Goodbye to Intern Year

I looked down at my iPhone as it marked mile 6…I know this is where magic happens. It’s when my legs stop hurting, when my lungs stop burning, and I am lost in the soft churn of the sunrise and the sound of the breeze.

I took up distance running during the busiest year of my residency in internal medicine. Something inside me signed up for marathons.

Maybe that something was anger – the day I heard my patient yelling at me after a 16 hour work day “I hate this hospital, and I deserve all your time!” I sat inside the facility room and cried, my dad was hospitalized and I didn’t have time to see him and just be a daughter. My dad deserves all my time.

Maybe it’s exhaustion – Obama care had brought so so many patients who had not seen a doctor in 20yrs, and in my 15min appointment, they have a list of 10 problems, and you just feel so so small and overwhelmed.

Maybe it’s the darkness – for a good 2 months of this past winter, I didn’t see the sun. My work started before the sunrise, and rolled well into the sunset. Living in darkness was isolating.

Maybe it’s the other things – that boy you loved that broke your heart but you walked bravely into another 14 hour work day, and all the friends you lost cause there’s no way they can understand why you can’t attend their wedding, their birthdays, and their worst days.

Maybe it’s grief – that day when you watch a daughter show her dad their childhood videos as he slips away. That day when a wife crawl into bed to hold her husband as he took his last breath. Or the family that finally overcame their resentment of each other, and unite at their parent’s death bed.

Maybe more times than not it’s pure joy – the day you watch someone wake up from a horrific illness, and know they’ll be alright. The day your patient made up a medical problem so they can have an appointment just to say you’re the best doctor they’ve ever had. And every single time you watch your patients leave the hospital safe and sound.

Back in high school, I ran for the races. Now I run for all the things in my life that I win and those that I can not. I run for those magical moments in time when everything feels wonderful and nothing hurts. At mile 6, I know that this run…it’s for me.

Mr.Smartypants, the things you should have known…

“We need to talk…I think it’s unfair for you to sit there and wait for me”

I closed the call room door. The sounds from my pager is fading into the busy background of the hospital.

“I think the traveling has created some distance.”

I continued to listen to the rest of this conversation. Each word he said began to erase the last 4 months we had enjoyed together. the amazing San Jose skyline, the kiss under the stars, the concerts and the dancing, and those little secrets about our childhoods.

 

It took all of me to keep my composure and tell him that it’s okay, I had nothing further to say about him no longer feeling the excitement, and that I must not be the right person after all.

But you see M, I knew better than your words. Because holding in all of my dignity and self-respect, my calm demeanor locked away all of the following that I could’ve said to you. But I didn’t…because you –  in your still 20 year old mentality, boyish naivety of the Silicon Valley engineer bubble culture –  would have been too technical to appreciate what I could have said.

So Dear M,

You didn’t feel the butterflies in your stomach after 4 months, and that’s okay, it’s normal, it’s the extent of how long our brain is capable of producing Dopamine. Honestly, after 15+ dates, I didn’t feel any more butterflies either, and it didn’t matter… because I know, 10 years from now, the things that I would love about you has nothing to do with chemistry, excitement, smart banter, awkward humor, the wine and dine. I know in 10yrs, you would know that we share the same values about family and education and life, that we would be the most amazing of friends, and I am always trustworthy, and eternally loyal to those I cherish.

I know I’m right, because I stand bedside with those dying of terminal illnesses, and it is the friendship, companionship, and steadfast loyalty that preservers through anything and everything…not chemistry, not butterflies.

But you robbed yourself of that chance, whether you were scared, or you were too busy. You told me once how difficult it was to meet the right person in Man Jose. I thought what a tragedy it would be for someone like you to live a life without extraordinary love. But now I know, that the biggest tragedy is in your pursuit of the “girlfriend 2.0″, the “next big thing,” the stimulation and the constant challenge, you would have missed the right person even if she stood in front of you. And for that…I’m sorry.

