Transitions
As evidenced by my lack of posts for several weeks, we’ve been in the midst of two busy months with the end of my emergency medicine residency and starting a new job working in the ER at Hunt Regional and Presbyterian-Kaufman. We do have some final pictures from our last days in Herbertpur and our time in Delhi posted along with this post – just scroll to the bottom to view the slideshow with music or click the pictures to see them individually.
My last month of residency was a bittersweet experience. I have loved my experience at Parkland and the wonderful staff who work in the ER. But I guess after 10 years of school and in training it was finally time to have the cord cut and be out on my own. Transitioning back to work and life in America has been with its challenges. Although we serve a very sick population of patients at Parkland who use the emergency room to get much needed healthcare in comparison to the dire medical need of the places we worked in India, the contrast was striking. We dealt with death on a far more constant basis in India as compared to the US. Here the expectation of most patients is that they come to the ER and they will get better – in India it is often that patients come to the hospital with the expectation that they could well die.
My last month of residency was a month of night shifts, which in some ways made the switch between India to America easier because I essentially stayed on the same schedule. In many ways caring for so many sick patients in India made me feel so much more comfortable taking care of patients at Parkland because I always thought – it could be a lot worse than this! I did find it somewhat amusing that my last night at Parkland was also one of the busiest nights we had had in a while – very similar to my last night on trauma call as a 2nd year resident when I had 5 gun shot victims show up in the ER within one hour. I worked a POD 3 shift my last night (this is the section that works primarily with the trauma team) and we got a call from Biotel (our prehospital EMS system) informing us that that a bunch of motorcycles were racing at around 120 mph and there was a big crash and that three of the people who were critically ill were coming to us. The first one to arrive was the worst, a young man in his 20s, ejected off the motorbike and then landed head first with no helmet.
Humor in the ED & Support Update
It's the beginning of February and we are having a hard time figuring out if we are still living in Texas or Minnesota. We have had almost two weeks of sub-freezing temperatures along with ice and snow which have again reinforced for us why we live here and not a 1000 miles further north! Melissa was quite sick last week and spent 4 days in bed with the flu but she seems to finally have turned the corner. Appachan and Ammachi and Chrisly were gracious enough to watch the kiddos for several of those days so that Melissa could work on regaining her strength.
We are continuing to make progress on our support raising goal although it has slowed the last few weeks. Hopefully many of you got a reminder postcard in the mail to continue praying for us and to consider supporting us financially to make our upcoming trip to India possible. We are almost 60% of the way to our final goal but still need to raise about $5500 to make the trip possible. We trust that God will provide us with the resources to make this trip possible and we are excited that we are now less than 7 weeks away from leaving for India. If you would like to help us with our trip just click the donate button on the top right or send us a check made out to Crossroad Church with "India Medical Mission" in the memo line for a tax deductible donation. Vivek got his visa in the mail today which was one of our last administrative hurtles to make the trip to India and the other kids all got a series of vaccinations a couple weeks ago to make sure they are well prepared for our trip. Thankfully Melissa and I did not need to get new vaccines for this trip which was better than our last trip whenI think we ended up getting over 25 shots between the entire family!
I wanted to write about the lighter side of the ED. People often wonder how people can work day after day in a place as stressful as the emergency room. Although I do meet a lot of people on their bad days, there are always patients or stories that bring a smile to my face or sometimes have me on the floor laughing. I think it is these lighter moments in the ED, the ability to laugh about the little things, the ability to laugh with my coworkers that makes my job fun and keeps me coming back to the emergency department.
Futility
I want to get back to my series of posts on different themes that I see in the emergency department and for this post I want to explore the issue of futility. Also wanted to let you know that we made it to Nebraska on December 31st after driving all night on the 30th and surviving a blown tire at 4:30 in the morning on a highway in rural Kansas. We spent a good hour trying to get ahold of a Triple A contractor to come and help us since it was about 5 degrees outside with sleeting rain - not ideal conditions by any means in trying to change a tire. Thankfully we survived that mishap and only managed to arrive in Nebraska about 4 hours later than expected. We were talking after this past trip about how blessed we have been in all of our travels (which I'm sure now is closed to 200K miles) that this was our first vehicle problem while traveling!
