wind blows deeply

Isn't that how it often works. Someone walks into the room, gets your attention and says 'I need to make an announcement.' Then, depending on the person, there is a pause of varying lengths. Sometimes only a second while they take a breath. A few moments while they look down, shuffling their feet back and forth. A few more while they look out at the group, trying to find a friendly face or someone with whom to make eye contact. Then they swallow or clear their throat. Another deep breath. And then it comes; good or bad, joyous or painful, hurtful or healing. Whatever it is, the news comes. Eventually.

Some of you already know this and have known for some time now. There are two things really.

The first is that I got a new, but only temporary, job at work. I am now a Project Coordinator. It's more like a project facilitator -- keeping track of the regional pharmacy department initiatives and keeping them on track, periodically pulling in staff to work on them, ensuring priorities are adhered to and maybe even sitting on committees. I'll still be taking care of the transplant patients I call my own. While it would be hard to give that up, I think this new position will help me become somewhat less attached ... which will be a good thing.

The second thing, perhaps somewhat more exciting, is that I will be returning to The Gambia in February. Unlike previous trips to Africa, this time I will be spending about four months in the country. Part of my role will be to continue working at the hospital; probably doing some teaching and continuing to improve the inventory system. The other part will be to help CVM coordinate the short term teams they will be sending in February and May. As such, I will be the chief hospital liaison -- setting up opportunities for the volunteers. I will also be more involved with their projects and help with follow-up. I probably have most of you on my email update list. However, if you want to make sure, just forward your address.

I will also need to raise approximately $2,500 per month ($10,000 total). If you are interested in partnering with me financially, please let me know and I can give you the specific details.

Of course, I certainly encourage you to pray for me too.

So there it is, after a long pause over the weekend, two, somewhat large, announcements.

I would be remiss if I did not also mention that today we pause to remember those who strive to protect the freedoms held so dearly by our country. It matters not so much if one favours or disfavours war. The sacrifice can be appreciated. There are others, like my grandfathers, who did not fight. While their sacrifice was different, the concept of service was still present for those conscientious objectors.

...we will seek alternatives ways to serve humanity and our countries in the spirit of Christ.

Macleans.ca has a recent article of interest: Don't send doctors: Saving Third World kids by training the doctors already there. Sort of a "teach a man to fish" philosophy.

I suppose this would all be easier if I had a five year plan or some career goals. I sat down last week to create a five year plan. The picture I painted had no references to my career. There was mention of family, relationships, giving, nurturing and enjoying the earth. And of course I knew that these were my priorities.

I am not object to change. A good adventure is something I often welcome. That said, my risks are calculated with a Get out of jail free card in my back pocket. New responsibility is not a risk. Moving is not so much of a risk. Going to Africa is not a risk. Things aren't a risk when things are within God's plan.

So, do I take the risk of leaving something in which I have autonomy, respect, trust and fledgling expertise? Do I try something described as a good career move? Do I even want to make a career move? Do I move even though something in a few months will put it all on hold? Do I say no even though the powers-that-be think I'm a very good fit? Is this my opportunity to be an instrument for change?

From my work inbox today:

I don't mean this to sound bad, but you need a life outside of work. Don't get me wrong we appreciate the little things that you do. Just try to enjoy your days off.

I do check my work email from home. Today it was between watching episodes of The Office (season 4) on DVD. In a few moments, I'll be heading out to a local coffee shop. I was thinking about doing some baking later on. And that's just today ... who knows what I'll get into tomorrow?

Days off during the week are quite different than days off on a weekend: more errands and chores, fewer people to get together with and generally lower key social options. What does one do when the dishes are done, the laundry folded and the blog written on? Is checking work email really that bad?

The most hilarious thing I heard the other day at work...

Clinic will be cancelled next week due to Christmas at the Mosque.

Our physician was trying to explain the annual pilgrimage celebration his mosque holds to his office assistant. She heard "something like Christmas." She in turn, passed along the "Christmas at the Mosque" reason along with the cancellation message. Our office, physician included, all had a good chuckle over that one.

