Things I'm working on this week: December 3, 2024

 It's December! I'm tuning in to Vlogmas, thinking about filming my own vlogmas, and working on a LOT of projects. 

First up- I'm attempting Jillian Moreno's 100 days of fiber stashdown, and I've moved my Electric Eel Wheel 6 to my living room so that I can spin on it every day. I've so far plied old fiber, started working new fiber, and even found and spun  one of the advent fiber boxes from Sweet Georgia yarns 2022. 

Second- I'm working on a pair of socks for my mother in law, out of Desert Vista Dyeworks yarn

Third- I'm working on a Recalibrate sweater

Fourth- I'm working on a pair of socks for my dad

Sixth- I'm working on an old crochet blanket, which is the right length but not the right width. I'm trying to see if I can cobble some of my scraps to add blocks and widen the blanket faster. 

Planning- I'm hoping to also make socks for my father in law, and my mom, for Christmas, as well. 

I don't know if I will be able to make it, since I want to make 4-5 socks this month, which is going to be a lot for me. But maybe it can happen? Time to get to work! 

September Update

 September has been quite an eventful month. We officially moved to a new house in August and then had to unpack as much as possible with busy schedules and full-time jobs, and P is also completing a Master's degree on the side. My parents visited us in early September, which led to another round of unpacking more boxes. We are getting there, bit by bit but it is hard when we've accumulated so much stuff, and have varying attention spans and energy levels. Which leads me to the next challenge: 

Pregnancy. 

P and I are expecting our first child in January. She is one determined little girl because 2 weeks ago, she decided she wanted to come early. In mid-September. When she is not yet viable for life. Thankfully, the doctors were able to protect the pregnancy, sew in a cerclage, and keep everything intact. Now, I'm on modified bedrest while we figure out the next steps. 

I'm not sure where I am going. Am I just taking the time off on FMLA/medical leave for the next 4 months? Will I be able to have enough benefits stored so that I don't have to be fired for not working or have to leave parental leave early? Will I have enough money to pay my mortgage? 

There is also the concern of will my mind be so undisciplined when I return that I can't go back to working? 

So much going on in my head, and I don't know what the next steps are. 

But knitting has always been there. And I am so thankful for knitting being there, as a distraction, as a creative outlet, as a way to channel my energies and have some semblance of control over things. As a community that I can reach out to, to access, to do Zooms with. The Stockinette Zombies have a twice-weekly zoom, and the Knit Girllls have a once a month zoom, both of which are for Patreon/subscribers. And the mental benefit I've gained from accessing their resources has been invaluable, especially in the last week when I have been feeling particularly down and left out of my friend's wedding activities (We were invited but had decline the invitation due to the pregnancy.), as well as the inability to go anywhere. 

So, I've had the idea to start a knitting podcast, more as a way to help me keep track of my projects, stay accountable, and keep sane in this insane time. 

I want to do a finish-a-long, a stash-down, except that it is mostly projects that I either started or had kitted up, and never go around to doing it. I have several ideas of what I want to do, including a daily vlog, a weekly or monthly accountability check-in, as well as documentation of the several knit-a-longs that I've joined. 

I think it will be good for me. I'm slightly intimidated to put myself out there, both myself as an entity/video as well as literally my face, since I don't want my patients to find my videos and judge me for not being in clinic, and instead cavorting around on the internet making silly knitting videos.  

After much hesitation, I did put out my first video. It is poorly shot, poorly edited, but it is done. I have to think about what I want to do next, and how I can make it better. Certainly, I think I will keep not showing my face, and focus on the content for now. 

WIPS Update May/June 2023

What a whirlwind the last two months have been! But then, these post-pandemic times have been just flying by rather quickly. In May, P and I went to Korea and China, which meant a LOT of knitting/crafting time on the various planes. Before we left, I finally finished his DK scrappy weight vest, which was mainly knitted from Knitted Wit yarns mill ends/scraps, and added in a few Yarn Cafe Creations and Hue Loco Color Riot mini-skeins. 

In June, we had COVID (caught from my parents), and while that meant time at home, I ended up not being able to knit much at all, as COVID-brain meant I couldn't even do a 2x2 rib. For three days, I ended up knitting a row, then realizing the mistakes the next day, laddering down to fix mistakes, and then made more mistakes in the next row. It was miserable. 2x2 rib is something I usually can do in my sleep, practically. I've given lectures while doing 2x2 rib, watched movies, listened to podcasts, held entire conversations, etc. It is the first patterned knitting I ever did. 

Later in June, having recovered from COVID, we meandered to Minnesota, to finally attend the Zombie Knitpocalypse. It was a great deal of fun, and I was glad we finally got to attend, as last year we missed it...because we caught COVID. Somehow, June seems to be the month in which we catch COVID. Probably something to do with letting our guards down and doing more travel. 

I heard that Shana Cohen of Shanalines Designs was supposed to be at ZK, so I tried really hard to finish my Recalibrate, which I had started at SSK last year. I did not finish it at ZK, but I did finish it a few days after we got home, and I am LOVING it. I really want to cast on another one, as I basically don't have to do many measurements at all. It uses up random fingering weight yarn, and uses less than 3 skeins. It may replace the 3-color- cashmere cowl as my go-to for 3 skeins that just go together but I don't know what to do with. 

It will also go great with my long dresses and the skirts that I may be plotting to make. 

Hope everyone is doing well. 

 

Peter finished his scarf! Including putting on tassels.

Working on my Recalibrate- also may have bought fabric in Rochester, and marveling that both yarn and fabrit match the teapot at the Thai food place. 