When there are Plenty of Fishies in the Sea!

My more than amazing girl friend (talented, smart, gorgeous) was crying on Skype over a glass of red wine and some crazy cake dessert after her very recent breakup. Like any good friend would, I assured her that there are plenty of fishies out there. Then about 20 seconds after I said that, I cracked up. Here’s what unfolded for me over the past 365 days with the “plenty of fish” scenario.

Look at the craptacular amount of options!

Look at the craptacular amount of options!

July 2012 (Just Don’t Go There…)

I walked into my bank 30min after my hot yoga (it’s where you do yoga in a 100deg sauna) beaming and glowing and feeling self-adored. It turns out the self confidence thing really does work (?). What was suppose to be a 10min talk to open a new ATM card ended up being a 1.5hr convo with the bank manager over everything from medicine, charity, to life. The guy was amazingly smart & gorgeous (very Ryan Reynolds, actually not kidding). But as we all know, thou shall not date anyone with all your personal security info (i.e. social security, account balance, address…). I turned down the first date a week later.

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August 2012 (How NOT to Court a Chickadee)

I go out dancing at a nightclub with my amazing girl friends and ended up meeting a handsome guy who was celebrating his birthday. Turns out…he’s a murse! (male nurse) That would be the last time I ever give out my personal cell instead of the local Domino’s Pizza number. In the 2 months that followed (since I was studying for boards and “can’t go out” but honestly I was no longer interested), he sent me about 20 poems over my phone and recorded a song that he wrote, sang, rapped, and played on a guitar for me (called “Wonder eyes” and it was good!). I love being pursued, but this was borderline smothering with continual daily texts/calls…songs. If it takes 2 months to turn down a date, the eventual breakup will take a decade…

pufferfish 2

Dec 2012 (the Long Distance Non-Potential)

My friend from college who now goes to medical school out of state drops by for a visit to catch up and “treat me”. We had a super romantic dinner with champagnes, overlooking the most gorgeous sunset, and we are embraced by that warm fuzzy feeling of talking to an awesome, understanding old friend. Above all, he was a man who knows how to treat a girl with dignity and respect. We talk about how we liked each other back in college, and how life took us on different journeys. And…as it turns out, life still takes us to separate, faraway shores.

Jan 2013 (No WORDS…)

I met a confident, young doctor (back in Nov) and who I’ve been texting for about 2 months. With all the interviewing I’ve been doing this year for residency, I never really got a chance to hang out with him. Turns out, no worries, that day came soon enough! He called me at 10pm asking to hang out. Against all my “mature lady” judgments, I let him. He came over, and the next 30min consisted of me deciding if I can call the police to get him out the door. Finally, I won and drove him to his car. “no means no.”

March 2013 (No Chemistry)

I start to explore any romantic possibilities with a guy who is on paper a potentially perfect person for me – highly educated, good person, athletic, and has a passion for life. The added super bonus is that we’re really, really good friends, and I am always 200% myself around him. You know what they say, solid friendships are the foundation of successful relationships! But it turns out, after several outings and amazing conversations, some guys are meant to stay…our very awesome and trusty friends.

l-super-cute-fish

So…telling my crying friend that there are plenty of options was the worst thing I could’ve said. Because you see, there ARE indeed PLENTY of fishies. But that’s what makes this journey in finding love so, so much harder. Because for that one awesome fishie who is simply meant to be, you will inevitably go through 100 not so right fishies…and life is so painfully unpredictable, fleeting, and short. We are not afforded an eternity for searching. My final word to my friend was…knowing the odds against you, do you still believe in love enough to have the patience, courage, and resilience to keep searching? I know I do…and you will too, if you have truly loved and been loved before <3

What Medical School Forgot to Teach Me

My adorable grandparents, who raised me for almost a decade of my life <3

My adorable grandparents, who raised me for almost a decade of my life <3

My 89 yr old grandpa, with a history of type 2 diabetes, very well controlled, spiked a blood sugar in the 500s (normal is in the 100s) on a Monday in February. He was a little more fatigued than usual, and my mom called me for advice. I was concerned about any infections. His primary care doctor ordered 2 doses of insulin that day.

