ch'ízhii ramblings

for no reason...

2011-12-22T22:15:00.019-07:00

this morning my day started with the call phone ringing. the strange thing was i had just looked at it a few minutes before wondering, "why has this phone not rung yet? is it even working?" as i started getting out of bed to dress for a morning run, the blasted phone decides to ring. it was a call from the emergency room to inform me that a patient with a gun shot wound was there. i must have gotten there fairly quickly because the e.r. staff were thrilled that i was there right off and they lined up to help with whatever i needed. my patient was a young man not quite out of his teens yet with an accidently self-inflicted gsw. the police were there interrogating him. i was a little incensed with the insistent questioning when we're trying to get the patient settled as he came in admittedly & obviously intoxicated. his labs revealed a bac of approximately 4x legal limit! was i ever annoyed. i was annoyed with my patient for coming in at that hour which resulted in my not running. i was annoyed with the cop's interrogation, as he kept interrupting. i was just plain irritated. as the day progressed, i admitted that the morning e.r. call and admission was a good experience for me. i also did a bit of suturing and salvaging the huge gaping hold the young man left in his foot. later in the day, i walked a brisk 4.5 miles which made up for missing the morning run. after all was said & done, i was embarrassed by my own lack of cool. :-/

my family. my love.

2011-12-16T22:00:00.003-07:00

"a happy family is but an earlier heaven."
~ george bernard shaw ~

if i had known how complete i would feel to have my family back together, i would like to think that i would have helped fate along. however, i must also appreciate & recognize that all things happen in due course. and at is is often said, things unfold & happen as they do for a reason. in a few posts dating back to june/july 2010, i may have alluded to going my own way meaning separating from the person to whom i was legally married at the time. thereafter, i was by myself for awhile and quite frankly enjoyed being "single". the more time i spent away from my marriage, it became clear that while i respected the institution of marriage, i did not like the person to whom i was married for many reasons which are better left untold; suffice it to say they were not frivolous nor inconsequential. and... let it be known that wiser & more confident women would never have stayed as long as i did nor endured as much as i did. as way lead to way, i ended up alone & came to love the freedom. and... as way lead to way... i happened upon a road less traveled by... which resulted in a reconciliation with the father of my children. it was not an easy feat, nor has it been smooth cruising but faith has kept us committed to mending & healing our family. giving our love another chance is making all the difference. ♡

wound care conference

2011-11-20T14:04:00.005-07:00

half of this past week, i attended a wound care conference focusing on diabetic foot ulcers. the epidemic of type 2 diabetes mellitus in the american indian population and [this is as far as i got when i started this post way back when].

what a day...

2011-11-08T23:29:00.086-07:00

it started with not being able to sleep around 0300, and then finally nodding back to sleep and having difficulty getting up for my morning run at 0445. instead, i was able to get up for my run at 0500. it was 27º f, is what my phone noted to be the temp at that hour in good old tuba city. the slush from the evening before had frozen down to the sidewalk so it was road running. =P thankfully, no wile e. coyote to creep me out. i trudged along at a cautious pace because i did not want to crack my noggin.

got to the floor to start pre-rounding at 0640, only to find the attending on-call to already be on the floor starting his rounds. so... i joined him and we were almost done with our acu patients when the students and the other attending showed up. while changing the dressings on an ex fix frame, one of the attendings was paged to inform that the first elective surgical patient had already arrived and was ready to be pre-op'ed. while the attending on-call went to pcu to finish rounding, i accompanied him. it was 0730, when he was paged to inform that the patient was already in the o.r. this was a huge surprise. a pleasant surprise. we are usually waiting around for our 0730 start time until 0830. a new world coming. yeah! so... we finished up on pcu and then proceeded to the o.r. i scrubbed in but observed mostly because one of the students was also scrubbed. it is nice to review but also anticipate the next steps so that i can at least assist anticipating the next step in the surgical procedures. they were turning over the room between cases rather quickly so i did not get a chance to have lunch until 1500. then we had a workshop on assembling ilizarov external fixation frames. we were done by 1700. by this time, i trudged home and was changing into regular clothes when a friend called saying she was in town. last minute calls such as this can be a bit annoying. certainly, i am not a neurosurgeon or a cardiothoracic surgeon but... i am still busy. a heads up would be nice. i don't like it when people expect you to just drop everything to visit with them and if you don't they're offended. wtf? anyhow... i made an effort to meet up for a quick chat. fortunately, she was just passing through & needed to get on home to phoenix tonight. then, i went to meet up with my friends with whom i had made plans. we chatted. when i started fading, i drove home. just as i was getting ready for bed, i received a call from my son.

the second i saw his caller id, i knew it it had to be some difficult news because we were not supposed to hear from him until he was done with this pre-deployment training. it was a call to inform me that he is ok but he was involved in a rollover of the combat vehicle he was in which involved the fatality of a member of his crew. while i am tremendously relieved that my son survived the incident with only bumps & bruises, this is the very first time he has had to experience witnessing & experiencing the death of a comrade.

what is a mother to do but pray. offer up smoke. be thankful that my son was spared and pray for healing for the family of the soldier who perished. while anyone can say this happens and is the risk that exists so matter of factly, it is still an outcome no family welcomes. and... we can all get on our political rants on both sides, the bottom line is... if you do not have a loved one serving and only have negativity driveling out of your trap, you best just shut the f--k up! especially around me. i am not a war monger. and, i am not pleased with the manner in which our country entered into this war. but... i love my son and i support him. and, i will pray for him and those serving with him every day. especially when sleep is elusive, as it is now. :-/

hear my prayers

2011-11-05T08:20:00.001-06:00

lately, i am having trouble sleeping. each night i wake early and am unable to go back to sleep which was never a problem before. my thoughts immediately go to my son. like this morning, i woke thinking about him. as the wind sloshed raindrops and rattled against the windows, i thought, "please let my yázhí be warm," knowing full well that he is training for deployment. the last two evenings, i spent some time looking at videos on youtube that demonstrate a minute portion of all that which my son will be exposed during deployment. it is more real now then when he called to tell me that he was sworn in and he had signed all his papers. it is more real now then when i stood in the freezing humidity at fort benning to pin my son during the turning blue exercises. i replay the moments when i have been selfish as a mother and try to forgive myself because i want to be strong for him. i relive the moments when i have been the best mommy and hear his laughter and feel his warmth. the reality of my son going to a foreign place where people are diabolically mad, crazed, fanatical & suicidal just wrenches my heart. i pray. i beg. i implore. i plead. i pray some more. i beg some more. i implore more. i plead more. so... when i seem deep in thought, i am.