I finished my self-striping OMG heel socks, out of Woolens and Nosh "I brought you flowers" colorway.

WIPS update April 2023

I've had quite the busy 1st quarter, but I did have some travel time and that means knitting. 

I've started on a vest for my husband using scraps from a Knitted Wit grab bag of DK minis from a few years back, and it is so addicting to knit on! 

I've also been working on some OMG socks in Woolens and Nosh in the colorway "I've brought you Flowers".

My travel knitting to our AAO conference in Colorado was two-at-a-time socks out of a Sweet Georgia Yarns sock blank. 

Hope everyone is doing well! 

-ZT

Gardening Update April 2023

I've really been getting into gardening recently, and as the days are getting warmer, the itch to plant delicious things for my family has grown stronger. I'm trying to use this as a way to document what I've done so far, so that I don't accidentally dig up the potato bed like I did last year...(oops), or halfway through the season, turn to my husband and say "Huh...what is this plant? Did we plant this?!"

Bed #1 has a TON of spring onions. I lopped off the early seed buds and ate them with eggs. The rest I'm letting grow for the many scallion pancakes I'm hoping to cook this spring/summer. 

Bed #2, I planted some arugula, which has just started to sprout. I have been lazy and haven't dug out the plant labels yet, so I stuck some sticks at the head of the row to show these rows were intentional.

I did plant some potatoes, and put some dead grass on top for mulching. 

I also sowed some arugula into a pot (so I could use up a seed packet), which I will likely need to thin soon. 

I planted some garlic, which I sprouted with water. I am hopeful these will do well. 

Thyme from last year overwintered and came back! Most of the other herbs did not make it. The mint did, as well as lavender, though: 

WIPS update- Jan 2023

Hi All! I made an audio recording (with some side commentary) of the post below. Check it out!

Happy New Year, everyone!

It is truly hard to believe it is 2023 already- every time my credit card company sends me an updated credit card, I look at the expiration date and think to myself, "Wow, I wonder what things will be like in that far-off year?" Well, the future is here.

Last month, I had listed my WIPS, partly in frustration of how many I had. Today, I will update what I have accomplished, and share my plans for what I would like to do next.

WIPS from last month:

• Quaere fiber/queen city yarns socks for me (1 sock done, working on sock #2) Still working on these socks, as they got misplaced in my travel backpack between Christmas break and New Years. I did turn the heel on the 2nd sock, and now am working on the cuff.
• Lollipop yarn sock (probably for P, might be for father-in-law or my dad) Finished! I focused a lot of travel time on these socks, and finished them in time for my Dad to wear them on Christmas Day, just in time for Florida to be in the 20's. As in, 27 degrees Fahrenheit on the beach. Good timing, right?
• two-at-a-time sweet george gradient socks from a sock blank (both at the instep, about to get to the heel) I turned the heel yesterday for both socks! I knit about an inch on each, and then turned the heels. Now am working on the cuffs.
• socks for me from souvenir yarn from Buffalo, NY, when P and I visited Niagara Falls in 2021. I devoted some time to working on these socks last weekend when we visited my in-laws for New Years. I finished the first sock, cast on the second sock, and finished the toe increases. This sock is now going to be my car knitting for a while until I can get to the heel.
• Sweater for P (Flax Sweater)- one sleeve down to decreases for the cuff. Finished! I tried working on this on car rides to my in-laws, and it was really hard- the bumpy road kept jerking my neck, resulting in neck spasms. Since I devoted the plane ride to Florida/New Orleans to Dad's socks, I worked on it on the way back from New Orleans/Florida, and completed it December 30th, just in time for P to wear it to my in-laws' house for New Years Day fondue. My father in-law in particular admired the sweater quite a bit.
• Sweater for me, in fingering weight yarn- V neck tee (probably going to try to make this either a cardigan or a long-sleeved top) Not much love on this yet, since I was working on P's sweater. I'm intending on picking it back up soon.
• Sweater for me, in fingering weight/handspun. Update to add that this sweater was designed by Bad Wolf Girl Knits, and is called the Frozen Fractals sweater. I've casted it on, and did 2 rows of ribbing on the neckline so far.
• handspun blanket I did work on this for a few rows, when the socks were not in a place for me to pick and and put down during one night of playing Spiritfarer: Farewell Edition video game with P. It is starting to get heavy, so I need to start using a lapdesk for me to avoid straining my forearms. I did wash and prep an 8 oz bobbin of handspun for the blanket over Christmas break, which is kind of like working on it?

Additional Updates:

I started the enormous task of re-organizing the living room and my crafting room, and while it is still early days yet, one of the more signficant things I did was to move my orange fuzzy dish chair to the crafting room, so that I would have a lounging chair where I could knit or read or just hang out in my little oasis. In order to make room, I cleaned out a black 9-grid, and we move that downstairs to house all of the board games that no longer work for P and our current lifestyle. The rearrangement has already paid off in that while I was sitting in the craft room contemplating what to do next, I started looking at some of the projects on my 9-grid, and decided to frog my worsted weight shawl WIP, which was a mystery knit along with Alana Dakos of Never Not Knitting in either 2017 or 2018. I finished clue 2 or 3, and then just got stuck when life got busy. While I am not against a worsted weight shawl, I have plenty of other shawls and would rather put the time, yarn, and energy into a worsted weight sweater at this time. So I did cast on for a Brick Sweater, which I had been thinking about making for a while, since hearing about it from Dr. Gemma of the Cogknitive Podcast. I'm not sure at this time if the sweater is for me or P (we have the same width in shoulders, but he has a bigger belly and much longer torso.), but we will see as time goes by. If it is a quick knit, I might make the first one for me as an experiment and an additional one for him that fits him better. I also have gorgeous DK weight yarn we picked up at Around the Table Yarns with which I'm thinking about making him a vest. Many Plans!

