Happy Halloween 2018!

Considering the amount of grief I give Dear Husband on the regular for his terrible, awful, no good puns, you'd think I would have more class than to choose punny Halloween costumes. Well, you'd be wrong. If I wear a costume in the hospital or clinic, it needs to be work appropriate, and I've decided punny is the way to go. Last year I taped candy Smarties to my slacks and went as a "Smarty Pants." This year my internet search yielded the following gem: bunny ears and a feather duster = "Dust Bunny." I already had the ears, and DH humored me by purchasing a handheld Swiffer. When I asked what he would be, he facetiously answered, "a vacuum cleaner." Ha! Challenge accepted. We stuffed a small pillow in a drawstring backpack like a canister, hooked together some vacuum parts to make a hose, and added the end of an old computer cord for a plug. DH went so far as to look up a YouTube video of vacuum cleaner sounds on his phone to put in his breast pocket as the finishing touch.

The perks of being an Elite Yelp!er include invitations to special events, such as the Ghostly Gallery costume party hosted by the Carnegie Museums of Art and Natural History. The night had an inauspicious start: I came home from clinic early but with enough time to create Dear Husband's costume. We headed out the door and managed to secure parking that was close and free...only to discover that we were 1 hour early...the museum was closed for hosting a separate private event...and I had forgotten to bring my photo ID. So we hopped back in the car and drove home. I had just enough time to finish my clinic notes, but by the time we arrived at the museum again, the free parking was all gone, and there were long lines both to get into the parking lot and into the museum.  

We waited in the COLD for at about 20 minutes before we could even get in the door, have our IDs scanned, receive our wristbands, get checked in, make a donation, and hang up my coat.

Finally, we were free to roam through the museum halls, enjoying DJed music and free samples of food and drink from local vendors. We sampled hard apple cider, savory flatbread, dessert crepes, chocolate milk, pork sliders, banana pepper bruschetta, pumpkin gelato, popcorn, deviled eggs, fancy juices, cookie dough, soda/cocktails, mini danishes, red velvet cupcakes, and the aroma of cooking waffles, because we just couldn't eat anything more.

The people-watching was excellent: an older man dressed as Fred Rogers and his wife wearing a red trolley costume; any number of witches and spiderwebs and an enormous evil Jack'o'lantern; Prince resplendent in purple; foods such as a banana and a hamburger; a school of Finding Nemo clownfish hats; two Grammar Police; several Harry Potter get-ups; Snow White and Prince Charming; an AED; and not one but two jelly fish made from umbrellas with tendrils--one of whom had rope lights and was accompanied by a woman in a light-up starfish onesie. Below is our action pose. We left tired but happy and sated. I hope they invite us next year!

What Residency Looks Like XXXXIIII: Blooming

The Neonatal ICU where I am currently rotating has a large coloring sheet hanging on the wall near the family lounge. When I was on night shifts, I stopped by a few times to add to the picture. The little pink flowers on the light green vine in the center are my handiwork. It's a good metaphor for the growth I've gone through this month. I was really trepidatious about working in the NICU triage area, as our major responsibility is to attend high-risk deliveries and resuscitate newborns in distress. It has been more than 2 years since the last time I rotated through the NICU and more than 1 year since I did my baby CPR training. Further, I had heard from other residents that the days are long, especially the 7a on Saturday to 7am on Sunday shift. Thankfully I have been assigned to work with another resident (except for that pesky 24-hour shift!). My first companion went to my first several deliveries with me, and for the really risky ones, the fellow has been there too. One fellow went out of her way to not only do practice drills with us but also to debrief with us after emergencies--especially the night I had to resuscitate 3 out of 4 infants. Best of all, NICU is a really interdisciplinary area of medicine, so a nurse is always at my side, and a respiratory therapist is only a phone call away. After the next 2 weeks, I will never work with newborns again, but I am glad I had to do this rotation, because it has helped me conquer my fears about unstable patients. Now, in a sort of daisy-chain effect, I am helping another resident get used to the duties, and she will do the same with my replacement.

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WRLL XXXXIII: Grand Rounds vs Mini Rounds

 

Sometimes residency looks like slim pickings after Grand Rounds. They used to serve full-sized bagels at this weekly lecture by a respected researcher. Then they switched to the little ones, which are probably better in terms of daily carb and caloric intake. But maybe it should be called Mini Rounds instead.

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That's So Pittsburgh: Outdoors Edition

About a year ago, Dear Husband and I joined the Western Pennsylvania Conservancy. We wanted to associate with a local organization doing good work in our area and were inspired to give of our time, money, and effort occasionally. In recognition for the couple of tree plantings we've done (here and here), we were invited to volunteer appreciation day. There was lunch of sandwiches and cookies at the WPC headquarters, followed by two nature walks and a drawing for door prizes.

Naturalist Charlie led the first talk, about the island now known as Washington's Landing (slick for neat photos from the Post-Gazette). During the French and Indian War, a young George Washington was traveling back from upstate New York to Virginia and spent the night  with a companion on this island in the Allegheny River. Or maybe it was Wainright's Island closer to the opposite shore, which has since been washed away. Anyhow, what was once a collection of glacier silt carried in the swift waters of the Allegheny has since been used as a cattle stopping ground on the railroad from Chicago and as an industrial complex. It was a brownfield eyesore until the 1990s, when various government and private groups came together to clean it up and turn 1/3 into riverfront housing, 1/3 into a corporate subdivision, and 1/3 into a public park. (Click here to find old aerial photographs from around Pennsylvania.)