this all makes everything that i am going through as a resident miniscule. my attending physicians can yell and rip me a new one as much and as often as they so desire. even in front of the entire tuba city community. i do not care. it does not hurt my feelings anymore. i will simply get up earlier. i will rise to the occasion & immerse myself because i believe that if i am good, my prayers will be heard. my pleas will be honored. my son will walk that tádídíínk'eh atiin back to the center of our universe -- our family.

i am sure it sounds silly, insane... you know... whatever! and, i never say that even if i am thinking it until now. all i care about is that my son remains intact spiritually, mentally, emotionally & physically. and... i will cling to whatever i can grasp to hold me steady with hope and faith.

the important things

2011-11-03T03:20:00.084-06:00

it's been a rough couple of weeks for my family. my dad ended up in the hospital. after much cajoling by my mom, he finally went in to be seen. he was flown down to phoenix the same day and was scheduled for surgery. my mom & i got down there last thursday. while many were having fun enjoying the mesa powwow, arizona state fair & asu homecoming festivities, our family was huddled with eyes glued to the computer screen tracking our dad's transfers from one part of the surgery center to another. breathing a sigh of relief after we were told a tumor the size of a baseball was excised from his abdomen in the whipple procedure. only to learn that he needed to go back the second day because his blood pressure would not stabilize. and... a third day. and... then had to have the endotracheal tube remain in place until he was determined a low risk for contracting a nosocomial respiratory infection. the fourth day post-op was dad's 65th birthday. we had a prayer done for him. the next day, the et tube was removed and dad got up to walk. a couple of days later, he was transferred from the icu to inpatient status. we remain positive. all the while, being fully aware that dad may still need to go through chemo & radiation therapy. the surgeon intimated that the extent and size of the tumor indicates a prognostication of combo chemo & radiation.

going through this with my family, i had a profound revelation. i will fiercely protect my family. i will pray for my family. i will make the best of everyday that i have with my family. i will make the best of this life that the gods have bestowed upon me to help others. this time we have is more finite than we realize. we all age from the moment we take a breath in this world. we can color our hair, we can dress up pretty, we can get as cosmetic as we want but what matters most is what is inside. relentlessly aspiring to compassion, humility, forgiveness, love, peace. that is what matters most. living the present and accepting the impending with grace. that is important.

write it down

2011-09-27T23:55:00.004-06:00

it has been awhile since i last wrote. there needs to be more frequent entries to track my progress, document my daily escapades and records my thoughts as i go through this part in my training. so much happens. a fleeting moment of "i got to write this down" or "i got to talk more about this" all passes and goes POOF into thin air.

today we had three surgeries on our schedule. i am very, and i mean VERY fortunate to be the only resident in this program where i am not competing with others to scrub cases. after three surgeries

baby steps

2011-09-14T23:50:00.018-06:00

it is amazing to think that last year around this time, i started my core rotation at tcrhcc as a 4th year medical student. everything seemed so foreign. to be honest, i am still in the dark about a lot of things but more and more ever slowly concepts that were taught in classes as classic presentations are illuminating themselves in clinical practice and i am finally beginning to appreciate some of all that book learning that sometimes seemed almost pointless. a couple of days ago, we had four surgeries and my attending allowed me to do a lot of the work. it was a good day to learn and practice. so many lessons. coming to this program, i told my attending that i wanted to learn all the boiled down tried and true surgical approaches and techniques. unlike my cohort, i will have a shorter time to enjoy the practice of podiatric medicine and foot & ankle surgery because i am much older than they are. as such, i am not interested in tweaking my own style later after residency which is a whopping 3 years from now. i just want the most efficient way to medically & surgically treat the gamut of foot pathologies.

the learning never ends

2011-08-07T23:52:00.000-06:00

"there is a reason why you decided to become a surgeon..."

~ dr. jensen, navajo woman general surgeon

it was a rough week in the o.r. especially on thursday. what should have been easy cases were far from simple. all that i thought i learned was nowhere, completely unavailable... my brain was denser than a molasses. and... unfortunately, my confidence was also non-existent. looking back on thursday, after having a meltdown in the dressing room restroom, a venting session, some time for reflecting + finally making peace with my paltry performance... crazy as this may sound... i am actually glad and thankful even that it happened. many thoughts zip + ricochet around in your mind. anger. shame. determination. resolve. and... accepting this is only the beginning, and i have so much to learn. and... tomorrow is another day.

up for a breath

2011-07-16T16:08:00.051-06:00

it was an incredibly busy week. many of my cohort will most likely tell me that my week was not as stressful as was theirs, and i would not hesitate to agree. however, i have to say again... it was a busy week!

monday. woke at 3:30 a.m. jumped in the shower. made coffee. packed in last items for tuba city. gave hugs to my family members in their beds (yes... i woke them!) before i was en route. i got to tuba city around 6:30 a.m. and began unpacking a few things. changed. put on my white coat, a longer one for the first time! yeah! and... hit the floor for rounds. "welcome back! where have you been?" abound as i walked through the hospital. it felt good to be back. coffee in hand, clinic started. and... it was a busy day! patients back to back to back to back. i scheduled my first surgery case.

07-30-2011 i wish i had finished this entry when i started it because that first week already seems like a lifetime ago. :/ it serves me right for relying on the [save now] kiosk way too often.

a threesome with don

2011-06-28T23:58:00.064-06:00

4.5 miles. ran. struggled through aches & pains. but... did it! yay! then, a quick scrub. and... lunch with my little family. funny tales & lots of laughing. aaaahh... the sound of happiness! so... lunch was a footlong from subway. yeah... a footlong! not a 6" or anything daintier! what of it?! i was famished! since i had a late start with the run, i did not eat anything before the run and did not want to eat anything after to spoil my lunch. anyhow... back to the footlong... i have mine down to a science and if they don't make it right, i don't go back to that location. 9-grain wheat. bacon with pepper jack. toasted. spinach. tomatoes. cucumbers. green peppers. olives. the yellow peppers. a few hard shakes of black pepper and the seasoning mix. washed down with a 12 oz. can of diet cherry coke! yummmm!

after lunch, i packed my overnight bag and hopped in the car. drove out to rock point and picked up my sister for a sisters night out. yes... in the middle of the week! neither of us knew where the brooks/isham performing arts center was in kirtland, nm. on came the navigator on my phone. as it turns out, the brooks/isham performing arts center is located on the kirtland central high school campus. once we knew where we needed to go, we went to get dinner. chinese food at a tiny place up the road. surprisingly, the food was good!

then we went back to the performing arts center and got in the will call line. the opening act was an old guy. i think he was local. he was quite entertaining. :) the announcements followed with a plug for each sponsor. finally... the man himself on stage: don williams. love his deep baritone voice! aaaahhh! he is 72 years old & can still jam, albeit while sitting the entire time in a chair. :) i would definitely pay to listen to him sing in person, again! =) i actually lost count the number of songs he sang. his show ran about 1.5 hours. the auditorium was full to capacity. that is not bad for a week night.