In all seriousness, I had a pretty hard week at work, (several 13 hour work days), so Saturday I just chilled at home, spent most of the day resting on the recliner, watching YouTube and working on projects. I opted out of playing board games with P and his friends. It was very relaxing, but at the same time, it made me realize for the first time just truly how many WIPS I had. I'm hoping to decrease the numbers for a bit, and focusing my attention on finishing things this year. (Yes, I know, I just cast on for another sweater with plans for 1-2 more, but planning for more intentionally finishing things before starting more.)

Thus, I spent some time and hand-wrote out a list of WIPS that were active, just scattered around my chair, and it was so helpful to see how many projects I already had in place, and made me certainly second guess starting the vest and the Brick at the same time. I had all this startitis energy because I had finished a few things, but this exercise helped remind me to pull back on the reins a little bit, and devote some of my energy to those things I've already started.

I think my theme this year is going to be Intentionality. What about you? With love and respect, Z

WIPS

Quick check-in, as work as been insane. My boss is about to be my underling in less than 10 days. We are all a little stressed around here. P and I are trying for a baby, and we are going to visit the fertility doctor in 2 weeks. Hopefully, she will have more productive things to say than just "exercise, lose weight, and get on Metformin." I feel like the theme of the last few months has been "too much to do and so little time." My craft room is migrating, one skein and one bump of fiber at time, down to the living room, where most of the fiber activities happen. The craft room is where I make my cards, in the occasion that I have to make cards, and where most of the supplies are stored. But I feel like I have so little time with P, my husband, that I would rather craft in the living room, so that we can have a peaceful coexistence, ignoring each other but basking in each other's presence. Of course, this is also Advent season, and all of the boxes are flowing in from various fiber companies, and I am perplexed, as I have already forgotten what I ordered in June. I almost submitted another order for a Sweet Georgia advent, until my subconscious reminded me that I perhaps may have already purchased one. In terms of WIPS (and this is just what I am currently working on): 

 - Quaere fiber/queen city yarns socks for me (1 sock done, working on sock #2)

 - Lollipop yarn sock (probably for P, might be for father-in-law or my dad) - two-at-a-time sweet george gradient socks from a sock blank (both at the instep, about to get to the heel)

 - socks for me from souvenir yarn from Buffalo, NY, when P and I visited Niagara Falls in 2021 

- Sweater for P (Flax Sweater)- one sleeve down to decreases for the cuff. 

- Sweater for me, in fingering weight yarn- V neck tee (probably going to try to make this either a cardigan or a long-sleeved top) 

- Sweater for me, in fingering weight/handspun

 - handspun blanket I have so many WIPS stashed in the yarn room, that I need to start working on them.

 We cleared out a section of the room to move a 9-grid shelf, and I found more WIPS. Oy. I don't want to frog any of them, not yet. I just need to designate more time to knitting, I suppose, or at least be more mindful about what I buy and what I use. Hope everyone is doing well, and having a good start to their holiday season.

Return of the Knitting Mojo!

I've been working on socks here and there and started some sweaters, but all of the sudden this fall, after a certain nuptial event, I started wanted to make all of the things. Partially because I don't have to worry about the Boyfriend Sweater Curse, and partially because now I don't have to do wedding prep/planning anymore! I should get started on thank you notes... Between knitting for DH, replenishing my sock stash after the Unfortunate Great Apartment Flood of 2018, and knitting for my new baby cousin, I've got startitis. So here is the list of what I'm starting/knitting/finishing/working on: Socks for Peter, out of sock yarn that we picked up while we were on vacation in Buffalo, NY/Niagara Falls a Baby Sweater out of White Birth Fiber Arts (Wee Envelope, by Ysolda Teague), for my baby cousin Rex

Socks for me in Beyond the Pines Socks for Peter out of Quaere Fibres, Heirloom Carrots colorway (these were initially meant to be socks for me, but I ended up getting too large of a gauge, and they seem to fit Peter perfectly in the foot so far.)

Socks out of yarn I got for Christmas, in sweet georgia yarn, in a double knit sock blank

I am also starting a sweater for Peter in Fibra Natura LIMA yarn that I've had from Tuesday morning for a long time, and I'm knitting the Tin Can Knits Flax Sweater I also want to work on a couple of patterns for me: the Ripple Bralette and the Shelley Top. I'm trying to get as much done and clear the needles as much as possible, since Jan 1st will be the start of the ZK (Zombie Knitpocalypse) knitalong, and I want to participate as much as I can.

covid diaries 3/27/2020

I'm listening to a recording of the Cleveland Clinic Lerner school of medicine's daily town halls, which have been thoughtful and insightful. As residents, my co-resident were somehow inadvertently added to the call, which I appreciate to some degree. Although most of what they are discussing are medical school matters that do not pertain to me, I wish our GME would do something of the same. It is nice to have someone in charge, in a position of authority speak with confidence and knowledge (they were aware of all the recent drama with early graduations from Columbia, NYU and Einstein College of Medicine).


At some point during the call, they asked for students to record their insights and experiences, and it occurred to me that I have my own platform to be able to do that. This blog has seen my journey through residency training, learning to be a skilled knitter, and now, COVID19.


So, for my own edification and perhaps others, I will return to blogging my experiences again. (I had stopped due to boy drama and just the hectic nature of training.) It does feel good to record my experiences again, and be able to share my personal experience with others. (I suppose this is where legally I state that my experiences and opinions are my own and not reflective of my employers/overlords.)