I was told that if you don't have anything nice to say than to say nothing at all. What can I say then? Well, work is not a fun place to be right now. It's stressful. I feel like I'm caught in the middle -- not sure how to balance needs and limitations at the moment.

It means that work can no longer be my life. I will put in my eight or so hours and call things a day. I will take every break and leave on time. I may not volunteer for committees or extra projects.

It means that I will be looking for distractions. I went to see my parents this weekend. I saw a movie. I called old friends. Tonight, I will write Christmas cards and letters (send me your address if you'd like one).

It means that maybe I will actually voice my needs and concerns instead of dealing with everything myself.

Internet pharmacy spammer gets 30 years in jail

Internet users may get a few less emails about cheap drugs filling their junk mailboxes now that Christopher Smith has been sentenced to 30 years in prison. This 27-year-old from Burnsville, Minneapolis, made US$24 million selling illegal prescriptions through his online pharmacy and has been blasting email users with spam promoting his illegal drugs since 2004. He was charged on nine counts, including conspiracy to sell drugs illegally, misbranding drugs and money laundering.
Rosalind Stefanac
pharmacygateway.com, August 8, 2007

Jordon wrote a few thoughts in his review of "Organic Community" (Joe Myers) that caught my attention.

:: For some reason, many men cling to the idea that their pastor needs to be a visionary leader, perhaps to justify their involvement in the church.
:: True community and traditional churches are incompatible. Part of the problem is the idea of a pastoral calling being a career and also the view that church leaders are interchangeable parts that can be swapped in and out for the good of the community.
:: The leader/pastor has been so ingrained in how we see the church and we have spent so much time building him or her up, it is going to take a long time and a lot of discussion for the church to move away from it. Ironically, for the first bit, it may even take a strong leader to have the church to stop thinking in terms of heirarchical leadership and start thinking in terms of community.

The first chapter, Organic Order, he relates the story of a woman who led a conference workshop:

"The fact is, for about 90 percent of the participants, our time together was a process of learning. They came expecting to learn. And almost all of them were excited to share their own techniques, too.
But I was not prepared for the other 10 percent. These people expected me to deliver a ‘checklist/bullet-point/how-to plan’ ... It caught me by surprise, and it distracted me from much of what I’d planned to do."

While Myers' book is about church community, the woman's story caught my attention in relation to an entirely different context. Perhaps I'm allowed to draw a parallel.
I mentor students as part of my job. It always brings a little bit of trepidation though; half are incredibly keen, soaking up anything you pass their way, and the rest are merely putting in their time. Because they are coming to gain real life experience, all hang tightly on to their safe textbook explanations of the way things are. So how do I create an environment in which they can become passionate, motivated, self-directed learners?

Today was busy. And like the Energizer bunny, I've just got to keep going. I'm am finally done with students for a bit. It was great to have them around for a while but also great to have uninterrupted time. After work was dinner and drinks for our departing resident. Then it was off to a wedding shower for another girl at work. It meant that I finally walked through my front door somewhere close to ten this evening. And, I get to work all weekend. (yay) And, I get to be on call tomorrow night. (yay). Hopefully there's time for a cup of Tim's in the morning.

No, this is not a post about the romantic meanderings of me -- or better put, the lack thereof. This is yet another post during which you are free to roll your eyes and give a quick shake of the head. Heck, laugh if you want. But do please at least try to feel my pain.
This morning, I paper cut my right eye. This is an act which takes great talent, grace and coordination. One is required to swoop a sheet of paper past the mid- to upper-third of one's face, close enough to make contact, and fast enough to exceed one's own blink response.
It felt like a shard of glass was embedded just above my iris and it caught on my eyelid every time I moved my eye or blinked. I tried keeping my eye shut. I tried holding my eye open under a stream of water (it was at least 15 seconds). And it's not like you can put a bandaid on it either. And I was at work; I was busy at work. I needed to read the evil stack of paper, decipher the illegible scrawls, assess the appropriateness of each order as it pertained to the patient, arrange for necessary changes and enter said order onto my flickering computer screen.
For THREE very long hours my eye watered, nay, poured forth with tears...which also made my nose run like the dickens. For the sweet love of bob. This is NOT something I would recommend to the masses. Do NOT try this at home. My eye still aches and it's been ten hours.