it is safe to say that i am a bigger fan than my sister but it was her idea to take me to this concert. we have a list of performers that we both want to hear in concert and we are going through that list... as we say... "before they die & we lose an opportunity..." or... "get them while they are young, hot & inexpensive..." mr. don williams was on my list for quite some time. and... i am fortunate to have a sister who offers to take me to such a show. ♥

07-30-2011 i started this entry a month ago, and am finally getting it up on the board. =/

determined

2011-06-27T17:30:00.001-06:00

i slept in. yes. on occasion, i allow the sun to rise before i do. as i got up for coffee, i noticed that groggy feeling of monday. bleh! it meant the weekend was over and i was a week closer to my vacation coming to end. :(

since i did nothing more than go out on the lake to fish and eat birthday party food yesterday, i felt obliged to run or walk. if i ran, it had to be no less than 5 miles. if i walked, it had to be no less than 10 miles. as time churned pass 10 a.m., i felt it would be best if i ran so i would get done sooner and be out of the heat that much faster. by the time i got out to the trailhead, it was a bit warm but i was not going to make excuses for myself. i told myself, "if you had just got off your hiney, it would have been much cooler when you got out on the trail! no belly aching!"

the first 3 miles, as usual, went fast & painlessly. mile 4 dragged a tad but i still felt strong. mile 5 was testy & seemed to stretch but i was determined to get it done. mile 6 was attempted. i ran 1/2 of it, and trotted & quick walked the rest. so... i am only counting 5 miles.

embarking on a long trail

2011-06-25T21:30:00.001-06:00

"nothing will work unless you do." ~ maya angelou ~

26.2 miles. outside the demands of residency, running a full marathon is my new goal. over the last two years, i would mention doing a marathon as something to do before i am 50. then a couple of weeks ago, i got back in touch with a college friend who has already run a full marathon and is beating cancer! her story motivated me ever more! as soon as the july 2011 issue of runner's world hit the newstands, i went out to buy the one with her photo gracing the cover.

once in between the covers, i came upon the challenge section where the first focused goalis 'finish[ing] my first 26.2' along with a 'first-timer's marathon training plan'. as i read through, it became apparent that i may not have the "base" i need to start training for a full marathon. according to the q & a, i have not been doing the requisite 3-5 miles at least 3-4 times weekly to condition my tendons & ligaments in preparation for long runs. as a podiatrist, this makes complete sense to me. being much older and hopefully wiser, i am all about being able to continue what i do, which is being physically active, without causing stress injuries. consequently, i am making a decision to put the horses before the wagon -- meaning, i will work on my base the rest of this year through to march 2012. thereafter, game on! so... i have a list of 1/2 marys i want to do for the rest of this year and part of next year to train for the full mary.

i am also seriously considering a training team. this is a bit out of character for me because i like treading my own trail and doing my own thing -- take a little bit of this and take a little bit of that -- and, make a brand of my own. if it costs money, i will most likely do my own thing. it would be even better if i can receive online support and tele-train with my friends, angela & nadine. that will be plenty camaraderie. in any event, today was the beginning of my will being tested, as it will constantly happen until my first full mary. i can sense it but... i am one stubborn fool that enjoys challenges. anyhow back to the story... i had never run more than four miles without stopping before today. this morning, i ran five miles. that's right! five miles! yay! as ms. angelou said, "nothing will work unless you do!" =]

racing myself

2011-06-24T20:00:00.000-06:00

"you bad @$$!" a compliment i like to hear from my boyfriend. and, today was no exception. i got out to the gamerco trailhead early. water. tunes. and... a cough drop. the plan from the outset was to walk 10 miles as fast as i could. got pass the 3 mile marker with the colorful flags and took a left onto the 2.25 mile loop. back at the 3 mile marker with the loop done, i took another left turn towards mile post 4. at mile 4, i turned around and then a nagging thought telling me to go farther, i took a right turn onto the northern most trail. at this point, i was unsure whether there would be a mile post marker for mile 5, so i turned on runkeeper to keep track of the distance so that i would not go more than another mile even if i felt like i could do it. mile 5 turned out to be between a pass between sandstone formations with a metal cut out of a wildcat on one side. now... who's brilliant idea was it to put that darn cat out there?! not exactly a charmer for someone like me trekking alone on foot with nothing more than a pebble in hand to ward off any rabid wildcat.

so... you can imagine my tiny bout of panic and a bit of a hissy fit when a sharp pain radiated through my right forefoot. yes! out there. in the middle of nowhere with no other person around, i had a moment when i thought i might have a meltdown. fortunately, i am too proud for anything like this to last more than a new york second. there i was... cursing my nerves! and... old age! nerves get pinched between the metatarsal heads and they can hurt like the dickens when you're running or walking. and... as we age, the fat pads that normally cushions the metatarsal heads get displaced distally as our toes begin to hammer up. consequently, the sensation is much like walking or running on pebbles. oh! hell! yes, hell! my right foot was hurting. i stopped. i stood there alternating between wiggling my toes and stomping my foot. for a minute. once again, i cursed old age & told myself to suck it up. and... for whatever its worth, "woman up!" lol! and... continued my trek! what choice did i have? it was the only way i was going to get home. =)

by the time i was back at mile post 3, no foot pain. there were two other women taking a rest at mile post 3. they were chatting it up and slugging their water canisters. i said my greetings and continued on. a few minutes later, i heard their chatter on my tail. and... being a competitive weirdo, i started trotting. then a quick walk. trot. quick walk. trot. until i could no longer hear their chatter. by mile post 2, they were nowhere in sight and only a man, dog & girlfriend jogging towards me. i stopped the trot and continued on with the quick walk. mile post 1, the man, dog & girlfriend had apparently turned around and were at least 75-100 yards back. of course, i wanted to keep them there, so... back to... trot, quick walk, trot, quick walk... and... finally back at the trailhead. yeah! =P

shaking off the lazy!