Yesterday was the first day that I had an actual full schedule of patients. It was a bit hectic, but mostly soul-nourishing to be able to connect with my patients and help them. I still felt a bit limited, since I longed to reach out and be able to actually touch my patients, do OMT to help their pain, and comfort them, but I knew that keeping them safe was the best option at this time.

It felt good to reconnect my identity as a physician and do actual good work. In the last couple of weeks, there were so many things cancelled (board exams, conferences, trips), that it was good finally to have a schedule again, if only for a day.

Later in the day, I had a patient come in (the "essential visits" includes a clause for severe symptoms, and the patient had severe pain). We were able to do an injection for his shoulder, and I was glad we were able to help him. But it certainly made me nervous and anxious that I had to clean myself obsessively afterwards so that I didn't bring anything back with me to my apartment building. After seeing this picture of myself, I put hand sanitizer all around my neck and upper chest before I left for the day. While I don't suspect him to have COVID19, it was still a way to help me feel less exposed and hopefully prevent me from bringing more germs home.

My bosses are asking me if I would be willing to sign up for screening COVID patients or working in the inpatient wards if they need more people. I said yes. I want to help. But I am also terrified. It has been over a year since I've worked the inpatient wards. I don't want to mess anything up. I'm grateful that I've been doing boards studying, which has been helping me to refresh my memory, but I am still mostly an outpatient provider. I don't know how much good I will do, but I am willing to try. This is the life that I signed up for, to make a difference, one patient at a time, using my skills and knowledge. I am scared to catch COVID19. I am scared that I will transmit the disease to my loved ones or those that I don't know. I am scared that I will not be able to take care of patients to the best of my ability, or be a liability to my team. But I know that I can continue. I will do better than the average person on the street. I have been trained, these last 4 years, to do good, to work in many different high stress environments. This is my final exam. This is our collective exam, our graduating class of 2020. We came in epically, a group of fresh, wide-eyed, bushy-tailed interns, ready to tackle the challenges of residency. We bonded over late nights, challenging patients, the pager that  just.won't.stop.ringing, those 4AM calls about normal potassiums and sepsis alerts that were 6 hours old. We supported each other through patient deaths, injust blame, and our own personal lives: marriages, pregnancies, births,  illnesses, family member illnesses and deaths, and so much more. We've learned and grown up together, and transitioned into confident physicians.

I don't know what the future will hold. I don't know what the next day, week, or month may hold. But I know that I am resilient, agile, and strong. That is how I was trained. We'll see what the days ahead shall bring. 



Random Aside Bonus: Paying it Back

November has started, and with it, my month of Pediatric ER at one of the other community hospitals. It is one of the larger hospitals in the system, and one of the only hospitals with a pediatric ER. I was very nervous when I started, because I thought I wouldn't know anything, and be in the staff's way the entire time, but to my surprise, I have learned something in the last year and a half, and I find myself with at least half a clue about the assessment and plan of most patients. Sometimes, it is only one-fourth of a clue. Sometimes, especially on musculoskeletal issues, I know more than the attendings do.

Every shift seems to have a theme, and today's was psych day.  Every child seemed to come in with some sort of psychiatric complaint.  Each of the attendings and PAs had at least one psych case to deal with, and now it was my turn. The patient was in his late teens and had been brought to the ED by his frantic mother because his high school counselor stated that he had suicidal ideations. When I saw the patient initially, he refused to talk. Every question was a one-word answer. Finally, I politely asked his mother to step out of the room, and suddenly, the words started pouring out. His parents wanted him to pursue a field he hated, but they would be the ones paying his tuition. He didn't want to disappoint them, but he couldn't imagine a life stuck in middle management in a white collar job.
His peers at school hated him for being weird. His teachers didn't like him because he didn't pay attention. High school was "a prison" to which he was forced to endure on a daily basis 5 days out of the week. He wanted something more, something different, but there seemed to be no way out.

I saw this patient, and in him, I saw 15-year-old me. I didn't fit in and I had few friends.My low self-esteem was reinforced by the fact that I was almost never invited to outings or gatherings.  I thought that my parents hated me and I hated them. I wanted to escape from parents' goals and aspirations, and I wanted to be a success without their input. High school was one of the most dreaded times of my life. And yet, ten years later, here I was. Face to face with the ghost of Christmas Past.

Today, I was able to tell this boy-man that he will be okay. That this agony will pass, and one day, he will be happy. That high school sucks, but it is better on the other side. I looked him in the eyes, as I wished some adult would have done with me, and told him that he was worthy and that he would eventually be able to become the person he wants to be. It won't be easy, but with enough hard work and determination, he will eventually escape from the darkness and depression and find his way to the light. Find people who will like him for who he is, and be amazed at the talents he brings.

 This patient was one of too many to count today that I saw during this shift, but it may be the one that matters most. The long nights of work and study, the anxiety of exams and practicals were all towards this goal. To reach people who really need it, and offer an hand towards recovery.

This is why I am a doctor.

September: Allergy/Immunology, Adventures in Research, and a Sick Day

Hey guys! This post took a really long time to write and polish, but I felt like it addressed some important issues. Sorry for the delay! October post coming up soon! 


It's late September. I'm at home taking the first sick day I can actually ever remember since middle school, and contemplating life. I've been such a go-getting, get things done person, that even on the days I feel bad, I get up and do the best I can. I don't want to inconvenience other people. I want to make sure I am getting my job done.