One of the benefits of working the weekend is having a couple of days off during the week. However, it seems like the last few times this has happened, these days off are not to be truly called my own.
This week is another story. I have slept in. I took care of some mortgage details. I picked up a few groceries (a few more than intended, as I was starting to get hungry). I went to a dessert auction last evening.
Today I made my eleven bean soup. Albeit, there are more than a measly 11 beans in the soup. I through a variety of lentils into the culinary creation (Sally would be proud I think). The soup has been simmering all afternoon, the aroma wafting through the house. So as I took care of a few emails, I realized my "toes were froze" and wandered downstairs and grabbed a bowl of soup. Tastier than Campbell's!
The true cure for cold feet is not a bowl of my delicious soup. I figure I should perhaps put on some socks and curl up under a blanket with my soup and a movie (or a book or some reading for work).

Yesterday evening I was awarded CSHP's New Hospital Practitioner Award. The person who introduced me, Donna (the coordinator of my hospital pharmacy residency), made it quite short and sweet. Essentially, "you can read about her in her modest bio but what you would read is the importance of faith in her practice." Fortunately, my acceptance speech [see continue reading] highlighted that point nicely. Afterwards, one individual commented that it was nice to see that I wore my faith on my sleeve and on the fact that I chose to include faith at all.
Later in the evening, I uncovered a suspected but unwanted fact about an old acquaintance ... in a relationship in which I'd worn my feelings on my sleeve. I affected me to the point where I walked back to my hotel. Thirty odd blocks. In the big city. On slush covered sidewalks. At 10:30 at night. In my boots with the pretty heels. I made it back safe and sound ... albeit my feet were rather sore and my mood not really that improved. Time to let go once again.

Now, just because my mom thinks I'm cool does not automatically mean the contrary. I actually think she brags about me quite a bit to all her work and social friends, but that's another post.

I don't often receive affirmations at work, so when they've come in pouring all week I figure it's worth a blog post. During my residency, a preceptor told me that every day you should look for one thing that went well ... many days that might be that you left on time, actually got to take a bathroom break or maintained professional composure. This week I've had an abundance of good things. Encouragement and praise from my bosses, the folks in the other office, and several patients. It's that patients that matter to me most, for they are the ones I serve. I am to be Christ to them; using the gifts, talents and abilities I have been entrusted with. So I am a pharmacist in a hospital and in a clinic. I advocate for the best for each patient and their family. This week I must have done something in the course of my day to day activities that made a difference. And I am blessed, for I have been used by God.

Here's the deal: This week the Council of the Federation will meet in St. John's July 27-28 with one of the topics to be the National Pharmaceuticals Strategy (NPS).

Want to know more? I've got a little history, a variety of links, and a few of my own opinions of course.

The OECD Health Data 2006 report just came out today. The jist? Fewer physicians, but more nurses, per capita than compared to other OECD countries. (By the way, that is 2.1 physicians per 1000 population.) Life expectancy is 79.9 years. Obesity is at 22.4%. Although based on actual height/weight, the summary failed to define obese. I'm assuming they use the WHO criteria of a BMI>30 (a BMI>25 is overweight ... BMI = weight (kg) divided by the square of height (m)).

What about me and my sort? Well, spending on pharmaceuticals increased by 4% (of total health expenditures) since 10 years ago. Saskatchewan boasts the largest number of pharmacists per capita of all provinces/territories in Canada (per CIHI). We (pharmacists in Canada on average) fall behind physician specialists, family physicians, dentists and optometrists for income. A whole bunch of nifty facts about Canadian pharmacists can also be found in this CIHI report.