2011-06-23T20:00:00.021-06:00

pyramid rock trail x 2 = 6 miles. walked. now... i ask, "what possessed me to do this in the middle of the day?" it was hot! as a matter of fact, my water bag was empty with some trail still left to go. and... this almost never happens.

so... first, i thought i would go back to the high desert trail to walk six or eight miles. then... i got this idea that i really wanted a sweat-producing workout that will leave me feeling spent. and, i packed my water bag with ice & h2o, and stuffed a luna bar in one of the pockets. as i was heading out, i grabbed a banana. off i plowed in my boyfriend's tanker.

once at the red rock state park, i noticed signs indicating the park being closed until after the rodeos on july 5th. did i listen? no.... i drove right through and parked. before anyone told me the park is closed, i hopped out and started walking. the first climb and descent were fairly easy. at the beginning of the second climb, i went back to the tanker to get the banana and luna bar that i left there in the shade so it would not melt. as i began trekking up the sandy hill at the first switchback, i looked back and the tanker looked so welcoming. i literally took one step towards the truck, and said to myself, "what the f---? you cannot quit now! you are already back on the trail!" i spun around and began walking back up the trail.

on top, i pulled out the luna bar & banana and inhaled them both as i turned around for the descent. i trudged along feeling spent but was so proud of myself as i got to the bottom and climbed into the tanker. i rolled my window down, buckled in, blasted my jams & plowed on out past the arena where some chubby 'boys' were working on the pens. they waved & i smiled back. yeah! :)

going with the flow

2011-06-21T22:16:00.003-06:00

it is 2200+ hours, and i am finally reading today's horoscope. it could not have been more apropos. so... this is what it read:

[n]othing in your life is written in stone, and you have to accept that things can change with little or no notice. [e]verything is fluctuating in your life right now, and it would do you some good to try to go with the flow -- be like a surfer riding a bodacious wave. [y]ou can choose to flail about and try to fight the current, but you'll only tire yourself out and feel like you failed. [i]f you go with the flow, you will experience a rush of excitement -- and power.

going with the flow has been the story of my life for the last 12+ months. so many changes. during such times, i learned that going with the flow, not compromising on what matters to me and honoring myself have been the most crucial life skills i could have ever employed. yay! to self-love! one of the best of advices from a fortune cookie. ♥

... for my fathers

2011-06-19T06:00:00.000-06:00

when father's day comes around each year, i cannot help but allow my mind to wander to thoughts of my biological father. one would think that i should be over this by now. after all, i am in my mid-40s. what the heck? this father's day, my thoughts are... happy father's day, burt cruz! ... wherever you are, thank you for your genes. and... a special thanks for all the quirks & idiosyncrasies that make me uniquely me.

and... for the man you helped raise me and shape me into the responsible adult i have become, my stepfather... thank you very much & happy father's day, dad! love & hugs! :')

... high desert trails iii

2011-06-18T21:55:00.043-06:00

10 miles. walked. at noon. what was i thinking? the heat whopped my hiney. ugh! the wind provided a strong breeze and further deceived me to believe it was not that hot. around mile 8, i began fading so i reached for my luna bar but was disappointed to find out that the chocolate had melted and it was a warm gooey mess. not wanting to be bothered with it instead, i siphoned water from my camel pak and trudged on. my arms hung and swung haphazardly with each step slinging the 2-lb hand weights i carried in each hand. again... what was i thinking? the miles counted down ever so slowly going backwards starting with mile 4, mile 3, mile 2 and mile 1. when i got into the car, it was much cooler and i drained the water pack. buckled in and inched out of the parking lot with my tummy grumbling folding in on itself. =/

... another day of learning

2011-06-14T23:50:00.081-06:00

faul & goss.

surgery day. i got up at 0300, and was en route to tuba city at 0340. start time was scheduled for 0730. leaving at this hour would give me enough time to check the mail at the post office and change into the hospital scrubs. my blue sky scrubs cap on, i went looking for my attendings. they are so easy to find. when i showed my mom this photo of my attendings, she said, "now, i know why you went into podiatry." lol! if only they all looked like that! =P the women at the hospital always ask how i can concentrate working with two handsome guys. my answer is easy. professionally, they are my teachers; and personally, they are just boys... my little brothers. anyhow... that out of the way...

the first case was a lateral midfoot fusion. it started rather effortlessly until the lateral wall of the cuboid sheared off with the fixation screw. ugh! in the end, the calcaneo-cuboid joint was fixated using two heat activated compression staples. then closed with 3.0 vicryl, 5.0 moncryl, benzoin and steri-strips.

second case was a t-t-c fusion. t-t-c = tibia + talus + calcaneus. this includes the ankle joint and subtalar joint. the patient was huge. we started with one o.r. table and eventually had to bring in a second o.r. bed because he started rolling off to one side. heaven forbid if he had fallen off! once the joints were resected, an external fixation frame was placed on this patient. the smith & nephew ex fixator looked similar to the frame depicted in the link, only much more rudimentary.

third case was originally slated as a stj fusion, and intra-operatively turned into a t-t-c fusion based on the extent of the osseous damage and what would be most clinically practical post-operatively. an external fixation frame was also placed on this patient. a synthes set was used in this case.

between the second and third case, we had a bit of a wait because our case got bumped back because an 85 yo female with c-spine fractures came in, and it was more emergent than our case -- being that our patient had been walking on his f***ed foot for so long, it did not matter in what order we went as long as we got to do our case. so... we took care of administrative business and rounded on floor patients. while i was on vacation, it turned out there was a storm of podiatry patients all requiring some form of surgical treatment. i was ready to cut my vacation short but i also knew that this was the last time i was going to be this carefree as a doctor.

apparently, there is a change that is going to occur and i will know it when it happens. that's what i was told. so... i am patiently waiting for it to happen to me. kind of like margaret waiting for her adolescent boobs to come in judy blume's "are you there god? it's me, margaret." lol!

after all was done for the day at the hospital, i text messaged my fellow female surgeon friends. we met up for dinner before i set out back on the road gallup bound. first, we got caught up on all the happenings with work, including the gripes. then... the important stuff -- relationships! lol! that done, i was finally en route at 8:30 p.m.

the drive was pretty uneventful but without fail, i got very sleepy just pass tse bonito. it took all the energy in the world to keep my eyelids open and my attention on the road. i pulled in at 11:20 p.m. and minime was waiting up for me. ♥

hwáah! what a day!☺

... high desert trails ii

2011-06-13T21:30:00.017-06:00

13.25 miles. from gamerco to mentmore. walked. the southern most route. quite scenic. great breeze. learned that the mile markers end at mile 4. after that, the next marker is until mile 7. then mile 9. then mile 11. then mile 12. and... mile 13. turning on gps on my phone to keep track of my pace by each passing mile would have helped. i slowed and finished a lot later than i wanted. next time, i will take the northern most route. ☺

... as if waiting for my return

2011-06-12T21:30:00.028-06:00

mountain sheep camp. 12 june 2011.

there are places in this world that give me a sense of my insignificance, and this is one. the last time i had been really here... cooking, laughing and watching my children covered in the black dirt of the mountains was about 12 years ago. it looks exactly as it did back then. a few cosmetic changes -- upgrades and decays to the sheep camp structures but the fire place around which i sat and ruled the outdoor kitchen still looks the same.

being me. being the diné asdzání that i am. i started a fire. sought the honeeshgish and stoked the fire. heated up the grill. and... made my náneeskaadí.

this place also anchors me to my traditions and cultural values as a diné woman. as i sit there tending the fire, with wisdom & words of my másání flow through me. renewing my spirit. replenishing my faith. strengthening my foundation by dropping my anchor back where i have always belonged.