Day 2, he appeared sicker and sugars remained high. I talked to his doctor’s office asking  very nicely for an infectious workup which includes blood work and cultures, chest xray, and urine studies. The nurse on the phone sounded younger than my sister, and did not know what hyperglycemia meant. The doctor ordered only one part of the labs that evening – a blood culture, and told his nursing home there was no need for a chest xray to assess for pneumonia.

Day 3, the results have returned and the nursing home said they were unable to reach the doctor.

Day 4 AM, my grandpa was in septic shock from aspiration pneumonia, and was admitted to the ICU. He never fully regained consciousness.

“Flowers…are a proud assertion that a ray of beauty outvalues all the utilities of the world.” Ralph Waldo Emerson

My mom called me, and I drove home to LA. The doctor’s excuse for 4 days of delay in care was “he’s old…I don’t want to be aggressive.” He offered no apologies. For the first time in my life, I cried because I was furious. I kept thinking of what my neurosurgery chief once told me “one day, you will know that your job as a good doctor is to protect your patients against the morons in the hospital” and his other advice “the worst prognosis is a nice patient with a nice family.”

I spent my time in the ICU since Valentine’s day. He became vent dependent meaning he needed a machine to breathe, he got tuberculosis (when he tested negative all his life), he got a feeding tube and then had a massive stomach bleed, and finally DIC, a condition indicating severe illness. He also assumed decerebrate posturing, indicating possible stroke, a likely complication of his severe shock. In between all these episodes were his doctors telling us to take him off of life support, a conversation they never fail to deliver when they somehow forget to discuss any other test results or procedures conducted.

My grandpa is on comfort care now, meaning there is no more treatments or blood draws. He gets a morphine drip and some IV. He is dying, paralyzed, and semi-conscious due to gross medical negligence. 

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“What’s in a name? That which we call a rose, by any other name would smell as sweet.” Romeo and Juliet

I thought of how much medical school failed to prepare and discuss with me: 

-How our treatment can hurt as much as it can save a life.

-How machines and medications and procedures can prolong not the living, but the dying process. 

-How the consequences of our inaction and negligence, ignorance and fatigue is real. 

-How not to sue another physician, a doctor who’s negligent at the end of his career at 65yrs old, who makes a very humble living as a primary care doctor in a country in gross shortage of primary care physicians. 

-How to act as a family consult with medical knowledge, and objectively decide to terminate treatment for someone I love deeply. 

-How to deal with my mistrust and anger toward members of healthcare when I myself am a physician. 

-How to advocate firmly for the correct course of care when it’s in disagreement with another physician. 

-How important it is to encourage patients and their families to be vocal, and strong advocates irregardless of how stupid it sounds. 

-How important it is for physicians to apologize in times of error, not because of policy or fear of lawsuits, but because the patient and their family deserves it. 

In 2 months, I will become a full time internal medicine doctor. I thought of all the families who have yet to come under my care, and all the things that can go wrong. I didn’t know…4 years ago…when I first began medical school, what tremendous responsibilities this lifetime was going to entail.

Amazing Spring Colors! A Little Adventure in Photography

Now the most stressful time of this year is over, I’m back to marveling at all the beautiful things San Diego has to offer in the Spring. I’ve been here for 3.5yrs and never had the time to really take advantage of all the colors (…and now I will…2 weeks before I move away…) 

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Orange!

Yellow!

Yellow!

Pinkness!

Pinkness!

Color overload!

Color overload!

Violet!

Violet!

No one gets sick of purple!

No one gets sick of purple!

Even more purple!

Even more purple!

Yet more and more violet!

Yet more and more violet!

White with a green background = I SOOOO LOVE!

White with a green background = I SOOOO LOVE!