But this morning, as I coughed my way through eating breakfast and getting ready for the day, I realized that going to work was a really bad idea. For one, coughing hard enough to make myself dizzy and give myself nosebleeds was a really bad sign. For another, I could barely remember the phone number for our office (which usually I can rattle off the top of my head with no problem), and I just plain felt bad. It was time to stop.

 I felt absolute guilty for calling so last minute and canceling. I imagined my patients already there, waiting for me and not being able to see me. I imagined my poor coworker, having to see all of his patients and all of my patients. It would be insanity.

But I couldn't see straight enough to walk across my living room, much less walk down the stairs, drive to work, walk across the parking lot, into the building, up 5 flights of stairs, and into the madhouse that our clinic usually becomes. I just couldn't.

So, on a perfectly sunny Thursday, 15 minutes before I was supposed to start clinic, already dressed in my work clothes and white coat, I called in sick for the first time in my adult life. It was painful. It was guilt-ridden. It was glorious.

As residents, and especially as health care workers, we are told that our job is essential. We must show up to work every day, and we must do our job well. Do not be late. Do not take unnecessary time off. Do not inconvenience others. These mantras are ingrained into our minds as students, and continue for the rest of our lives. One of the popular medical blogs, KevinMD, has published several articles recounting this particular dilemma. It is inconvenient to our schedules, the patients, the medical staff, and our fellow residents and physicians if we have to call in sick. Many times, there are horror stories of physicians who were ill and were required to work as well as many examples of physicians who work through illnesses , whether their own, or those of their loved ones "by choice" as the alternative would be more inconvenient to their patients and coworkers.

In one of the above articles, the internal medicine physician whose children are ill mentions that the patient she discharged for bronchitis asked for a work note and "a few days off", and the physician was envious. I often thought the same thing when I saw my patients in the clinic, who have guaranteed vacation time, a regular 40 hour work week, and guaranteed sick days. But then again, we as medical professionals did enter into this strange dichotomy somewhat by choice. We wanted to become physicians, to help others with the knowledge and skill that we have attained after sacrificing our youth, energy, and sleep. But we are not always able to take care of ourselves.

After reading the countless horror stories of medical professionals forced to work, I am ever-so-grateful to our changing times and modern GME requirements. I am grateful to the culture of my program and the understanding program directors and GME coordinator, who all supported my decision to stay home, and called me to make sure I was okay. I was able to catch up on well-needed rest (after coughing all day), and was able to return to work the next day, still hoarse, but no longer dizzy.

Adventures in Research

To graduate from residency, I am required to complete two research projects, one of which must be a quality improvement project. As I am in the second year of the four year residency, it was time to start getting my feet wet. Our hospital, and the programs associated, are not known for its medical research culture. In fact, our first day of orientation as interns, we were advised by the grants coordinator (the closest thing we had to a research coordinator), that we were better off  "tagging on to someone else's research" than starting our own, and "just get your name on a paper" so that we could "get it done and over with." It was quite discouraging. As we are a community-based hospital, I knew that we weren't going to be in research mecca, but it would have been nice to have a little bit more guidance. Thank goodness, I am on Allergy/Immunology this month, and the program director there was starting a module-based program to educate osteopathic physicians on medical research. Thus, my afternoons and nights have been filled with watching research videos and taking copious notes, and plotting for research. It has been tedious, and difficult, and my knitting has suffered, but hopefully worth everything in the end.

Allergy and Immunology
Allergy and immunology has been the most interesting month so far. It is such a sub-specialty field that I felt quite out of my depth when I first arrived. All of the patients we were seeing were patients that I had only read about in my textbooks and told that "most likely, you will never see one of these patients in person". But Di-George, Common Variable Immunodeficiency, B-Cell Lymphoma, were patients that the fellows no longer even batted an eyelash at. They were the "run-of-the-mill" patients. It was bizarre. Gradually, though, I learned what they were looking for, and how I could contribute. The physicians were great at diagnosis, but awful at doing osteopathic exams on their patients. Every chance I had, I would treat the patients with OMT, which increased the reimbursement that the physicians could charge for.

<Knitting content>
There isn't much knitting content this month, as I was gearing up towards getting my IRB completed and because I was getting ready for my friend Liz's wedding. I did finish up some baby sweaters in preparation for my friend Laura's twins. I will be carpooling with Laura on the way to New York, so I wanted to give them something.

That's quite a bit more exposition than normal, but hopefully more knitting content next post! Spoiler: I am going to Rhinebeck!

August: Pediatrics, FDM, and knitting!

It's August! I'm officially a second year for a month! Hallelujah!

Really, though, not much has changed. I still rotate every month through different rotations. I still see clinic patients (though now, I see them every 40 minutes instead of every hour, and I 'm in a constant struggle to get faster), and I have to take house call every 6th week.

This month, I was in outpatient pediatrics, with a community provider's office that was recently acquired by the mega-conglomerate. The physicians in the office were mostly transitioned but occasionally struggled with some of the transitions that were now enforced with the new management. It was definitely an interesting process to watch. With my transition away from hospital/residency medicine to outpatient, community-based medicine, it was a bit difficult at first to revert back to a shadowing role. I was no longer the main decision maker in the process, and for much of the rotation, I didn't feel like I even had much of a voice at all. I did not want to anger or embarrass the physician I was rotating with, so I often had to spend more time with my mouth shut and staring at the floor if I did not agree with the physician's conclusions. Most of the time, though, it was fascinating to see how his management different drastically from that of our "in the trenches" comprehensive care we provide to our patients.