Apparently I cannot do anything quite right in the eyes of a certain antagonist at work. Being more than slightly overtired after 6 days in a row at work, including a callback on Monday, I may not be reacting well. I do not want to accept mediocrity in myself - these folks deserve better from me. Yet my attempts at (a) working within the team and (b) trying to improve practice don't appear to be compatible in the present context. I'm finding it difficult to focus on the small positives when the criticism is never ending. (Yes, I once again stepped on toes and received a reprimand of sorts.) Perhaps the criticism cuts so deeply because it simply points at my fear of never being good enough.

Immediately after writing this post, I will tuck myself into bed ... for this hero must again begin saving the world in 7 short hours.

Tonight I was your hero ... (1) I cheered for the Oilers and mourned for Roloson, and (2) while being on call, did some math (the long way) re a medication for a trauma patient and prepared two medications "from scratch" for a wee one. So it is now tomorrow, and I must rest ... needing-no-sleep is not one of my super powers. (I guess that makes playoff hockey fanaticism and basic math without electronic aid some pretty awesome super powers.)

And my other super powers? Hmmm, let's see: I can make you some really quite tasty food, I'm great at listening yet slow in advice giving, superbly capable of going out for coffee, my valid passport enables me to enter foreign countries to visit you, sometimes critical thinking - but sometimes I choose not to use that one, and to close off this list, I think I'm wonderful at liking all of you an awful lot.

What are your super powers?

Two things that caught my attention at work this week:

1. Gender and white coats:
- if you are male and wear a white coat you are a doctor
- if you are female and wear a white coat you are a nurse

I kid you not (this happens quite frequently). Right at the beginning of any 'patient interaction' I'm careful to explain that I'm a pharmacist who works in the hospital. I re-iterate this at the end, in case they have questions they think of later.

So, one particular interaction this week: I spend five or so minutes talking with a family about a patient's allergies and medications at home and changes in hospital etc. Twenty seconds after leaving the room, and still within earshot, a nurse enters the room to talk with the patient and family. What do I overhear? "I was just telling the nurse that was here...."
Please believe me when I say this is not a rare occurrence.

2. Pharmacists have an inherent belief that medications work

I think you'll understand at the end of this analogy.

Say I was going to buy a really, really expensive car. Nothing practical at all. Something simply for the looks and status symbol. So I make my way down to the dealership. I see the car of my dreams sitting off to the side. The dealer approaches, noticing that I have my eye on the car. He starts by saying, "Excellent choice. This car is simply fantastic. It is absolutely everything that you want ... the power, the bling, the sex appeal."
But what he says next catches me off guard. "But you'll have to be careful. Definitely get winter tires -- you can't be too careful with that much power on icy roads. And of course, you'll want to avoid gravel roads. Even a small paint chip can be extremely expensive to repair. Well, you should probably get the oil changed every 1000 km or so -- you wouldn't want to put the engine under too much stress. And don't leave it out in the sun or the rain or under tress or in a public parking garage. The interior is wonderful ... so no eating or taking your cup of coffee along to work in the morning. But you are unequivocally going to love this car."

Nonetheless, you see how this is all going. And as pharmacists, we come to the table knowing that these medications we hand to you are going to work. And perhaps too frequently, we don't work as hard as we should be trying to get you to buy in. At the same time, because we know they work, we want to be diligent in telling you the risks. We are not trying to scare you off -- but I think many times we do. In the world of risk-benefit analysis, you hear a lot about risk and maybe, just maybe, not enough about benefit.

I think I am a hero ... maybe, kinda, sorta. I had folks over for sundays and movies on Friday, and they finally left sometime after 2. They did ask sooner if they should leave, but I insisted they stay. After all, I did have the weekend off. But no, Saturday morning, my dearly needed sleep was interupted with request to come into work to fill in. Seeing as I see myself at the bottom of the list, I realized the situation might be a tad desperate, and wanting to be a team player, I dragged myself in. I am also a hero for agreeing to cover areas in which I normally wouldn't cover. Areas like peds and psych. This does give me the opportunity to learn about things outside my main practice area ... but a little consistency would be nice. Overall, it's still a great place to work and you really should think about coming.