We learned that both the river and the greenscape have changed a lot since the 1700s. Both of the rivers around Pittsburgh are now dammed to allow more water traffic, slowing the Allegheny considerably. Washington may have seen trees like the maple and sycamore growing on the banks, but the sweet gum and Chinese sumac (aka tree of heaven) that dominate now are recent additions. In fact, WPC might have to cut down the Chinese sumac, because a few years ago the Chinese spotted lantern fly was found in Pennsylvania. This non-native species is a big nuisance and apparently requires the Chinese sumac for its life cycle. And while emerald ash borer and chestnut blight are other tree diseases that have come into North America, we have exported things like sycamore canker stain to Europe. The vector for that one was taking sycamore back to England and crossing it to make London plane trees, another popular urban tree nowadays.

Arborist Brian told us all about those and other trees. Did you know that the Eastern White Pine was the first symbol on a flag of the American Revolution? That conifer was the rural version of tea taxed by the British, who wanted its tall straight trunks for ship masts. Unfortunately, people used the trees for all sorts of things, including furniture, matches, and roof shingles, without a thought to conservation. By the time Teddy Roosevelt came into national office in the 1900s, they were practically gone from the Eastern Seaboard. You can identify them by their soft needles that grow in groups of five (above). To the right he is standing underneath a redbud tree like the ones DH and I helped plant. They're hoping to make early April a tourist draw to the city to see their pink foliage, not unlike the cherry blossom festival in Washington, D.C. Judas Iscariot is said to have hanged himself from a Middle Eastern variant of the redbud tree, whose flowers turned from white to pink-red because of the blood on his hands.

Washington's Landing is a neat destination. DH and I talked about packing a lunch for a picnic overlooking the river. There's a trail that goes most or all of the way around the island, as well as a marina and a seafood restaurant. Come visit us, and maybe we'll take you over the river and through the woods!


Editor's Note: If you enjoyed this edition of That's So Pittsburgh, you might also like to read about the Pittsburgh Botanic Garden or an eating tour of the Strip District.

What Residency Looks Look XXXXII: Showing (Off) Your Work

Sometimes residency looks like showing (off) your work with a friend and colleague at the local medical education conference. We're trying to bring medical education to social media and invite you to follow Teaching Rounds on Facebook or Tumblr and @MedEdPGH on Twitter.

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What Residency Looks Like XXXXI: Study Time

Sometimes residency looks like participating in a women's health research study. This is the mobile in the exam room. I don't mind putting my body to the uses of the advancement of science, and the extra cash didn't hurt either.




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Retreat! Retreat!

The weekend Dear Husband and I were supposed to travel to Charlotte, NC, for my grandfather's memorial service, until Hurricane Florence invited herself to the party. The service was postponed, and we found ourselves suddenly available to join our United Methodist friends on retreat at Raccoon Creek State Park. This expanse of greenery houses a number of different kinds of campsites hard on the border with Ohio. It was incongruous to listen to the low-flying planes taking off from the airport just a few miles away. DH and I missed the early evening worship, which involved stones inscribed with things people wanted to let go of (below), but we arrived just in time for the campfire, complete with singing, s'mores, and silly round-robin stories about intrepid soap merchants capsizing their Conestoga wagons in the Mississippi River and distrustful heiresses offing each other in space capsules floating on the Atlantic Ocean.

We all stayed up much too late, and some of us--namely moi--did not sleep so well, as someone had tried to fix the sag in the mattress by placing a 2x4 down the middle. Besides being hard, it tilted the mattress, and I constantly felt like I was falling off my half. DH slept okay. We both missed the early morning yoga outside, but there was still first and second breakfast before morning worship and book study. The weather could not have been nicer.

After a late lunch we decided to hike to the Frankfort Mineral Springs (short history; long history). It was reported to be 1 mile each way, but the trail maintenance for the first half was almost nonexistent. At the point we had to clamber through fallen tree trunks, with chest-high flowers and brush beyond them, I and some of the other actually turned back to the cabin to change our shorts into long pants and sandals into closed-toed shoes. While the first half of the trail was low-lying along waterways, the second half that went over a hill was comparatively much easier. At one point we had to cross a narrow wooden bridge, and there were spontaneous cries of "You! Shall! Not! Pass!" and "What is the air-speed velocity off an unladen swallow?" Clearly, these are our people. After a long hour-plus of bushwhacking, we arrived at a grotto with a small waterfall on one side and the spring emerging from the face of the rock on the other. It was hot enough that we all dunked our heads and drank from the fresh water before hiking back to camp. On the way, we stopped to make a tableau among the ruins of the spa that used to profit from the springs (below).

We returned in time for a delicious dinner outdoors before some people packed up and the rest of us had quiet evenings before bedding down early. Breakfast was a delicious smorgasbord, even though we never did figure out what happened to the blueberries. While DH and I are still looking forward to celebrating my grandfather's life with our family, it was a blessing to say "yes" to this unexpected opportunity to commune with our friends in nature.