The physician's patient population were a mix of white suburban, well-to-do families with money to spare on summer trips (Myrtle Beach, Hilton Head, etc), who were mostly here for well-child exams,  juxtapositioned with young ethnic mothers on Medicaid with new babies in tow for newborn exams. It was boring and fascinatin
g at the same time. I had a good time learning from the first week or so, but the monotony of the same questions (5 fruits and veggies a day? 4 servings of dairy? less than 2 hours of TV?), and the stark contrast to my own patient population ( mostly urban, elderly African Americans) seemed to mock the necessity of this rotation. At the same time, I was fascinated by how the physician I was following maintained his relationship with his patients. Sometimes, he was a father, scolding them for not doing this or that. Sometimes, he was a guidance counselor, gently shepherding the lost sheep towards his goal. Sometimes, he just nodded, disapproval in his eyes, and used his "you are an idiot but I am going to be nice to you" voice in order to avoid conflict. There is so much psychology to be learned in the art of clinical medicine. I may not have learned as much pediatrics as I would have liked during this visit, but I certainly have gained insight into the nuanced skills necessary to gain the respect of patients and keep them coming back.

FDM: Fascial Distortion Model
To some in the osteopathic world, FDM is the epitome of everything they railed against. It uses excessive force to achieve its goal. Its modalities cause patients pain while they are utilized, and patients will be sore, bruised, and limp home with a packet of ice and strict instructions not to use heating pads.At the same time, it is one of the best modalities for treating weird spots that are nagging, painful, and just won't resolve. In spite of my reservations, I attended the weekend course for FDM, and found it to be immensely helpful.

Other life news

I got to go home for a few days at the end of July/early August because my brother was on break. It was so nice to go home, get to eat good Chinese food again, and to see my family!
-> Vegas, as usual, the only place where ringing slot machines are the soundtrack to your arrival

I also visited my friends Marlie and Al in mid-August, and played with their dog and the dog they were petsitting

Knitting content: 

I'm finally finishing up my sweaters! I participated in the sweater knit along hosted by the Grocery Girls, and it was so much fun that I decided I wanted to finish up some of the other sweaters in my queue. I am still working on finishing the button band on my Calligraphy Cardigan, which I am making wider than the pattern calls for because it seemed to be more flattering for my body shape.

I finally finished my Drachenfels shawl, which I bought the yarn for in early November last year when I was in Grand Rapids, Michigan for an audition rotation. Through the last year, it's been a nice reminder of that crazy time, the wonderful people at Michigan Fibre Studio, and the crazy chain-smoking AirBNB that I lived in while I auditioned.

In addition, since I've been at the pediatrician's office, I've been knitting at lunch and during my downtime. It has been helpful to keep me from going crazy with the monotony of the day. I've been knitting on socks as well as on my Bifrost scarf from Infinite Twist

I bought yarn for a Faded shawl, but I haven't decided which one to make yet. Yes, I have also succumbed to the faded trend by Andrea Mowry. It is just so tempting! 

On the plus side, I did discover a really nice restaurant next to the office which offers "express lunch", which means they give you soup, salad, and a sandwich for a set price, brought to the table within 10 minutes of you sitting down, or it is free. It has been so nice to have that resource so that I don't have to resort to the fast food restaurants down the street.

All the ramblings I can think of at the moment. ~Z

It's May!

As I started this month, I thought a lot about countdowns. The countdown to my vacations. The countdown to the end of Intern year. And the countdown to finishing this ridiculously hard and yet, at then end of it, extremely educational stretch of 13 days without break. I know that many of my friends and fellow residents have worked much more than that, and maybe I am making a bigger deal of it than it needs to be, but it is actually spelled out in our duty hours requirements that we should only work 80 hours per week (I worked 83) and that we should be relieved to have mandatory day off every 6 days that we work. But reality and requirements are not often the same thing, and reality was that someone needed to be on call and work night shifts and weekends while my fellow residents took care of babies, attended weddings, worked on their marriages, and attended conferences. I cover for them, just as they will cover for me when I go to China to see my grandmother, and take care of her in the precious time that we have together.

I'm back on internal medicine this month, which means managed insanity. Insane schedules, insane work hours, and insanely noncompliant patients. While I completely understand autonomy for the patient, I am also somewhat perplexed sometimes why patients who refuse all medical care come to the ER and want to be admitted to the hospital. There are cheaper ways of obtaining 3 meals a day and an air conditioned room with crappy television service.

Knitting has been interesting, as I start working on the Fairy Hill Shawl!

I'm excitedly waiting for my beads to arrive. I have the perfect yarn that I bought at Stitches Midwest 2016 last summer, from Dramatic Knits, in their Cherry Blossom Colorway. It screams spring in the most polite manner, and will be elegantly paired with citron colored beads. It will be the perfect thing to work on during the long plane rides, though at the same time, perhaps sleep deprivation is leading me to insanity, as the thought of hundreds of tiny beads scattering throughout a trans-Pacific airliner jet when we hit turbulence sickens me to my stomach.  Stayed tuned!

August/Sept, and Into The Wool Fiber Retreat!

I discovered this in my drafts folder, and felt so embarrassed I hadn't published this! I had meant to! ~ZT

Ya'll, August was a tough month. I was on my surgery rotation, and it was rough. The hours were technically 5:30am-ish to 5:30pm, but that also meant that I was getting up early to round on the patients, and there were more days than not where I stayed until 7 or 8pm to do double rounds with the OMT team. It was by choice, but it was still a bit rough. I felt bad for my OMT preceptor as well, since she also had to stay late to make sure that I got my numbers in. The surgical team typically does not do surgical consults, and so it makes things a bit difficult when my graduation requirements state that I must treat at least 50 surgical patients with OMT over 4 years. Thankfully, since I was on surgery, every patient I treated with OMT was one more that I could count towards that number. Most days, I came home too tired to do much more than cook, eat, and sleep. A few days, I didn't even make it to the bed and fell asleep on the couch.