... sisters day!

2011-06-11T22:00:00.093-06:00

the day started with my shortest workout. 2.5 miles in 31:57 minutes. that... i... am... sure... is... snail... pace... by some standards but i was pretty darn proud of myself. there were sand bars to go through & sage brush to whack through in certain areas, up and down. towards the end, i could feel the pain in my quads as i trotted up the sandy trail. yet, i really would have liked doing one more loop; however, time got short on me because i started my day dragging my butt. it took me close to one hour from the time i put my running gear on to when i actually laced up and hit the dirt. instead of attempting another loop, i came home & ate breakfast. my daughter had made potatoes, eggs & spam. without any prompting! an act such as that deserves reward which in this case was eating the food & proclaiming it the best she has made so far. =]

then... i jumped in the shower & ran around getting myself gussied up for a day with my sister and niece. first stop, the flea market. oh yeah! we walked and looked at things. a definite purchase each visit is alkąąd which is really good with coffee and my guy's favorite. the prices are going up which is inspiring me to want to learn how to make it at home! the next stop was pino's for tobacco. after, we just walked around downtown to all the places where we could ogle jewelry and native influenced attire -- richardson's had some beautiful jewelry at bro' discounts that were very reasonable. we made our way down to navajo spirit and back. we really liked what we saw but the prices were outrageous! i will have to polish up on my sewing skills and start making my own mod native outfits. yeah! when we got hungry, we stopped at jerry's cafe for vittles. my sister and i had chicken a la mexicana which had saute'd jalapeños. oh... my... gosh... the heat burnt out through my ears but i was determined not to tear. heheheheh! we went in search of good coffee but the coffee house was closed at 2:00 p.m. the sign on the door indicated it would be open to 3:00 p.m. on saturdays. typical of the silly melodramatic woman that i can be, i waved my fist at the door and we decided to get coffee at the only starbucks in town. first, we had to stop at walmart and brave the crowds. second, the mall for a pair of workout shoes for my niece who is picky but reasonable. thank goodness!

finally... we got our coffee and sat at a table, telling stories and laughing! we made our way back my new home (when i'm not in tuba city) where my grinding stones and cooking sticks are. we cooked dinner and watched two dvd movies, "country strong" and "going the distance" before my sister and niece headed home to rock point.

it is always nice to spend time with my sister. we always have so much to talk about and laugh. when it is time to go back to our homes, there is always a bit of sadness (for me, anyway...) because it is usually quite some time before we can share another day. we made plans for our next outing is on june 28th, which will be to listen to don williams perform at the brooks/isham performing arts center in kirtland, nm. yay!

kudos for high desert trail system

2011-06-10T13:50:00.102-06:00

along 1st loop. high desert trail system. 10 june 2011.

along the high desert trail system on friday. what a pleasant discovery! since going on my break, i resumed a pursuit that i really enjoy: hiking. or... in my case, walking fast! really fast! almost as if about to get into a jog. a huge positive about this trail is the setback from the city & the dirt path. no exhaust fume to inhale. no pavement to incite shin splints. no gps required as the miles are well marked and path is well demarcated.

there are two trailheads: east side is right south of gamerco and west side is at mentmore. one way, the trail is 11 miles. round trip is, of course, 22 miles. from the gamerco side, the trail bifurcates at mile 4 and meets back up close to the mentmore trailhead. this means that you can virtually experience two different trails going either way. from the gamerco trailhead at mile 3, there is an additional loop which measures out to 2.25 miles. this trail is also the home of the kent hodges memorial 1/2 marathon, formerly known as the squash blossom 1/2 marathon. it is held in the last weekend of september. and... i have decided i will be running this 1/2 mary. yeah!

while walking this trail, so many ideas came to mind about what i can do as apart of my research and public health education for residency. type 2 diabetes is a preventable disease with which we contend often as podiatrist. it is a disease that afflicts many in indian country at epidemic proportions. a disease which has been allocated funds but dealt with more cosmetically rather than substantively. the concepts are still forming and will eventually be realized. interestingly, it is one which i have been reeling through my noggin for quite awhile and it goes something like this, "t'áá shikee' bee naasháa doo. t'áá shijáád bee naasháa doo. hózhóo naasháa doo." much like the prayers in my culture. it roughly translates to, "i will walk with my own feet. i will walk with my own legs. i will walk in beauty." it still needs something else. i will come to me. soon enough. perhaps, on my next walk. and... i will be writing about it again. =]

gettin' back on the trails

2011-06-07T22:45:00.003-06:00

pyramid rock. june 7, 2011.

yesterday, i finally got back out there. started back with walking & intermittent spurts of running. probably more like jogging. but... hey, i am back out there. it was 6 miles on monday. today, it was 4 miles in the morning and 3 miles in the afternoon on the pyramid rock trail. for some reason, i was certain it was at least 3 miles one way & was rather disappointed to learn that it is 3 miles round trip! so... the challenge is on! i plan to do this trail 2x in the morning!

today, an acquaintance on facebook posted a link about a brooklyn marathoner who is also a cancer-survivor. as i read her name and looked at her photo, there was something familiar about her smile. back when i was at cornell, there was a girl by the name of angela that lived in ujamaa which is the dorm i lived in. she was a hotel-y. she always had a smile. a huge contagious smile. you could not help but smile right back at her. and, she was really sweet. while we were not close, we hung in the similar intersecting circles. we were friends with many of the brothers of phi beta sigma, the brother fraternity to the sorority, zeta phi beta, which i eventually pledged. anyhow... as i read the story about angela, it dawned on me that i know this person. i got so excited & friended her on facebook! this evening, we messaged and caught up a bit. even though i like, comment & update with some frequency on facebook, sometimes, i start thinking it is a wasteful time sucker. in any event, this time... i am thankful to facebook for enabling this reconnection.

i am so psyched! though i have always said i want to run at least one full marathon before 50, now... i am determined to run a full mary by 45! that is before september 1st, 2012! what's even more exciting is... angela & i are planning to meet up and run a marathon together! i am so excited that i am actually rather giddy. i hope this feeling remains when i start running those long miles. =] i am also planning on inviting another friend from cornell to join in this full mary. she's been running for awhile and has done a few 1/2 marys. oh... i am so excited! all because i am inspired by angela's determination to return to running after recovering. heck yeah!

i did it!

