was thick and moist, there was plenty of good gravy, the mashed potatoes and corn were passable, the sweet potato casserole was SWEET, the creamed spinach was salty, and the gratis cornbread was cold (ick). You can see my homemade orange-flavored cranberry sauce in the corner. It turns out the only reason we've been married for 15 years is that I keep forgetting DH doesn't like cranberry sauce, while it's my favorite part of the meal. Ah well, more for me!

 

Thursday, November 26, 2020

Thanksgiving 2020

 

Since there aren't any meetings or classes today, I'm back in my "office" for the holiday shift. The residency bought Thanksgiving lunch for everyone who had to work today: turkey, mashed potatoes, stuffing (flavored to perfection), green beans that were surprisingly not boiled to within an inch of their lives, gravy, cranberry sauce, and pumpkin pie. I skipped the dinner roll but was glad of the cranberry sauce--so afraid was I that there wouldn't be any that I made my batch early and brought it with me to the hospital! (There's a long story about how I assumed there wouldn't be a potluck this year because of the pandemic, planned to buy my team a hot lunch, and both Boston Markets within driving distance were booked for Thanksgiving. It turned out there would be food on Thursday but not Friday, so we pushed our plans back by a day; Dear Husband will deliver the food to the hospital so we can celebrate together but away from every else. Whew.) 

Today I am grateful for my life and health, for my loving family and amazing friends, for a comfortable place to live, plenty of food to eat, more books than I could ever read, an excellent education, and my dream job right out of training. If we haven't seen each other in a while, please reach out. I want to make time for a Zoom chat, Google Duo, walk in Frick Park, or a plain old-fashioned phone call.


Sunday, November 22, 2020

Step into my office


Welcome to my office! My division currently does not have enough space to house all its faculty, so I have been sharing an office with several of the fellows and two other attendings. However, four of us are now trying to work in there at the same time. Given rising COVID cases and the fact that our employer says the most common source of at-work infections is break rooms and people eating together, as opposed to patient interactions, we do not feel that this setup is particularly safe. (One of the four of us was out earlier in the week for COVID testing, so it's not idle speculation.) Therefore, I have taken up residence in the empty conference room--at least for the weekend, while there are no meetings or teaching going on there. It's a wet morning in Pittsburgh, but this is still one of my favorite views of the city. You can also see the "congratulations on being halfway done with your first week as a hospital attending" card that Dear Husband got me. He's so supportive about the fact that we rarely get to see each other for two weeks. Yesterday was my half-day off, and we spent part of it eating dinner and watching half of Enola Holmes, until an early bedtime for me, except then I did two hours of charting and emailing until I actually fell asleep.


Saturday, November 14, 2020

What Attending Looks Like

I know I said back when I finished residency and shared my last bloopers post this summer that I wouldn't start a new series about attendinghood. However, every once in a while I would like to give you a window into my world.

Despite how incredibly over-busy I was this week, I made time to look up the tracking number for a parcel that the email that showed up in my work in-box claimed was from the American Board of Internal Medicine. I didn't end up reporting it as phishing, but it sure seemed fishy to get an unsolicited shipping announcement with a link. (Instead of clicking on it, I copied the purported tracking number and entered it into the USPS web tracker. It appeared legit.) Lo and behold, on Friday a big flat package arrived in the mail with my certificate in Internal Medicine. (Photo altered from my real name + MD to "Frau Doktor Doctor, MD PhD.")

The other package that arrived at the same time contained three Lyrica "surgical caps" from Etsy. I started my first two weeks as a ward attending in the hospital today, and I wanted to take extra precautions not to bring COVID home with me. In addition to wearing scrubs (which I don't do when I see patients in the clinic), I bought the caps to cover my hair. They say "one size fits most," but I am unfortunately in the minority: if I pull them all the way forward, the front edge reaches my eyebrows! (My child-sized head is the reason I failed all N95 mask fittings until Thursday, when a special set-up showed that there is exactly one model that fits my petite jaw. The nurse running the test told me I should have eaten more ice cream, because the masks fit better with a double chin.) Dear Husband even demonstrated his remarkable attachment to me by walking 4 miles round trip through Homewood Cemetery on an unseasonably warm Sunday afternoon to a locally owned shoe store so I could try on Dansko clogs to wear instead of my usual sneakers. The risk of me bringing COVID home on my shoes is honestly pretty low, but the risk of me bringing home a drug-resistant bacterium is actually pretty high. They didn't have the fancy punched-out leather ones from their website, so I went with a matte black, waterproof pair that were very comfortable for the 12 hours I wore them on my first shift.