OK, so Caro left a comment and wanted to know about updates. I've been busy with other stuff (ie young adult retreats with 1.5 hours of broomball and then hottubbing, hanging out with my folks who came to visit, getting my trip to Europe all figured out, sleeping), and haven't gotten around to blogging anything lately.
Anyway, excuses aside, I've decided to head off to Regina in July. I'll be closer to most of you who read this, farther from others (but still within a reasonable distance), so you'll have to come visit.

Canada warned the United States on Wednesday that while it has seen no evidence of prescription drug shortages at home, it cannot act as America's "drugstore."

"To me it is a matter of common sense that Canada cannot be the drugstore of the United States. Neither American consumers nor Canadian suppliers should have any illusions otherwise," Health Minister Ujjal Dosanjh said in a speech at Harvard University.

"It is difficult for me to conceive of how a small country like Canada could meet the prescription drug needs of approximately 280 million Americans without putting our own supply at serious risk...
Read more

Not to mention that the Canadian Medical Association and the Canadian Pharmacists Association, as well as many disease advocacy groups, oppose Internet Pharmacy and supplying prescription medications to the US.

When I was little ... well actually right up into university, my parents would take pictures of us kids in our brand new school clothes in front of our house.
That memory floated through my mind as I walked to work today. Albeit, it was the first day of work, not school, but the memory surfaced none the less. When I checked my email this evening, my dad had sent an email from Montrȡl (he's at a conference) wishing my a happy first day at work and mentioned the same "photo-on-the-first-day-of-school" thing. Ah yes, father and daughter think alike.

My first day was uneventful. After listening to my new boss complain for an hour about his job, and how we couldn't get the right computer programs, and being short-staffed, and how busy he was, and general other stressors ... after that hour, I realized I'd just made $40. Then I realized that Mr. Martin just took $20 of that from me. It was an odd few moments as I pondered all of this. Then I came back to reality and listened to the boss drone on and followed him around on a tour (both of which were repeats from my site-visit/interview a few months ago. Oh well, at least I survived.

Then I moved on to learning the new (to me; old in actuality) pharmacy computer system. Not intuitive at all. I'm sure that I have not retained any of what I was 'taught' today ... good thing there's tomorrow.

I promised some details of my camping adventures. Essentially, driving between provinces provided a decent amount of time for deep conversations. One of them went something like this:

Taking one extreme to its completion, treating medical conditions like high blood pressure or diabetes is life-support. While some people have moral/ethical objections to machines that keep people alive, for example in the ICU (respirators to keep you breathing, dialysis machines when your kidneys can't filter out enough crap, and defibrilators and pacemakers to keep your heart ticking), treatment for less acute illness rarely is questioned these days. However, the goal of any medical treatment is either to prolong life or to improve quality of life.

Quality of life is a whole other discussion that didn't take place on a road somewhere in Saskatchewan. It was the intervention into length of life that I wished to talk about. I questioned whether or not it was appropriate for myself, as a health care professional, to be so presumptuous as to play god in this manner. Who am I to esteem a long life? Now an answer was not found under the prairie sky that day, but these are the questions and points that still remain:

(1) Whether God causes illness and/or allows illness, presumably it's all a part of 'the plan'. (Perhaps the presence or lack of "the plan's" existence/necessity is worth a discussion in the future.)
(2) Presumably God could/would intervene at any point and allow or disallow a medical intervention to an individual, according to 'the plan'.
(3) People should use their gifts, talents, abilities and knowledge to do good unto others. (Again, is prolonging life a good thing?)
(4) Is there a line in medical treatment that should not be crossed when it comes to length of life? (How does one treat chronic conditions [heart disease, blood pressure, kidney disease, diabetes, mental illness, thyroid disease etc] vs acute ones [infection, trauma]? Is there (should there be) a difference when it comes to treating the young vs the old? What if a person choose not to treat a chronic condition and now they end up in hospital with a complication? What about life support?)

I don't have answers. I don't know if there should be answers. But an answer would sure be nice.