2011-06-03T23:00:00.012-06:00

as someone who has known me since i was five years old, and has seen me go through different lives with a variety of career changes said, "about time, young lady! are you sure this is the one?" all i could say is, "i better be! i am lots in the hole for this piece of paper!"

heartfelt thank you goes out to many people that have accompanied me on this journey. my daughter, who saw me through so much. her childhood was shaped by and around my choices and she was such a trooper. i pray that she takes from all this that dreams are possible! my parents & siblings, with whom i had a rolling account for loans. i might as well sign over all my checks to them. my family's unconditional love, i will never forget.

we did it!

yeah... relish this milestone before forging on to the next. residency. three years.

anything can be

2011-06-02T09:00:00.001-06:00

"listen to the mustn'ts, child. listen to the don'ts. listen to the shouldn'ts, the impossibles, the won'ts. listen to the never haves, then listen close to me... anything can happen, child. anything can be."

~ shel silverstein ~

graduation is tomorrow. most recently, on various occasions i have been asked, "how does it feel to be graduating from medical school?" truth be told, the reality of it has not yet sunken in though the gravity of a doctor's responsibilities has been a constant reel playing & replaying in my mind.

medical school was a long haul. it took longer than it should have. it was harder than it should have been. while going through medical school, i learned very quickly that certain relationships and activities are not conducive for medical school. when asked to share my thoughts on medical school with other native students that want to become doctors, the one advice that was most prominent in my mind is... you really have to want to do it! no matter how hard it gets, you really have to believe in yourself. no matter how others may try to drag you down with them, you have to be your own counsel. no matter that it means missing out on family gatherings, you have to find other ways to project your presence in your absence. no matter that you will be broke for a long time, you must learn to be okay with walmart fashion & bargain hunting. no matter that you may not make it to all your children's activities, you have to find a way to instill in your children the value of possibilities & the necessity of sacrifices. you have to foresake many aspects of what made you you up to that point in order to become a doctor.

you learn to compartmentalize. you learn to triage. you learn to focus. you learn to be your own axis. these are traits that i never thought i had in me.

the first quarter of my first year, i withdrew because i was not performing to the level i should have been not because my partner (now, the ex...) at the time got sick. he actually contracted an infection which took him out of commission for several weeks and needed help. after leaving medical school with my tail between my legs, i went to work in the law office of the ex. long hours dealing with demanding clients and reeling in new clientele. lots of hours & work for which i was not paid. when i needed money, i would ask my family for help. i worked my butt off to make the ex look efficient. even if i have to say so myself, i was good at being an image booster for him. working for free & not standing up for myself to demand my worth was the most demoralizing thing i have done to myself. this was a default position which i knew i would be returning to with tail between the legs and head hanging to the ground if i did not do anything about my dream. it was the impetus for returning to medical school more determined.

even when i was pulling the anchor in certain classes like biochemistry, giving up was never an option. even when i was hissed at by a 3rd year resident because my mistake made more work for him, my chin was up and the spring in my walk did not wane the next day. it was the first and last time i cried in medical school. often, i simply told myself, "it is this which will eventually pay dividends not working for free for someone who supposedly loves you." and given the alternative, there was no way i was going back to that.

while members of my cohort complained about professors, preceptors, other nitpicky crap... i continued to breath and put one foot of the other and kept on moving. you learn to sift out encouraging words and surround yourself with supportive friends & family.

it is through this process, i learned to compartmentalize and learned to focus on studying when my ex was not acting supportive. eventually, the relationship with the ex became a casualty of triage. my determination built a new universe with its own axis which no longer included the unnecessary baggage -- sad to say but... the stuff that was just getting in the way and being dead weight was no longer allowed any mind. it was the most difficult aspect of medical school for me because i am a compassionate and forgiving soul who is always looking for the good even the worst case scenario. while i am sad that my actions may have caused pain for another, the collateral damage was unfortunate but necessary.

in plain words... it was a selfish act. that is a requirement for anything to happen.

all in a year

2011-06-01T22:30:00.084-06:00

"in three words i can sum up everything i've learned about life: it goes on."
~ robert frost ~

when life happens or to put it more crudely... when $#!t happens, we may get stuck in the thick of it and flail about. the sticky $#!t grabs hold of any part of our being that we leave exposed, loose and unprotected. it takes extra effort to extricate oneself from the sticky $#!t scum. once it is off, it allows for us to focus what can be.

today marked the one year anniversary of my decision to strike out on my own. it also marked the beginning of my 4th year med school rotations. at this time last year, after completing my first day at the tucson v.a. hospital and a walk up towards the pcc campus and back, i was laying flat on my back in the middle of a full-size bed in a 2-bedroom apartment (which i had all to myself) listening to rodrigo y gabriela on pandora. i recall feeling a bit al a loss on what to think about the changes that were happening for me but i distinctly remember feeling a sense of relief. it was something akin to a heavy water-logged cloak being lifted away and i was literally pounds lighter in that instant. i exhaled.

in two days, i will be graduating with a doctorate of podiatric medicine. in the last year, i have travelled many miles, experienced many places and made new friends & renewed old friendships while living on the trail of the brotherhood of the traveling white coat. i also passed another board exam and all my rotations. i even had a few skin-to-skin cases in the o.r. i now have a residency with housing in a stone throws distance from the hospital. while i am happy & proud for myself, these milestones carry much more impotance when they are shared with those dear to me.

more importantly, i have my family back for which i am grateful. i am truly blessed. life continues to teach & ceases to amaze. a few realizations as life goes on: the resiliency and forgiving nature of the human heart. the tenacity of true love to transcend time and space. the power of prayer and faith to change the trajectory of paths so they converge and come full circle. the humility of our essence to accept the gift of another chance without hesitation. and... the determination of hope to keep us moving forward.

life does really go on.

challenging constructs

2011-05-20T20:00:00.105-06:00

student dr. suen: hi, patient's name . i'm student dr. suen. are you able to get up onto the exam table?

patient: yes. (she climbs onto exam table while wondering aloud....) i thought this was the specialty clinic.

student dr. suen: this is a specialty clinic. you are in the podiatry clinic. you're here to have your feet examined & treated. am i right?

patient: yes. but, i thought i was going to be checked by the doctor. (she says while looking me up and down with obvious skepticism on her face)

student dr. suen: you are being seen by the specialty doctor. i am the doctor.

navajo. woman. specialty. doctor. a navajo woman specialty doctor. a construct that apparently presents a quandary of sorts. it certainly did for this patient as i stood there challenging a paradigm which my people have long accepted.

this visit took longer than the standard 15 minutes i was giving all my other patients because she decided to ask for the same treatment she had been previously denied. being a diabetic with multiple co-morbidities and being on numerous prescription medicines deemed her a non-candidate for oral anti-fungal treatment for thick, hard, discolored dystrophic toenails. after i gave her my explanation for denying her request for a prescription for oral anti-fungal treatment and offering her an over the counter topical option which she would have to pay out of pocket and trimming down her toenails, she admits that she was previously denied for the same reasons i had given her. so... it seems when i told her the same thing she had been told by another doctor, a white male specialty doctor, of the potential hepatic damage... she believed that i might really be a specialty doctor.

towards the end of this visit, patient asks me, "what tribe are you?" i respond, "navajo," which surprised her. then, she asked my clan. though we were not related by clan she says, "ahxéhee' shiyázhí. i hope i see you again next time. i have been coming here and no one even offered to help me with my toenails. they are too hard and my eyes are not any good because of my cataracts. you are the first doctor that has touched my feet, offered to cut my toenails, scheduled a follow-up appointment and referred me for the diabetic shoe program." though it will take more than one visit to win the confidence of patients, i am determined. ☺

need some umph!

