Day 1

Tengo internet en mi casa! Es muey fabuloso! I can tell my host family and I are going to get along great. Their house is awesome! I have fresh / safe water to drink from a dispenser in the kitchen, a bathroom mostly to myself on the lower level, a fan in my room, and they even have a dog!!!! She is the sweetest thing with big puppy eyes and a loving disposition.

My host mother and her daughter live in the house, and my host mother’s little grand-daughter also visits here. They are Adelina, Elise (ironic!), y Subi.  

I am surprised at how much Spanish I understand, but my speaking skills are pretty crummy. THIS IS GOING TO BE AWESOME! 

I just got back from going out with some of my cohort. It was fun exploring. And now I’m ready for bed!






The Match…All of my hard work, pining, anxiety, anxious carpet pacing, Scrubs watching, sparse sleep and husband-Skyping led up to yesterday. It all culminated in an epic moment of email checking, a flurry of texting, and almost-vomiting in anticipation.

For you non-pharmacy individuals, I am talking about the American Society of Hospital Pharmacy Match. AKA The. Most. Stressful. Thing. Ever. (at this point in my life). Basically we pharmacy kids are really encouraged to do clinical residencies. A residency typically takes place at a hospital (though there are some community and outpatient styles cropping up as well), and you work your butt of for a year and get paid half as much. In essence you learn a TON by going through a bunch of different clinical rotations, do a big research/improvement project, and get exposure to a lot of cool and different stuff. It makes you much more competitive in the job market, and just and all around stud. Sounds amazing right? Problem – there aren’t enough residencies for everyone.

Statistically speaking there are enough positions for about 2/3 of the applicants, which doesn’t sound that bad, and it isn’t really…unless you’re restricted to a certain area or a big metropolitan centers, or are really picky about where you’re applying. For example: many of the Portland-Metro area’s residency programs had ~100 applicants for 4 positions or less. Of the 100 they interview 30. I decided to keep my applications restricted to PDX because it’s where my husband is and where we’d like to be for now. I applied to 5 places. I got full interviews at 2. Within these 2 sites they each had two different residency programs, meaning I was eligible for four spots.

The interview and rank process:

For the big facilities that get lots of applicants interviews are a group affair. I was with a group of 4 – 5 other candidates for my interviews, and while the actual interview process is individually conducted you basically spend the day with others. The interviews are full 8 hour day events where you experience situational, professional, clinical, and behavioral type questions, evaluate and present a patient case, give a presentation, and have a tour/meet everyone that ever worked at the hospital ever. By the end of the interview you are totally exhausted, you go home, you drink a beer, you snuggle your dogs/husband, and you sleep.

Regardless of how awesome you are or how stellar your interview went you still have a couple weeks to dissect what happened and determine how you probably utterly botched your chances with a shoddy answer, etc. While you are busy berating yourself for being an total failure you have to “rank” the places you interviewed at. Basically you tell a computer system that out of all the sites you went to you liked them from best to least in this order. Then all the sites rank all the candidates they interviewed based on who they liked from best to least. If you and the program you interviewed at rank each other in the top spot, bah-dah-bing, bah-dah-boom, YOU MATCH. You have a job next year! Flowers and confetti rain from the ceiling and you get a tiny unicorn for a pet. If not it goes through a process of seeing if you “kind sorta match” and then pairs you. If no one you like ranks you highly odds are you didn’t match…your pet unicorn dies and you wallow in a puddle of chocolate and kleenex.

Here’s the tricky part. As long as your participating in the Match you are contractually bound to work for the organization that you match with. Which means that while you’re waiting for results you can’t job hunt. The Match results aren’t released until March 21st. I was watching Facebook posts crop up from all my friends stating where they were going to be employed next year. Meanwhile that little voice in my head was saying, “You don’t have a job, you probably won’t match, you’ll probably end up living in a box, and probably not even a refrigerator box because those are too nice and expensive for you.”

The tiny voice in my head is a total jerk. In the interest of incorporating more graphics into my blogs here’s a picture of my dogs looking at me and telling me the tiny voice in my head is (in fact) a total d-bag, and that I should listen to them because they think that I’m pretty much the best thing since sliced bread.

Yesterday was March 21st. The Match results were supposed to be released at 12:00 pm EST. At 6 am two of my girlfriends texted me and asked where I’d placed. And I thought – silly girls, the results aren’t even posted yet. To which they both retorted…have you checked?

First thought: they talked to someone else who already got their results. I don’t have an email. FRICK!

I quickly checked my email and saw I had a message from the ASHP site. Heart pounding, palms sweaty, totally expecting the first line to be “We’re sorry. Thanks for playing.”