So I just got the phone call (and the email) about where I'll be working at next year ....
[drum roll]
It's the Grace General Hospital, aka hospital #3. A larger community hospital (thus, no medical residents/students) located somwhat on the west side of town.
I did not get to go to St Boniface hospital. I haven't been able to get ahold of the resident I think will have gotten that position (she had been trained to do work shifts there).
There was also a little confusion, because I had initially been placed at the hospital where I currently do my work shifts (the Health Science Centre), but I got a call from the health region's pharmacy director who said he realized he'd made an error just after sending out the email announcements. He mentioned that Health Sciences had ranked me quite highly (of course, I thought, I do my work shifts there), as had the Grace and also St. Boniface. But I had put restrictions on Health Sciences (i.e. not ICU because I don't think I can handle the shift work ... 12 hour days and 12 hour nights). And had I actually been placed at Health Sciences, they likely would have placed me in the ICU.
Although I didn't get my first choice, I do think the Grace will a great place to work. The staff are all quite young, they seem to have a good clinical program up and running, and there are also lots of new plans in the works.
But I think I will also have to move - more like I want to move. I'm down in the south end of town so it'd be much better to be a tad closer to work. So I'll be apartment hunting once again.

PS - It's Kimmer's bday tomorrow. If you see her, give her a great big hug or send her flowers or take her out for coffee. Hope you have a wonderful day Kimmer!!! :)

So I now have to decide my preference for work next year. (I've agreed to stay in Windy-peg for another 12 months.)
My current choices are:
1) Major teaching hospital
2) Smaller (in comparison to #1) teaching hospital, awesome staff
3) Medium sized community hospital (much smaller than #2), great staff,
4) Small sized community hospital

Pros / Cons
*teaching hospitals: you get to work with med students and residents, lots of teaching and educational opportunities, opportunities for specialization
*community hospitals: smaller staff, no residents (i.e. a bit less fixing of common mistakes/omissions), a bit more freedom to do things (less beaurocracy), less technology / access to information

Order of current preference:
#1 = (2)
#2 & #3 = (3) & (1) (not sure on the order)
#4 = (4)

Although, sometimes I think (2) isn't really #1 preference.

Hmmm, decisions like this are tough. Confounding everything is, despite our preferences, they are going to put us where they want us anyway. From what I gather, the other two residents don't want to go to (3) or (4). The higher ups have said that at least one of the residents will be going to either (3) or (4). That leaves me. So if I put (3) as preference #2, I'm likely going to go there (although, I do see a lot of good things going on there). But if I put it as preference #3 who knows. One of the residents really really would like to go to (2), as would I--thus, some competition. The third resident is A-OK with going to (1), which I'm a bit hesitant to do.

My brain is going crazy trying to figure out what to do and what I think other people are going to do. And truth be told, I really don't know where I want to go. But my preferences need to be in ASAP.

Right now my life seems like that board game "Careers" ... I'm trying to figure out my magic formula of fame, fortune and happiness. The Winnipeg folks have upped the stakes a bit - and have done a pretty good job of meeting the fortune and potential for fame aspects. But the tough part is to figure out what my happiness requirement is ... or rather, what weight I place on fame and fortune. I do need to figure this all out soon though.

OK, here it comes. Another 'jenn is feeling crappy about her life' blogs.
Before I start, I should mention I'm thankful for a few God interventions this week:
1) I was taking the elevator at work one day this week (up to the 7th floor where the ICU is) - all alone in the elevator - when a man got on at the 2nd floor. As he selected his floor, he noticed my 7th floor selection, and probably glancing at my white lab coat, he asked if I worked on the 7th floor. I said yes, and he responded by saying something like 'it takes a lot of heart to work up there'.
2) Another day this week, the -70 degree freezer in which I was storing 300+ samples for my major research project for this residency began alarming. I was a tad stressed with other things, so it was a panicky hour while I searched the hospital for another department with freezer space I could beg/borrow. It turned out our freezer was fine. The samples are ok. I could have used a few more deep breaths.
Now on to the 'jenn is feeling crappy about her life' bit ...
1) I am disconnected from life around me. I attend all sorts of things, but it's only for an hour or two here and there. Don't get me wrong - I am really thankful for my acquaintances. But that's all they are ... I'm not sure that I can strech any of them into the friend category just yet.
2) Related to the above, I need to figure out the rest of my life pretty soon. I have the opportunity to sign a contract to stay with the Winnipeg health AUTHORity for a year once I'm done - which means extra money. I am not sure if I want to stay here or go back to SK (or somewhere inbetweeen). Then there's also that missions stuff I had postponed for this year.