2011-05-19T21:09:00.000-06:00

regression: the act of going back to a previous place or state; return or reversion.

first, it was my left hip. the adductors were being gimpy. so, i gave them a bit of a rest & started again. then, it has been my piriformis being irritated. though, i have been stretching it out, it has not completely resolved but i have resumed walking & running, again. i miss my once a week session on the stairmaster. i also need to buy a good seat cusion for driving & position my gunning the gas pedal foot in a manner that it does not strain any other but my calf muscles.

that said, i need to get my hiney back in gear. -30 lbs. since last june is not where i should get stuck! sadly, i am started to slide back like sand sifting back down the hole you dig with a shovel. i need another -30 lbs., dammit!

p90x, i will try. running, i will most definitely do. weight training, i need to do especially in my arms to be stronger in the o.r. i want to be -30 lbs. by my next birthday! now, if i get -10 lbs. or -15 lbs. or -20 lbs., i will take that! yeah... actually, i just want to be healthy. i want to be around long enough to pay off my humongous, ginormous, colossal student loan debt and see my children marry and become parents. ♥

regression is not always bad. it gives one time to reassess, regroup, and revamp! nothing wrong with regression. it presents one with a challenge to dig deeper for more umph! for that push required to crest an ascent or jar one off a plateau one's been stuck on. ☺

a river & a man

2011-04-20T19:00:00.005-06:00

"no man ever steps in the same river twice, for it's not the same river & he's not the same man."

~ heraclitus of ephesus ~

it is not the same river & he is not the same man. the river is most definitely much more. gentle. comforting. tender. soothing. even gallant. and... a man can never go wrong with chivalry.

2 wise old men

2011-04-18T04:30:00.000-06:00

sargeant & scooby

the initials

2011-04-17T18:30:00.047-06:00

at first, the sight of them annoyed me
... almost incited panic
they mar even the cheapest plastic ware
i mean... seriously??
who initials plastics that can be replaced
nothing worth more than 10$
yet, the initials are there...
on every piece of plastic bowl
including the lids
now, they are simply a reminder
... of what was
eventually, they will rub off
... and, we will replace them as necessary
or they will be inadvertently left
behind at the next ndáá'

an unexpected day

2011-04-16T20:00:00.011-06:00

the sign warns, "báhádzid - doo kóne' na'adáa da."
church rock, new mexico. 04-16-2011.

since items on my weekend calendar got cancelled, i asked my friend for a motorcycle ride. first, i asked to ride out to camp asaayi' but apparently the road in is dirt or gravel, and would have proven to be a tough ride. so... we headed east toward church rock and pinedale, nm. my friend had patients out that lived out pass old uranium mill and slurry sites so we rode out to the end of the road. at that dead end is this sign. i can only imagine what it looks beyond this fence and sign. it read, "báhádzid - doo kóne' na'adáa da." it amazes me that the posters of this sign would want us to believe that this fence contains & bounds all of the báhádzidii on the other side, preventing any of its escape. the winds have been kicking up for the last few weeks, and no amount of doo kóne' na'adáa da is going to keep the radioactive material on the other side of this fence. bleh!

unfortunately the bridge right pass the turn-off to pinedale was being worked on and the detour was a dirt road, so... we turned around and instead decided to ride out to mcgaffey lake as i had never been there before. first, we stopped at a roadside food stand to buy navajo burgers and brisk iced tea which turned out to be lemonade. the road to the lake is marred with potholes and corrugated from wear. once at the lake, we picked a spot on the southside and took out our little lunch. we sat there munching our burgers as my friend counted the number of people there... 97, 98... oh and 99, 100. the breeze picked up a little so we mounted back up and rode back out to i-40. on our way home, we stopped off at starbucks for some coffee. in front of safeway, we were approached by a young man panhandling. he chatted us up and then wham... "do you have money to spare?" it would be nice to help everyone that asks but we're both going through lean times, and had to sadly turn down the young man.

nbpme part ii

2011-04-13T18:00:00.001-06:00

... i passed. awhile back. that's all. now... onto nbpme iii. and... of course, there are more exams ahead. it just never ends, apparently. haha! :●/

the thing called denial

2011-04-10T20:19:00.106-06:00

"i was steeped in denial, but my body knew."
~ suzanne finnamore, split: a memoir of divorce ~

often, we "know" exactly what is happening by virtue of that sense better known as intuition, or what we feel instinctively when we are fed lies. at first, we deny anything sinister is suspect. always extending the benefit of the doubt. then eventually we end up denying ourselves the respect we deserve. knowing full well, we continue to persist in a emotionally toxic environment, accepting & savoring crumbs when we should be having cake & frosting. (i am speaking in plural 1st person because i know i am not the first nor the last woman who has been through the messy d-word.) in the future, i have to love myself & not accept mediocrity because ... gosh darn it! i deserve better! ... and, thou shall not ever allow thyself to be in denial again when thy gut tells thou otherwise. =●/

dejected

2011-03-14T09:01:00.050-06:00

why? because i am one of those pod med students that did not match today. and, of course... i feel like a reject.

so... after you pay $350.00 or something like that and go through the hoops of interviews which also puts you out quite a bit... you get this post on your caspr account which either tells you you have been matched or you get a "we regret to inform you... blah blah blah blah blah blah blah blah blah blah blah blah..." if you were following, i never quite made it to frisco, texas, which is on the north edge of dallas/forth worth, where most of the residency interviews were centralized, because my car was broken into and i was robbed! i knew that was going to be one of those moments i would replay in my head, and second guess my decision to turn around and just come home.

this is how the stats for this year's match played out. just to give you an idea. it was not pretty. when i started pod med school, they had more residency slots than number of students graduating, and we were being told not to worry. what the heck happened?! positions available: 493. contending applicants: 555. matched applicants: 429. positions unfilled: 64. applicants unmatched: 126.

i am one of 126. and... i cannot speak for the other 125, but it most definitely feels like $#!t. maybe worst. but i am so numb that i cannot even type as i am posting this while i am attempting to keep my composure and not go ape $#!t. my thoughts are much more animated than the calm & cool sereneness i am exuding! it's much like watching a movie where the character pulls it together to look outwardly with it while simultaneously imploding. all i can think of is the 250k$ that i am in the hole for, and wondering how am i going to get trained and employed so i can start repaying my debt! *gulp* $#!t.