Of course, Olympic season also did bad things to my sleeping schedule. I love the Olympics. I love the sportsmanship (or lack thereof), the competitions, and the general joy of celebrating athleticism and the power of the human body. As a former media translator who helped cover the Beijing Olympics, I think it is safe to say that I am obsessed with the Olympics. Thus, the fact that I had to get up at 5AM and the fact that most of the interesting events were broadcasted at 9pm primetime did my sleep no favors.  NBC, you are the bane of my existence. I understand you need the numbers of viewership for your commercial sponsors, but still.

Thus, it was with great relief that surgery rotation ended and I was able to look forward to something I've been waiting for a long time: my first knitting retreat!

I was so privileged to attend the Into the Wool Fiber Retreat 2016, hosted by Dana of Unwind Yarn Company and Just One More Row podcast, Wendy/Sillyfru of Sassy Pants Knitter podcast, and Ashley of Twist Fiber Studios. I've been watching Dana and Fru's podcasts for a long time, and I was also a big fan of the Caffeinated Knitting podcast, whose co-host Daniela was one of the former hosts of the ITW retreat. For the past 2 years, as I watched all of the fun and shenanigans reported on the podcasts, I promised myself that if I got through the craziness of medical school alive and found a residency, I would find a way to get to ITW. ZK, SSK, and Rhinebeck are on my list of yarny things to do, but ITW seemed such a special retreat to be able to go to, and it was hosted by some of my favorite podcasters.

Indeed, the retreat was spectacular. I had so much fun, and made so many friends, and I just feel so lucky that I got to be a part of something special. I drove 18 hours roundtrip, but I don't mind it a bit.

The beginning of the retreat was a bit hectic. I arrived just barely in time (at 4:45pm) for check-in, which closed at 5pm, but the Ashley and Fru who checked me in were gracious and so nice. I found my way to my cabin, said a quick hello to my fellow cabinmates and unpacked my stuff, then ran my car back to the parking lot. I couldn't find a single person afterwards, and I panicked a bit as I walked around trying to find the opening ceremony gathering area. Fortunately, I ran into two lovely individuals, Jen of Daizie Knits, and Willow they set me straight. They took me to the gathering area, and I was able to find people to sit with.

The next few days passed in a blur, and I had a wonderful time.

Seasons of Love

You know the song: 525600 minutes...

Now that we have that earworm going in the background. I just wanted to take a moment and think about the fact that I have been a doctor officially for a year. It has been an amazing process, and I am constantly learning more about what I need to learn, but somehow, in the past 6 months, I have stopped feeling embarrassed when people call me doctor. I have learned to proudly step into the role and instead of shrinking back because I don't know something, I step forward and state that though I don't know everything, here is the information that we have and here is the plan going forward.

Somewhere, in the past 3 months, I have learned how to better deal with patients. How to tell them I need to go in the most polite terms, and how to look and them and ask questions to get a better answer and get the answer that I was looking for.

I learned to stand up to nurses, and that even the best nurse does not have the same knowledge base that a doctor does. We learn and approach patients from different standpoints, and while I constantly learn from my nurses, I also learned that sometimes it does take a physician's standpoint and critical thinking skills to say that no, this patient does not require this drug and yes, really, they do need this lab value.

Somewhere in the last month, I learned that present myself with the passion, compassion, and composure of a physician. I stopped thinking of myself as a glorified medical student and started becoming a little less scared that I would be found out as a fraud and be sent back to medical school.

Somewhere in the last 12 hours, the clocked ticked past midnight, and the Seasons passed by, to make me an official 2nd year resident, a "senior".

I have had to excuse myself out of a room to cry after I gave the patient their cancer diagnosis. I have watched as patients I performed CPR on die in front of my eyes. I have intubated patients who appeared in front of me and could not breathe. I have called patients with the good news that they were losing weight, and counseled patients as their HbA1c continued to climb despite their best efforts. I have delivered babies and put their mothers pelvis back together after delivery. I have injected patients' knees and watched as they walked out of the room pain free without a limp. I have performed OMM on patients who swear they had 10/10 chest pain, and watch their face in amazement when their pain resolved.

It has been quite a year. Here is to another great year, and to the incoming interns, good luck. You got this. You can do it.

End of March: Convocation 2017, Sweater and Teaching Dr. K to knit!

March ended so quickly, and it was a much better finish than the start. I learned that I passed my COMLEX 3 boards (medical boards step 3), which meant that I was pretty much done with standardized tests until my licensure examinations in 4th year of residency. I am so relieved to finally be done, as I had visions of failing. And yet, I actually did better in my step 3 than I did in my Step 1, finalizing that my experience is always more than I imagined.

I had such a great time in March, more than I had initially expected for my orthopedics rotation. I learned to read Xrays, and how to vocalize the reads, I learned how to do knee injections quickly and efficiently, and I learned how to be faster in doing clinic encounters. I did not enjoy the 6am start times, but I learned that getting for cases was much better than trying to get up just for clinic. I liked having that little jumpstart to the day, learning about the different cases that orthopedics managed. I peeked into a few OR cases, and renewed my love for the OR, but was happy that I didn't have to scrub in for too many cases. My suturing skills were quite rusty.

I was also happy with the generosity of the orthopedics residents, in allowing me to go to Convocation, the premier and ultimate annual conference for the American Academy of Osteopathy. I had a blast, getting to see my OMM friends and colleagues again.