I don't work directly with COVID patients, but I might take care of some while their tests are pending. And there are plenty of others with chest pain, back pain, cancer, asthma exacerbations, bloodstream infections, unexplained kidney failure, delirium after a prolonged hospitalization, and everything else I'll see between now and Thanksgiving. Low person on the totem pole again as junior faculty, I am working on Thanksgiving, just like intern year. I suppose it's just as well, because 2020 is not the year to travel across state lines to eat with other people, not matter how much we love and miss them. (I'm also working Christmas.) Please stay safe out there, wear your masks, and distance as much as you can. Yesterday we got a briefing from the Chair of Medicine about new bed spaces being opened up and asking for volunteers to staff them. We're seeing the aftermath of indiscretions on Halloween weekend, but also coworkers, church members, and households not taking as much as care as maybe they could have. Maybe scrubs, caps, and clogs are "hygiene theater" like having your temperature taken when you walk into the hospital building--today I was so cold after my hike from the far parking garage that the automated robot reader couldn't pick up my temperature at all--but maybe the fact that I'm willing to dress like the virus is serious will help someone else take it seriously too.

Saturday, November 7, 2020

St. Mary's Cemetery


On an unseasonably warm fall afternoon, I took a walk through St. Mary Cemetery in the Bloomfield neighborhood of Pittsburgh. It is one of the Catholic cemeteries in Pittsburgh, having been purchased in 1848 after St. Patrick's and St. Paul's Churches' burial grounds filled up. Those bodies were eventually moved to these 44 acres of lawn and gentle hills right next door to the new Children's Hospital of Pittsburgh, which opened in 2008. (The red brick behind this brilliant yellow linden tree is the back wall of the faculty building across the street from the main hospital building.)


The Burke family--father Michael (1847-1910), mother Bridget (184701927), son John (1873-1902), and daughters Mary (1878-1881) and Mary (1887-1888)--are interred on a hillside that appears to be eroding. You can see the garage where I used to park as a resident in the background.

There are grand mausoleums like this one, to the Vilsack family, as well as headstones that have fallen over and sunk into the ground (below left). There were not many Eastern European names that I could find; they were mostly Irish, with some Italian ones noticeable. Some of the Irish markers note the county in Ireland in which the deceased had been born before they emigrated to the United States.

I saw two of these textured crosses (middle), in different parts of the cemetery. More recent gravestones sometimes have portraits, and St. Jude here appears to have a cowlick. Or maybe a tongue of fire.



There's a whole section on a hill for priests, pictured above, with big beautiful headstones. This big one is for the Reverend Charles S. Maguire, born in Ireland in 1768 and immigrated to Pittsburgh to serve as pastor of Old St. Patrick's Church in April 1820. He then founded St. Paul's Church (now Cathedral) in 1829 and served until his death in 1833. In a different, flat section of the cemetery are the graves of the Little Sisters of the Poor. The crosses have mostly (been) broken off the older headstones. The newer deaths are marked on a large granite stone.
I don't have pictures, but I did notice some interesting punctuation: Mary. Elizabeth. The periods marked the sudden ends of their short lives (I believe they were children when they died). Then there was "Our darling May / May Singer died Mar. 31, 1891 in her 12, year." Her parents outlived her by 30 years.