First actual words of the email? “Congratulations!” I’m pretty sure my mouth dried up so bad at this point that I could have sanded a wooden post with my tongue. I quickly read on to discover I had matched with my top choice. I immediately called my husband (and woke him up) and we had a brief telephonic celebration full of me squealing and jumping around and him groggily congratulating me. The rest of the day was filled with finding out where my friends matched and a fair bit of happiness tinged with some disappointment.

In any case, after months of agony and worry. It’s over.

But wait…I’m doing a residency now. It’s not over. Actually, if I understand correctly…my sleepless nights are just beginning.

Sleepless nights, I think there’s a word for that. Oh, yeah…”Adulthood”.

I’m 3 weeks into my ICU rotation…and I’ve seen quite a bit. I’m also motivated to be healthy more than I ever have been in my whole life. I have found this rotation to be more motivating than fitting into a wedding dress or looking good on the beach. If you need some motivation too here you go.

I’m sorry if I sound preachy but in 3 weeks mostly what I’ve seen are 40, 50, and 60 something people who are obese and have caused most of their health problems themselves. If you live poorly and are admitted to the ICU because of heart disease because you have clogged arteries, fatty liver/cirrhosis because you drink too much (if you’re downing >3 beers a day), you have diabetes because you eat crappy, or you’re just obese and have some underlying disease that you don’t know about here is what will happen to you (or me if I ever get this way):

1. They’ll strip you ass naked when you come in, in front of 10+ other people. 

2. You will stay ass naked for the remainder of your stay. You’ll have a sad excuse for a covering which you’ll probably tear off because you’ll be delirious from your disease/injury/the drugs we give you and because you’ll be examined every 4-6 hours. Plus they’ll strap you to the bed so you can’t pull your tubes out and put giant mittens on your hands. 

3. 15+ more people will see you ass naked every day. Including your family when they come to visit you and other people who are wandering around the ICU to visit their families. The nurses will do their best to protect your modesty, but our #1 goal is to keep your naked ass alive.

4. You will have tubes shoved down every orifice in your body. You will be poked and prodded by a parade of people every couple of hours. And because you have tubes down your mouth you can’t say a damn thing about it. 

5. Doctors, nurses, and yes…pharmacists make mistakes. It will happen. They are common, and it’s unlikely it will ever be caught until it’s too late. It usually won’t kill you, but you’ll be damn uncomfortable or disabled afterwards. And you know what? It’s not the doc’s/nurse’s/pharmacist’s fault. Everyone makes mistakes. There is a big difference between mistakes and negligence. If you don’t want to be vulnerable to our mistakes then don’t come to the hospital. Better yet, how about eat healthy and treat your body right so you don’t NEED a hospital.

6. Hospitals are gross and full of nasty bacteria. If what you came in here with doesn’t kill you, whatever you pick up here might.

7. Doctors are inconsistent. Your treatment will be changed at least 3 times during your stay because doctors don’t agree with each other. It will also make your length of stay longer, more painful, more expensive, and also potentially more deadly.The drugs we give you will make you delirious, and a chain of events will unfold where we don’t know if the problems are caused by what’s wrong with you or what we’re doing to you.  

8. Its. Damn. Expensive. A day in the ICU will probably run you or your insurance close to $10,000. And almost nobody is in the ICU for just a day. If you’re fat and unhealthy and have a heart attack you’ll be here for at least a week, and you’ll probably be owing about $100,000. Does eating healthy still seem too expensive?

9. You’re entire family’s life is put on hold because you’re so ill. In just three weeks I have seen more anxiety and sadness than in my entire life. If it’s hard to find the motivation to eat healthy for yourself do it for your spouse, child, or parent. No one wants to be forced with the difficult decision to take you off life support. Please don’t ask them to do that. 

10. You’re family is clueless as to what you’d want done (in most cases). Most families want heroic measures taken to save their mother/father/brother/sister/spouse, even when it’s hopeless. Which is probably not what you want. It’s costing them a huge chunk of change and prolonging everyone’s suffering. Have a frank conversation with them. An advanced directive isn’t enough because they will fight it. And “brain dead” is not the same as “persistent vegetative state.” If you don’t want to be a potato for weeks, tell your family. It will save suffering for you and your loved ones.

Having said all that please get up start walking/running/being active and eating healthy. It’s in your best interests. Most people don’t just “keel over.” There is a long and arduous stay in the ICU before your trip out…and hopefully we’ll make sure you leave through the front door and not the back. 

I am back in Central Oregon and fall (which officially only lasts about 2 weeks here) is dying. The trees are mostly barren, the temperature is dropping, and the winter sun is shining gloriously more often than not.

