...and follow Me

Yesterday in the Gospel, Jesus encountered the rich young man, who went away sad, unable to detach himself from the things of this world to gain the next. It's easy for me to simply think of material possessions that I could give up, and consider myself good to go. I have all of two purses, still sleep in a twin bed, and Michelle is embarrassed by the paucity of my DVD collection. But to me it's all just stuff.

However, as I reflected, I realized that it's easy for me to be detached from things when I am financially secure. If someone wrecks my car, I have insurance, and the ability to buy a new one. I am not living paycheck to paycheck, and can afford splurges like a trip to Ireland or an extra dinner out. I tithe, yes, but it has never been a matter of deciding whether that money goes in the collection plate or to pay my electrical bill. Would it be as easy for me to be detached if I had no way to replace the things I owned?

Furthermore, what of attachments to things besides possessions. If Jesus asked me to give up my job, would I follow Him? What about my health and ability to be active? My eyesight or one of my limbs? My family? The opportunity to worship freely, or to live in a land of relative peace? My ability to call my free time my own? Would I, too, be walking away sad?

And yet, all of these things are gifts from God, not things I've earned. Why should I not be willing to give them back to be with Him?

Medically clear doesn't mean okay

I mentioned in my last post that one of the jobs of the third (non-emergency-medicine) attending at the main ED is medically clearing the psychiatric patients. Denver is one of the few cities with an inpatient pediatric psych unit (we referred to them from KC) and has a lot of resources and a lot of patients. Many of the families of patients in the Medical Day (psych) program-or who have recently gone home from inpatient-are instructed to bring their kids to the ED if they are having behavior issues. Here there is 24-hour psychiatric coverage and the ability to be monitored or admitted to the psych unit if necessary. These behavior issues can be anything from a patient saying "I want to die" to being handcuffed by the police for violent behavior. And all of them need medical clearance before they can be appropriately placed.

I suppose one could easily walk in and out within a minute and a half, make sure the kid's heart is beating and then order the urine tox screen. But that feels like a dismissal of someone who has spent their whole life being dismissed. And though they put up a tough front-acting like they don't care about the scars on their arms or the fact that they are living in a group home-you can easily hear the cry for help, and I want to show them that I see them as a person and care about them, even in that briefest of encounters. It's one of the hardest parts of my job so far, knowing that I can easily say "medically clear" and walk away, but that they are likely in for a lifetime of conflict, heartache, and ER trips just like this. I wish we did a better job with pediatric mental health from the beginning, teaching parents how to discipline and set boundaries, but also how to show affection and listen. Teaching kids how to express their frustrations in appropriate ways and to treat others with kindness. Screening for family history of mental health or risky social situations so we could watch for it.

Instead we see probably an average of 40-50 kids a week hitting the ER because there aren't a lot of other options. I'm glad we have the safety net, but sad that we need it at all, and doubtful that it's making any lasting changes. I guess I would just encourage all of you who interact with children or teenagers in any way to let them know they are loved and worthwhile every chance you get, and that they don't have to do anything alone.

Working Girl

Well, I'm three shifts in to my big girl job, and I've already had to present a patient at my first Morbidity & Mortality conference (did NOT feel like a stellar start). I wish I'd appreciated the hand-holding more as a resident. Because in real life, there is no candy bowl or Mario Kart tournaments or Chief's office to escape to. There is just do your work.

And I don't mean "just" do your work. Because when it's a brand new computer and hospital system, you have super complicated kids, and you are making the final decisions for the first time, that work can seem pretty daunting. There was a very real moment of panic at the end of my first shift when there were 27 patients in the waiting room, every ED bed was full, and I had finished exactly zero of my notes--what the heck have I gotten myself into?

But Day 2 was better. And so was day three. And everyone has been super nice. And I'm not the only one that feels slightly overwhelmed. One of the other just-graduated-attendings told me today that even though she did her residency here, her first day was still a bit rough. "No one's standing behind me telling me what to do. Are you sure you don't want me to check this patient out just for kicks?"

Small successes--I did my first two sedations today, have learned a few nurses' names, and have gotten quite proficient at medically clearing the psychiatric patients (something I didn't realize was a big part of my job during my main ED shifts).

It's all just growing pains, and thankfully I've got a good support system and excellent training, and soon I will be able to look back on this trial by fire and smile.

Deer in the headlights

Just finished my "shadow shift" in the ED, and have my first real shift on Saturday. Apparently, "shadow" means "see your own patients and carry your own phone" so even though I was nowhere near my usual efficient self as I tried to navigate a new system, I still was the one making the final decisions. It's weird knowing that I'm not going to run the patient by anyone who will hopefully catch anything I missed. That there isn't another, much more experienced set of eyes looking at my patients. I felt sneaky discharging the patients, like someone should still be double-checking me.