Being the animal fanatic that I am, you know that no post about Spring is complete without some pictures of adorable animals I’ve found lately enjoying this beautiful season! 

So cute!

Kitty loving the season!

Kitty loving the season!

Match Day 2013: Dreams Do Come True

(Match Day: every year, medical students across the country will open an envelope on 3/15 to find out where they will go for the next 4-10 years of their training in their chosen specialties. The hospital and student preferences/selections are determined by a computer algorithm after 3-4 months of grueling cross the country interviews for desired candidacy.)

***

26 years ago, my mom loved me enough to leave me in China with my amazing and loving grandparents. She came to America alone to pursue an education and a future for me. She wanted to bring me to a place where any of my dreams can have a chance. I came to America 9 years later.

In 7th grade, Mr.Honda had a farm of chickens, rabbits (with countless bunnies), and a classroom iguana. I fell in love with biology the day he made us plant vegetable gardens on the back alley of Paul Revere Middle School. I touched a giant potato bug, screamed and almost threw up (please google potato bug).

At 13, I remember calling 911 and a random lady drove by and stopped to hug me while I panicked in front of my house. Later that night, I stood in the corner and watched some Kaiser critical care doctors save and stabilize my grandma. My prayers for more time with her were answered. I thought it would be “cool” if I became a Kaiser doctor one day.

Trying to stay calm enough to pose for a pic before opening the envelopes!

At 17, I was jumping with my little sister on my bed after opening my UCLA acceptance e-mail, I was going to my dream college.

On my 19th birthday, I listened when Annie told me that my best friend and roomie, Karen, passed away from cardiac arrest, 4 hrs after I told her no one dies from coughing, 8 hrs after watching her laugh over my bday dinner. Her mom came to clean up her room, and I will never forget the face of a mom who had just lost their child. In that place of guilt, and pain, I chose to become a doctor…selfishly hoping I will never be that helpless again.

Gift basket making before the BIG day! So many little champagnes, and candy to wrap!

4yrs ago, I was in Washington DC on my Georgetown interview when I received the call that I was accepted to my dream medical school UCSD.

On 3/15/2013, I opened an envelope on match day that realized a lifetime of little hopes and once impossibly long term dreams. I will be starting my life as an internal medicine resident physician at Kaiser Permanente.

The little envelopes hold our futures…how we managed to wait and look at them for 30min is beyond me :)

Every doctor tells me I will never forget my match day. I thought of my amazing family who gave me the love, and support to pursue dreams that are often so out of anyone’s control, and so distant. My friends whose crazy shenanigans, and advice allowed me to survive the last 4 grueling years with sanity and fun. My incredible teachers who taught me to be passionate and perfectionist with my education.

And lastly, God, for giving me the beautiful and truly wonderfully blessed life that I do not deserve.

A little map of the bay area classmates! Apparently Sun lands in Sunnyvale (totally accidental)

Drop Electric Run into Ur Bucket List

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This is important! Black light don’t make any neon colors glow. In order for ur garment to glow, you need to make sure it has fluorescein materials inside! Otherwise u risk being a lump in the dark.

Since I’ve had some serious posts lately, it’s time to lighten the mood!!

Some of the amazing decorations on the track!

Some of the amazing decorations on the track!

I had the amazing opportunity to do the Electric Run a week ago. It’s basically a 5k run that raises money for your local charities. However, different from most 5k or runs, this event was particularly fun for the runner. The entire track was decorated with black lights and sound systems, underground tunnels, and EDM (techno) music.

Our team was called tutuhot and we all wore tutus :)

Our team was called tutuhot and we all wore tutus :)

I was amazed by how many children and families were in attendance. Overall, it was amazing sharing such a fun night with my awesome friends…and of course 10,000 other runners.

Cutest person in attendance! Very family friendly event!

To register, please go to the electric run website for a city near you :)

Hope you all had an awesome week!

Posing next to a light studded tree :)