I am currently in Barnes & Noble attempting to tackle the overwhelming task of applying to residency programs. I am stoically avoiding the the barista counter where I would order a comforting vanilla steam warm milk (which would be mostly cream and utterly/deliciously fattening – I’m readying my body for hibernation). Unfortunately, I also forgot my headphones so I am listening to a couple 3 tables away from me engage in what appears to be a first/blind date and it is all too amusing, clumsy, and awkward, but in the effort of keeping good karma I’ll refrain from ridiculing them here, as I am sure I have appeared at least half-as-idiotic in public many times before. I doubt they realize that as they share all about themselves to each other they are also sharing this information with the rest of the quiet cafe. Word to the wise – take your first date some place private, noisy, or preferably both… =)

My reward for all this, I am telling myself, will be purchasing the 3rd Harry Potter in paper back and snuggling up with it later tonight (with the steamed milk I will inevitably purchase).

I have read all of the Harry Potter books once if not twice before, and I passed by the Harry Potter product table on my way to the Children’s Section. They had giant books containing photographs from the movies, lego kit, magical recipe books, and wands. WANDS I tell you. The little kid inside me started salivating. I pictured myself getting one of these wands (regardless of the fact they are made of ridiculously cheap plastic) for Christmas and brandishing it around my apartment, pointing it at my helpless husband and crying “STUPEFY”. At which point I would make him pantomime falling lifeless to the floor in an effort to make me feel magically empowered. (He would do this, I assure you, because he loves me. Also, he would confirm the fact that I would cavort cheerfully like a five-year-old with a piece of overpriced plastic corporations have convinced me will give me magical powers).

Additionally, I am so BUMMED that Pottermore isn’t available yet. (If you don’t know what that is, don’t look it up, you will only be more disappointed in me).

Yes, my maturity level is well beyond my years.

In any case, I am CONVINCED my Harry Potter know-how will get me into a residency program. It will give me the competitive edge to make myself distinguished among 100+ applicants for 4 spots. I’m just going to make like Hermoine Granger and study my little brains out and write genius cover letters and wow them at the interviews. However, all the materials I have to gather for my applications are overwhelming. January 1st is looming closer and closer (much like The Grim), and the seeds of panic are starting to sow themselves into my gut. But, typing this is making it better, and I am becoming more resolute in carrying out my plans, and get my application on!

All fun and self-teasing aside. I really do love the Harry Potter books because they seem to carry a strong message of courage, selflessness, and love. Which is something I think the world can always do with more of, and I am not ashamed to love a children’s book that conveys these values so artfully. It is a wonderful escape when one is away from home, family, and facing what seems to insurmountable challenges. Whenever I put down one of the books I feel bolstered, and think that if Harry Potter can fight off hundreds of Dementors, if Hermione Granger can punch Draco Malfoy in the face, and if the ginger Ron Weasley can date a hottie like Hermione, by God I can successfully complete my rotations and rock the hell out of these applications.

What I mean to say is that Harry Potter might actually be the equivalent of mind-chocolate.

Thank you J.K Rowling, you have given me a wonderful gift.

Please plug me in…

Alright. Things are starting to settle down here in central Oregon. I am being blessed with at least mostly sunny days. To the bemused humor of my current co-workers I come into work and state, “The sun is out!” in the same manner one would remark about a flying saucer or Republicans agreeing to increased taxes. To the chagrin of my husband I text him and let him know what beautiful weather I’m enjoying and invariably his response is, “Yeah, well it’s crappy here.” His polite way of saying, Yeah, I know. Shove it.

I am finally getting some sleep so I feel all sorts of energized. I have my charts for my presentation complete (all 20 pages of them), and I’m experimenting with my five-finger shoes (if I was a cool blogger I would insert a link here – but I’m totally not) to see if they solve this arch pain business. Keep your fingers crossed!

I have developed my nasty moose cough for yet another year in a row in response to the abundance of pollen in the area, but thankfully I have left over prescription cough meds from last year when this happened. As a true pharmacist I have diagnosed myself with chronic bronchitis and am doing everything in my power to avoid paying a doctor $200 to say, “Yup, you’ve got bronchitis…again.” I feel like I should get a kickback when I already know the diagnosis, like people that get money from the power companies for installing solar panels on their roofs.

I’ve been wrapping myself up in the solitude here as I am still enjoying it (and not being in a classroom) and decided that since I am unsuccessful at learning one language through Rosetta stone I should at least go for broke and be unsuccessful at three languages. So I spent the last 2 hours dabbling in the languages until I found the ones I wanted. I’m going to continue with my Spanish, start brushing off my ridiculously rusty French, and going for the opposite end of the spectrum – Chinese! So far Chinese is the most fun. So many of its sounds seem like running water to me with its “shhhh’s” and odd intonations. So excited for this epic fail! I wish it was like the Matrix and I could just plug in and say in my best Keanu voic, “I know Mandarin.” And then proceed to whip Laurence Fishburne’s ass in a Chinese pronunciation battle. Take that Morphius.