That's pretty much it. I've really been trying to look for God in the everyday stuff. If I see Him in the small stuff, it might be easier for me to see Him in the big stuff too. *sigh* I just thought it would get easier at some point.

I finished my rotation in internal medicine. I said good bye to the med students and residents. I had a good lunch. I did the end of rotation evaluation with my preceptor. He said I was smart. That's probably what I'll remember from that conversation for a long time. I don't know why it mattered so much, but it did.
I went home. I didn't get home though. I got halfway home when I realized I had forgotten to put a dose recommendation in a patient's chart. I'd even told the attending physician I would get back to him on it. So I hopped a few buses (in a rather creative manner) and found my way back to the hospital. I wrote the note. I said goodnight to the nurses. I began home -- again.
I got home and made an amazing beef stirfry. I ate half of it. The recipe will be at the end. I then continued working on an afghan. I'm making afghans for the other two pharmacy residents. I'm about 1/6 done one of them right now.
For supper today I had grilled cheese and Campbell's tomato-vegetable soup. Mmmmm, sodium. Probably some trans fats too. Somehow I'm not dead yet.
Only 41 days and I'm coming home.

1) Mix sauce (up to onions) - add beef - marinate (if you don't have time to marinate - don't worry about it)
2) Cook in wok/frying pan until beef is cooked.
3) Add vegetables. Add cruchier ones (e.g. carrots) first, and softer ones (e.g. mushrooms) last.
4) Eat.

Hmmm, so my boss tells me to go home at Thanksgiving. So I figure, hey why not check plane tickets. So I go online and lo and behold the lowest plane tickets I've ever seen.
So folks, I'm coming home. (Oct 10-13) See you then.

I got to see a bone marrow biopsy today. And I totally blacked-out about 2/3 through it. I saw the needle go in. I saw them take 2 samples. Then I realized that my breathing was getting a bit shallow. No dizziness. No tingling on the neck. No wooziness. So I backed up to a wall and was in the process of sliding down to a squat when I completely black out. And coming to is really disorienting. For a few seconds, I couldn't remember where I was, or what time it was, or if it was all just a dream.
Later, my supervisor/boss said: I think you are emotionally drained, I'm really worried about you. It felt like it came out of no where.

I'm right in the middle of 3 weeks on the bone marrow transplant / leukemia ward. It's really quite interesting interacting with patients living with cancer. I feel like I'm struggling to keep up with understanding the cancer and treatments and complications that my patients keep presenting me with. And they are really amazing people ... they are really in control and want to take charge of their health care as much as they can. I'm really glad to be a part of their 'consultant' team. After all, that's a huge part of my job as a pharmacist: work together with the patient to identify and achieve their goals. I sometimes forget that. That I exist as a pharmacist to serve and meet the needs of my patients.

So last night I got a call from a good friend I graduated with. She'd had a bad day at work, seemingly similar to quite a few people from my class. You know, I don't recall a class on how to deal with bad work environments or questionable bosses. No one mentioned that the first job of our careers might not be the dream job we always imagined it to be.
And I never realized how hard this pharmacy residency might be so hard. I'm so tired that I can't think straight anymore. And these 12 hour shifts are killing me (and leaving very little time for all the reading and projects I need to get done).
So about that conversation; It was good to have a conversation with someone who wasn't from work. With someone who still remembered what intense learning could be like. With someone who knew what it was like to be a new pharmacist. With someone I'd had numerous late night phone chats working through our frustrations together. It was great, but at over 3 hours after a 12 hour shift, it left me a little tired today. So once again, my project did not get worked on. Ah well, I think I work best with that looming deadline anyway.