The good news is that I like the people I've met so far who are starting with me, even though because we're all new, we won't really be working "together" for a while, I finally got my access all set up, and I don't have to worry about learning a whole new city in addition to a new hospital system.

But still I'm having a lot of trepidation as I get ready to start, knowing that I'm just going to have to truck through the overwhelmingness of it and learn as I go. As one of my new co-workers said yesterday, after doing something different every month in residency, having no idea how things work and who people are should be old-hat. Hooray for us.

Alive

"The glory of God is man fully alive." -St. Irenaeus

This is an oft-quoted statement from one of the early Church fathers, but I wonder how many people have thought about what it fully means. I would think that all of us, whether religious or not, would want to live our lives "fully alive." To be fully alive, I think it naturally follows that we must be fully human, because that is what we are. A tree cannot be fully alive by trying to be a flower, or a mountain, or a butterfly (indulge me in my anthropomorphizing). Man cannot be fully alive unless he is fully man (or woman).

Blessed John Paul the Great, before he was pope, was a great philosopher and spent much time and energy developing an anthropology that drew from ancient Greece to Jesus to modern day. In Gaudium et Spes, which he had a large part in writing, we learn that “Man is the only creature on earth which God willed for
itself, [and he] cannot fully find himself except through a sincere gift of himself.” (GS 24) I don't have the knowledge or ability to defend that statement as it deserves, but I do know that my own experience has shown this to be true. JPII also said that "to be human means to be called to interpersonal communion." If you take it from a religious perspective, it makes sense that, created in the image of the Trinitarian communion, we would only find fulfillment in relationship with others and God. From a biologic, psychologic, philosophical perspective, we are the only beings capable of conscious thought, with a will and an intellect, able to experience love.  Man does not make sense in isolation, only in communion.

So we can see that man, "fully alive", must be in relationship, and that relationship can not be one of selfishness and utilitarianism. Communion can only be achieved through self-gift and a receiving of that gift. So much of today's world facilitates relationships that give me something, that I profit from, and that allow me to rise in the standards of the world--wealth, beauty, power--which, as you'll notice, are not what it means to be "fully alive."

It's counter-intuitive only because there are so few voices for truth, and the voices of the world are so loud. If you stop to really think about it, it's completely intuitive. It's a challenge that I continue to take upon myself to live in a way that will help me become the best version of myself, the most fully-alive version of myself. Which is to say the version that gives of myself, is in communion with others and with the God who created me in His image.

Home Sweet Home

Things I did in my first 24(ish) hours in the state:
-Nap (very important first step)
-Avery Brewing Co's The Reverend Quad (mmm)
-Meet Lucy, the newest family member
-Breakfast with the twin, good coffee, Sunday paper
-Mass at STM
-Open house to see lots of fun people
-Cook Greek food
-Stuff my face with said Greek food, plus Mary's seven layer cake, out on the back deck with the mountains as a backdrop

Success.

Take a good look around...

As I wind down my final hours in the city too big for one state, I'm trying to cram 3 years of memories into something a little more manageable. Besides the obvious residency events and people that I will miss so very dearly (and because it makes me too sad to think about it), I've tried to come up with a highlight reel of sorts for the city itself. And so here is my list...

Things That Weren't Able to Keep Me Away From the Mountains For Very Long (but that I will still miss)

The Z-Man. After trying probably most of the top BBQ joints in the city, I can definitively say that Oklahoma Joe's is my FAVORITE. Like don't leave a single fry crumb or drop of BBQ sauce on the tissue paper favorite. And I will dream about that onion ring perched atop a mountain of brisket and provolone, slathered in half regular/half spicy goodness, the perfectly seasoned fries, and the baked beans that are a meal in themselves. Too bad it probably doesn't ship well.

Fireflies and greenery. I know that in general, humidity is evil, but I will miss the walks in the park after dinner with overbearing foliage and flocks of lightning bugs. Reminds me of Grandma's house.

The Plaza. Let's be honest. All you really had to say was four-story Barnes and Noble and free parking and I would be there. Throw in dozens of shops that I actually don't mind setting foot in, a handful of decent eateries, and the best Christmas lights in the city, and it's even better. Plenty of days off spent window shopping. Or real shopping. And the Art Fair? Yes, please. Give me this over Park Meadows eight days a week.

Getting through the airport in less than 15 minutes. DIA is pretty much everything I loathe about air travel. I'll trade the abundance of post-security food options for the ease of walking right to my gate every time. All this is supposed to be changing, so I may not have anything to miss. Too bad. Throw fairly manageable roads in here as well, both traffic and ease of travel. KC is WAY more navigable than Denver, and I will miss the sense of freedom that comes with that.

Tank 7 on tap. 'Nuff said.

But really, compare that to mountains, blue skies, family, no humidity, mountains, more microbrews than you can count, the Broncos, family, Coors Field, mountains, the new puppy...you get the picture. I'm ready to be home. But I'll be back.