Maybe I do need to get out more.

In the midst of it all I’m narrowing down where I would like to apply for residencies. Right now all the sites revolve around Nevada, Oregon, and Washington. I have a pipe dream for Hawai’i, but HAH. And California is on the radar too, but I think the sales tax alone will terminate that dream fairly quickly…but a girl can hope. I just hope I get a residency, any residency. Oh, pretty, pretty, please.

Now I want pie.

Count the strokes

I have now been back in the states for 2 weeks and adjusting to my life in Bend.

I have been blessed with a wonderful preceptor, a new car, a great place to live, and beautiful surroundings.

Despite all this I am feeling tired and depleted as I still haven’t really had a day of rest since my return. I’ve been meaning to write a humorous and informative post, but find my energy rather lacking. I’m pretty sure all this is happening because I didn’t get a unicorn in the Amazon – as I am confident that among their many other fantastical qualities, operating as a life-source battery is one of their features. Sort of like a 10 volt plugin adaptor that’s in a car, except for my soul. In fact as I’m writing this my dog is looking up at me with eyes that state, You are pretty much overreacting. Look at me I’m fine. It’s not my fault you didn’t get a unicorn. I’m going to go to sleep now and dream about a day when you actually let me eat my own poop. Pretty sure that would be as good as a unicorn.

I wish I could be satisfied by eating poop.

I want to get my frustration out by running, but I’ve been hit with what I suspect is a case of plantar fascitis (ie tendonitis in my feeties). So no jogging for me for a little while. I’ve been popping ibuprofen like candy and been trying not to think of the words “ulcer” or “GI bleed”.

In the meantime I feel much better after having written this. Thanks for letting me vent out.

Rock on with your bad selves.

PS – I guess I should explain the title. You see when you’ve been rowing for 4 hours in 85˚ humidity you start to attain a Zen-like mindset. I got through it by counting the strokes. Reflecting back on it now I realize I’ve never been more focused in my life. There were no phones, no homework to do, and the scenery was pretty much the same for most of the way. Unlike here where I think we all experience culturally-induced ADHD with TV, ads, city going ons, our phones, and the demon-spawn Facebook (which is to me what poop is to my dog – disgusting, but oh so nummy). So when I started to panic a little today from my giant “To Do” list and scattered life between Bend and Portland I took a deep breath and counted the strokes. 1 to 100, and remembered what it felt like, sounded like, and where my head was at. I feel like eventually I’m going to end up sitting with my paddle on the floor counting softly to myself – but hey, what fun is crazy without wooden oars painted and signed with names like “Team Freaky” on it for props?

Goodbye Iquitos

Ok, so the scholarly part of my rotation is officially over. I have my official graded paperwork back saying I passed (whew!), and we fly out tonight. We will get into Lima around 10 pm or so, and then sleep in the airport until 4 am when we can check in for our flight to Cuzco. I´m a little nervous about the altitude at Cuzco, but I´ve been taking my Diamox like a good girl today.

Yesterday we went to the zoo, it was small and kind of sad compared to the zoos back home, but it was still pretty cool. There were tons of monkies. I had an amazing photo op with an anaconda, and got close to a capybara (the largest rodent in the world. Dr. Broadman also gave her lecture to us regarding her perspective as to why the world is in the global crisis it is in now. It was…interesting. I didnt necessarily agree with what she had to say, but it was still enlightening to hear her point of view.

I’m a little sad I didn’t bring more books to read because I’ve ended up having a bit more downtime than I had originally expected.

So a word on Peruvian idiosincrasies I’ve discovered –

1. They add ¨ita¨on the end of everything here to make it more cutesy.
2. To live here you must now how to whistle loudly without using your hands – as this is the only way to gain your friend’s attention. Chachi has all of us trained to his whistle. I now know how my dog must feel.
3. Mototaxis are the best way to catch a nice breeze
4. Bring your own toilet paper…everywhere
5. ¨Chupa¨is their word for chug
6. Bull Moose is played in every country.

Now- for the unicorn quest. I’m pretty sure the Shamans have them, or the tribal chiefs, but they APPARENTLY don´t speak English – and thus couldn’t assist me in my unicorn quest. Bah! I bet they live in the highlands anyway. I will find one next week as it is Inti Raymi, and unicorns will def be around for the winter solstice here.

P.S. I am super excited to try guinea pig as a main dish. Heellllooo cuey.