The headstone below had a lot of history on it: In addition to the IHS Christian cross on the top and "U.S.N." in relief, it reads: "Frances P. DeLowry / born Apr. 1, 1893 / enlisted in U.S. Navy Oct. 19, 1910 / killed in battle / at Vera Cruz, Mexico / Apr 22, 1914." Below that must be a brother who not only served but survived two tours of duty: "Richard J. DeLowry / Oct. 26, 1896 / Aug. 10, 1973 / W.W.I Navy--W.W.II Army."



This is clearly still an active cemetery, as you can see by the big new stones above. Sometimes the style or condition of the marker is newer than I would expect from the dates, or there are flowers or other mementoes for someone it is unlikely to still be remembered, such as the marker on the left: "Wife and children / Ellie G. / wife of Michael Sisk. / died March 14, 1881; / aged 23 yrs. & 4 mos. / eternal rest grant her Lord." The Gothic tower on the right is damaged but still interesting.


It was a pleasant walk that didn't afford much aerobic exercise, as I kept getting distracted to investigate the grave markers rather than keep moving to get my heartrate up. Another day I will come back to explore Allegheny Cemetery next door.

Monday, November 2, 2020

Where I'm From

I am from the sandbox next to the lilac bush,

from hot pavement under foot

and cold water from the sprinkler.

I am from the bottle rocket brigade

and an aluminum fishing boat, the red hymnal

and poker only on vacation.

I am from 1066

and raspberry bushes behind the farmhouse.

I am from Andes mints and Uncle Dana's stuffing,

Thin Mints, and peanut butter, and snowballs with marshmallow.

I am from Easter photos in front of the azaleas,

nose in books, and grips, and midnight chess.

I am from Hradovice-Strimelice and Veselé Vánoce

and developed Heimweh in high school.

We play Trivial Pursuit on New Year's Eve.

N'zdar, y'all!


This is a poem I wrote during a class with medical students modeled on George Ella Lyon's poem "Where I'm From."

Thursday, October 22, 2020

The Great American Relay

Thanks to the pandemic, there are no marathons or other running races happening. Then Dear Husband stumbled across the Great American Relay. It is a partnership between the Boston Running Club and the American Association for Cancer Research with 379 stages between Boston and Los Angeles over 36 consecutive days. Because this is a topic that affects DH personally, and because he has missed the chance to do any competitive running this year, he invited our church's new pastor to join him. The legs close to Pittsburgh were already subscribed, so he signed them up for an 8-mile stretch an hour east of here in the Laurel Highlands.

Luckily, I did not have clinical responsibilities on that day, so I drove the two of us out there. It was a beautiful day for a drive sunny. I just wish there had not been a pandemic, so we could have explored the cute little towns of or Ebensburg. As it was, I dropped DH off at the Sheetz, where he met up with the race organizer, Vince, and his running partner. This is the starting line. They set off along the county route, and I drove to the local public library, where I had quiet and free internet to chart review on my patients for the week. I wished I could have visited the local historical society.

On my way to the exchange point, I drove past Ebensburg's war memorial, the namesake of the park in which he would be handing the baton off to the next runner. It was originally planned in 1912, then dedicated in 1915. There are 5,500 names of wartime veterans from Cambria County. A time capsule was buried in 1975, and the park was rededicated in 2011 to veterans in peacetime, too. You can see some pictures here. 

Unfortunately, they made excellent time AND I took a wrong turn getting back, missing the triumphal arrival and baton exchange. Luckily Vince and the guys got some photos; here is a backlit one of them at the parks sign. Unfortunately, DH had wrenched his ankle after stepping into a hole while running on the berm. This made the run less satisfying for him then it might have been, because it kept him off his feet for several weeks afterward. However, he was able to follow the progress of the other relay runners on Facebook.

The last leg ended yesterday with a dip in the Pacific Ocean. We feel sympatico with the final runners, as we visited the Santa Monica Pier in the last week or so before everything shut down for COVID-19. Here are some photos from our spring break trip.