Perseverance
I am often amazed by how strong a person's will to live can be. Of course there are also many patients I have met over the years where I have wondered why they try to claw on to the last bits of their life when they are so ill. Often times that is a decision a family makes to somehow keep their loved one alive when they probably should allow their family member to pass away in peace. I'll focus on the issue of futility in my next post but this week I wanted to share some stories of patients who have truly amazed me by their desire to live even when the odds are stacked against them. I find it difficult to imagine how complex of a medical system many of my patients have to navigate to get care. I also have a hard time understanding the amount of suffering my patients have had to endure just to stay alive.
Courage
What does it mean to be courageous? To me it invokes the stories of soldiers conquering distant lands, fighting for freedom, being self-sacrificial but I think I have been more deeply attuned to this quality as I have interacted with many patients as they deal with some of the most saddening and painful experiences of their lives.
I’ll be honest – most of the patients and the families I have cared for over the years in the hospital are not courageous. I’m not sure I’d be much different if confronted with the reality of death, of a lifetime of suffering, of losing someone dear to me. Most people come to the emergency room unexpectedly – they were not planning on being in the ER. Most of the patients that come in from a trauma or suddenly get sick come in pain, crying, asking for comfort – they are scared. So it is very noticeable to me when I encounter a patient or a family member that faces the problem head on – finding the courage to face their fate.
Medical Mission Trip to North India
First a couple of quick updates. We just attended the Global Health Missions Conference (GHMC) that gathers together every year during the 2nd week of November in Louisville, KY. It was a time of much needed spiritual encouragement and a time to meet with several organizations that we have been considering partnering with in order to facilitate our return back to India. The conference is the largest of its kind in the US with over three thousand medical professionals that have a heart to serve in medical missions here and overseas. The last speaker we heard yesterday, Dr. Carol Spears, was especially encouraging to hear about how God has worked in her life and through her sufferings to call her to a life of mission service in Kenya.
We also wanted to let all of you know that we have set into motion most of the things that need to happen for us to go to India in early 2011 to work at two missions hospitals that are part of the EHA network of hospitals.
The Dog Days of Summer
So the end of July and August has been unbearably hot in Texas. I believe we've had almost two weeks of greater than 100 degree weather! Our plants are wilting and so are our spirits as we try to stay indoors as much as possible. I finally had some time to work on some of the pictures from our big road trip to the west and northwest coast which I've uploaded along with this post. I think I've got a couple hundred more pictures to look through to get to the end of our trip and then I can start taking some new pictures!
Finally an Update
No we have not disappeared to the ends of the earth or gone missing. It has been many months since we updated the blog mainly because of the demands of residency and taking care of three very active children but don't worry we're doing well...maybe I should rephrase that...surviving my second month of all night shifts in the ED.
A quick overview of the last few months:
- Vivek is now 9 months old, we cannot believe how interactive he has become
- Karuna and Luke started their second year of homeschooling and are loving every minute of it
- I finished one month of night shifts in the ER, a month of day shifts in the ER, a month in the ER at Baylor Dallas and am now on a second month of nights at Parkland/Childrens
- Melissa helped to start up a Side by Side chapter in Dallas three weeks ago and they are going through the book Sacred Marriage
- We harvested our crops from the past year incluiding 4 honey dew melons, lots of raspberries (they are still bearing for us) and strawberries, and ate our first pomegranate from our tree
- I traveled to Boston for a week to attend the annual American College of Emergency Medicine conference
- We traveled to Nebraska for a week to visit Melissa's family
An Update Long Time Coming
Clearly we have not done the greatest job keeping the blog updated over the last two months or so. Hopefully I'll be able to remedy part of that this evening. Since our last update, I've finished two more rotations of intern year, Vivek has gotten to 3 months, we made a 4500 mile road trip to North Carolina, Florida & Alabama, made another road trip to San Antonio and have spent lots of time in our garden.
Vivek at Three Weeks!
We have not done a great job of keeping the blog updated but I'm going to claim it's all because of three children under 4 in our home. We are actually doing extremely well and Vivek is growing like a weed. We had written earlier about how Vivek's bilirubin was elevated when we left the hospital but after two more checks at the doctor his levels came back down quickly. He has been sleeping and eating a lot. Just this past week he started being awake a little more often but still sleeps or eats away most of his hours in a day. Of our three kids, it seems that Vivek has slept more than the other two...perhaps he is trying to catchup on lost sleep since he came about three weeks early!