Now the Knitting content:
I am almost done with my sweater!

I worked on it quite a bit when attending the lectures, and it actually made me pay attention more. I was alert and listening instead of getting bored or frustrated that I could not take down the information fast enough. I listened to what was being presented, and only took notes on the pertinent topics. 

I brought yarn and needles, and accomplished the impossible: I taught my advisor how to knit! She picked it up pretty quickly, in fact, and it was so fun to do that. On the other hand, I also tried to teach my senior resident to knit, and that turned out hilariously bad, as he slipped all the stitches in an attempt to "knit more quickly", however I suspect he was trying to do it badly so that he would get out of further knitting lessons. I took the hint rather quickly, and settled for making him things in the future instead of making him create his own.

 In addition, I spotted some knitters and crocheters in the wild! A spouse of one of the physicians had a baby blanket she was working on, and she stated that she always brought along a blanket to work on "at these types of events".

 In addition, I spotted another physician working on a hat on the first day, so I quickly snapped a picture during lecture. I should have known, as osteopaths are fairly tactile people, but it was good to have proof nevertheless.

 All in all, March was a wonderful month.

Starting March: Orthopedics and Scared Witless

February has whooshed by so quickly, and with it, my month of OMT and Family medicine, as well as boards. February was enjoyable, painful, and hard all at the same time. We found out at the end of January that our residency program was not going to be accepting new residents for next year, and all the sudden my cozy plans of meeting and marrying the NASA scientist, settling in and buying a condo at the end of the year, and flying home to see Grandmother in July went out the window. My future was all the sudden much more uncertain than I had expected it to be. After the tumultuous year of auditions, applications, and interviews, I was thrilled in March 2016 when I matched into a 4 year residency program. I thought I was set for the next 4 years. No more applications or interviews. No more uncertainty of where I was going or where I belonged. I had my residents and advisors and program directors. What was happening to my life?

All of this occurred just a few weeks before my boards. The end of January and the beginning of February became a chaotic and stressful time, trying to ignore the fact that I might not have a residency or future anymore, imagining myself in an empty clinic with no residents or attendings, and yet trying to study and focus on boards at the same time. It was scary, stressful, and saddening. I didn't know from day to day where I was going, what I was doing, or who I was anymore. I was expecting to become one of a new type of physician, and instead found myself one of the last of the breed. I was expecting to be settled, and instead found my foundation to be threatened.

It is now a new month, and I am on Orthopedics. I have a plan going forward, something that will take a bit of work but might just allow me to secure a future. I am scared witless that I will fail, but I am determined to have some success, determined to find myself some kind of future. I am fortunate that I have the backing of my program and GME, but all the work will have to come from me. More on this in later posts.

In knitting news, I have a couple of finished objects. I had quite a bit of scrap yarn let from a few pairs of socks I made at the end of the year, and I combined them to create these fusion socks.

In addition, I finally finished my TGV-Europe Shawl! I started this last summer, casting on the plane from New York to London. I knit on the project while riding the TGV from Paris to Barcelona in May 2016, and had planned to cast off on the way home. I initially had intended this to be a one-skein project, as the designer intended, and I used a gorgeous skein of red yarn from Stash in Corvallis, Hazel Knits fingering. However, in London, my mom and I had gone to a LYS and bought gorgeous 50g skein of creamy merino and a soft skein of midnight blue light fingering yarn that coordinated with my red shawl perfectly, and I decided that I would add both skeins to the project and make a red-white-and-blue shawl that would show both my love for the US and the wonderful time we had in Europe by incorporating the UK yarns.

November: ICU Month and Felfs

November is more than half over, and yet I move as if in a dream. Between the election, the arrival of cold weather, and the long, hard, crazy hours in the ICU, it seems as if a century has passed and yet at the same time flew by in a blur and a blink.

ICU month. How to describe the craziness and yet long monotonous days in the windowless little room where I type my notes? Fear, elation, and sleep deprivation.This month has been filled with long days and nights, learning about the most critical patients and worrying about tenths of decimals that show whether a patient has heart failure, kidney failure, or a heart attack. Patients come and go: some get better, some get worse and are transferred to tertiary facilities, and some end their lives in front of our eyes.

I've learned this month to keep walking, keep monitoring, keep talking to the nurses to make sure everything is going as I ordered. I've learned to run at the first sound trouble and to gird my loins at the sound of the overhead speaker. I've learned to think fast and act confident, to speak to patients in a caring and firm manner, and that the nicest patient have breaking points and the crankiest patients have their soft spots. It's been a contentious and challenging month, and it is with great relief and a little bit of sadness that I move on to the next month: OB.

Knitting
I've done some knitting despite everything, as the fall weather and gorgeous browns, yellows, reds, and orange leaves outside my window enticed me to wrap myself in the season's best hues. I've purchased yarn for mittens and hats, and am waiting for the right time to cast one. In addition, I was in need of some supportive knitting company one day, dropped by the yarn store, and happened upon a felf making class. What are felfs? Little clever slippers designed by Cat Bordi, taught  in simple steps by the ever-clever Bonnie of the Artful Yarn. They are addicting indeed. I've finished one, and am in the process of making another. I suspect I might even make some for ornaments as well. I'd never felted before, and this was another new process for me. It was so much fun to step outside my comfort zone and learn something new, and refreshing to be amongst knitters again, in a light and laughter-filled room with windows that looked out to tree-lined streets, away from the dark, dim hospital hallways full of death and suffering. I haven't quite finished the slippers, but Bonnie's instructions make the assembly process seem like it *shouldn't* be too much trouble. We'll see!

Hope you all are well,
~Z