Sunday, October 18, 2020

The Hike to Nowhere

Dear Husband and I wanted to get out of town for a weekend hike to catch the changing foliage. A friend from church recommended the Roaring Run Natural Area, an easy hour's drive east in the Laurel Highlands. We invited one of my colleagues, her spouse, and their dog, for an afternoon in the woods. I plotted a ~6-mile route that would take us across and up the gorge--from which we were promised spectacular views--then along the top and gently down to the streambed for a level walk back to our cars. While the weather could not have been nicer (60 degrees and sunny), the scramble up the slope on leaf-covered tippy rocks in face masks was a little more than we had bargained for. And the "vistas" never materialized--perhaps because the leaves were still on the trees? But we had come for the foliage anyway. (I used a filter on this image, but there really were "Starburst" colors on the trees.) 


DH: How far is it?
Me: We're almost to the top.
DH: Why, can you see snow?

On our first snack break, DH asked me whether I had brought the folding spade with which to bury his body, after he expired from exhaustion. No, I said, I was planning on a natural burial under a layer of loam, leaves, and twigs. In which case, he reminded me to remove his sweater, as the polyester fibers would never break down.


Unfortunately, the train really went off the rails as we tried to change from one trail to the other. Neither the map nor the signs/blazes were particularly clear, and the people we asked for directions were either lost themselves or thought they knew but weren't sure whether the connector we wanted was still being maintained. We finally gave up after walking resolutely east and farther from our cars. At the time we should have been arriving back at the parking lot, tired but happy, we turned around and retraced our steps, including scrambling down the steep slope again. Thankfully, we had all brought snacks and water, worn our hiking shoes, and had good attitudes. The light held out, and everybody got home safely. (Including the 4 ticks we found among us!)


Heard on the trail: a woodpecker and something that snuffles (a Heffalump, maybe?)
Seen on the trail: a chipmunk, a cardinal, a deer, a pair of satin undies, and an Ebenezer

On our way into the woods, we had passed a pile of flat stones that someone, probably a child, had made into a house. "Oh dear, I thought. What if that family drove all the way out here, and then the kid had a melt down and wouldn't walk any farther and was placated by stopping and being allowed to build this before they left?" (We hid a baggie of dog poop near it, so it was an important landmark.) I planned to take a photo of it on the second leg of our journey, but it was gone--or rather, had collapsed or been knocked over. While the dog poop was retrieved, I rebuilt it, our Ebenezer, a sign that we had gone out and come back. It reminded us of the hymn that Baptist minister Robert Robinson (1735–1790) had composed at the tender age of 22.

Come, Thou Fount of every blessing,
Tune my heart to sing Thy grace;
Streams of mercy, never ceasing,
Call for songs of loudest praise.
Teach me some melodious sonnet,
Sung by flaming tongues above.
Praise the mount, I’m fixed upon it,
Mount of Thy redeeming love.

Sorrowing I shall be in spirit,
Till released from flesh and sin,
Yet from what I do inherit,
Here Thy praises I'll begin;
Here I raise my Ebenezer;
Here by Thy great help I’ve come;
And I hope, by Thy good pleasure,
Safely to arrive at home.

Jesus sought me when a stranger,
Wandering from the fold of God;
He, to rescue me from danger,
Interposed His precious blood;
How His kindness yet pursues me
Mortal tongue can never tell,
Clothed in flesh, till death shall loose me
I cannot proclaim it well.



"Ebenezer" comes from the Hebrew ebhen hā-ʽezer, or "stone of help." Robinson used this verse about the Israelites fighting the Philistines:

Samuel took a stone and set it up between Mizpah and Shen and called its name Ebenezer; for he said, “Till now the Lord has helped us.” So the Philistines were subdued and did not again enter the territory of Israel. And the hand of the Lord was against the Philistines all the days of Samuel. ~1 Samuel 7:12–13

While we wandered, no blood sacrifice was necessary to bring us back to the fold. The ticks, too, were vanquished, and the blister I was sure had developed on my right insole never materialized. We are all at least a little sore today, but our spirits remain unconquered. I sent an email to the Park Service asking them to improve their signage, and next time we'll try a less ambitious hike, maybe just going out and back along the creek, which should be roaring in the spring, after the snow melts.