... a day for healing

2011-02-14T16:00:00.091-07:00

"love cures people, both the ones who give it and the ones who receive it."
~ karl a. menninger ~

it is amazing how much can change in one's life in the span of a few months. and, how many of one's own words one can eat. of late, i find myself reflecting and going through much introspection. going back a year, i found my post & was reminded that i had gone to a movie on valentine's day. however, it was the year before that i was home for my niece's kinaaldá, which i thought was last year. in any event, the movie was valentine's day, it was a movie that my daughter and i had planned to see because we are romantics; and, it was my daughter who had given me the heart shaped sucker which i had photographed and posted.

though i shared my thoughts and feelings about certain events and happenings in my life, for the most part, my personal life has never really been for public consumption. and, i rarely shared about negative issues that wove in and out of my life with a frequency that would not be tolerated by most. it was one of those situations which most of us, including me, would look at from the outside and say, "why on earth, does she put up with it?" and look at the matter with pity and subdued annoyance. because i did not want to appear as a whiner or killjoy, and truthfully, embarrassed as heck for persisting in such a predicament, it precluded me from speaking out, loud.

today is valentine's day, and it is one of those days when one looks back. sometimes one must in order to fully appreciate the present. i am grateful i am no longer just getting through the days yearning... for acceptance, respect, hugs, stability & love.
the present is... happy. soothing. compassionate. giving. spiritual. nourishing. peaceful. & healing. ♥

... toward a more perfect union

2011-01-26T19:22:00.173-07:00

while standing in the checkout line at the local grocery store, i perused the magazine racks for some reading material which would provide some insight. anything that would make sense of all that is happening in my world. though distilled to the bare minimum, i read the stories. actually... anecdotes about the paths four couples took, "toward a more perfect union."
i wonder... is it really that simple? and... if it is, that simple... why is the divorce rate so high? and... why am i apart of that astronomical statistic? am i that incapable of making such a "simple" thing work?
while exploring these questions, there is one salient point that keeps resurfacing... communicating from the heart rather than with the head. the heart is much more forgiving than the mind. the heart is much stronger than the mind. the heart loves and the mind judges, bargains, justifies and reasons.
the heart is simple. the mind complicates all things.

... redemption, of sorts.

2011-01-25T21:16:00.001-07:00

another skin-to-skin. actually... two! back-to-back! practice! as they say makes perfect. perhaps, not exactly perfect. but... as close to perfection a novice with limited skills and knowledge can achieve. =]

having had a bad day yesterday, i did not expect to even perform surgery. at best, i thought, i would scrub & stand off to the side. be as inconspicuous as one can possibly be in the o.r. as a matter of fact, i took my time scrubbing. i helped the circulating nurse prep the surgical sites and finally went out to the scrub sink while the rest were coming in having already scrubbed. as soon as i stepped to the table, i was handed the marking pen. straight dorsal linear incision over the 2nd mtp joint. half moons along the lateral and medial aspects of the digit meeting at the plantar sulcus. disarticulate the digit at the mtp joint. excise all tendonous structures. approximate the skin edges for closure & debulk excess tissue as necessary. suture. cut. suture. cut. suture. cut. suture. cut. again. again. until completely closed.

the first case was without a tourniquet. a wet surgery. cauterize as necessary to minimize bleeding. the second case had a tourniquet. however, because he had some issues with his metabolic panel, more specifically his potassium, the surgery had to be done under local anesthetic while the patient is awake the entire time. he did not tolerate the ankle tourniquet well. as soon as the digit was revised, the tourniquet was let down. yet, he still complained of pain. as it turned out, the plantar distribution was not fully anesthetized. so... more anesthetic injected. feeling complete numbness but pressure which is expected, the surgery continued. more debulking before approximating skin edges. closure. dressed the wound and placed in post-op shoe. just like that, i had 2 cases in one day! a good day in any student's career doing surgeries for which said student assumes no liability. however, the learning must continue. the next order of business is learning dictation.

interview... argh...

2011-01-24T20:45:00.001-07:00

it was telephonic. and, i still felt like i was standing in front of a firing squad. ugh! the social questions, i can handle. those are my strength. the academic stuff that relies on rote memorization is not my forte. there were a few memorization academic questions which i tanked. they were not hard questions. yet, i still performed poorly. bleh! i am praying that the manner in which i handled the social questions and having answered some of the academic questions correctly will count in my favor. and... i worked my hiney off while i was on rotation at that particular site which i hope also counts favorably. crossing all my fingers, toes & even my eyes. ha!

my sleeves are rolled up. next is my 2nd board exam. i cannot afford to not perform well. that would be a 900$ mistake.

the other site for which i did not interview due to the amarillo fiasco never called back. so, i assume that i am out of the running for that residency. sadly that was closest in vicinity to my family. however, there were some issues for which i had reservations; and as such, perhaps it is for the best. i am a believer in all things happening for a reason though we may not initially accept or understand the "why?!"

blunder

2011-01-18T20:32:00.051-07:00

it sounds like THUNK! PLUNK! FLUNK! ... and, i am not the best at accepting my shortcomings though i have many. up to this point, with my limited surgery experience, every opportunity i was given had gone well. the incisions were well placed. dissections as clean as can be expected for a novice. hardware fixations secure. closures everted just so for minimal scarring.

today, the misfortune of the weekend must have put a funk in my learning trunk. the blade got away from me a tad and unplanned incision was extended. upon closure and tourniquet letdown, the area of the skin where the unplanned incision though sutured remained white & pasty. ugh! one can predict from this blunder that that particular spot of pale spot would most likely become necrotic and form an eschar that would take a loooooong time to heal, especially in a diabetic with poorly controlled glucose levels. this meant, the attending... my preceptor had to scrub back in, resect and disarticulate the proximal interphalanx, excise the pasty white skin, reapproximate the skin for closure, close, blanche the periwound and assess capillary refill before dressing the surgical site.

when blade in hand, take control and do not allow anyone else lever the appendage needing to be amputated. lesson learned. it was humbling to say the least to stand there and watch my preceptor crunch, snip & sew -- correct my mistake -- in less than 5 minutes, flat! next time. sigh!

texas... bleh!

2011-01-17T17:18:00.002-07:00

never having been to texas or through texas... and, having mixed tales of texas, i was actually looking forward to my travels to texas, to find out through my own experiences. well... an experience it was. a bad one. so much so that i said, "i never want to visit texas, again!" a female doctor friend of mine strongly suggested i wear a black or dark blue pants suit with a white, off-white or beige blouse. originally, i had planned to wear a black dress suit. in any event, it was the pursuit of a black suit which brought us to the westgate mall right off the i-40 in amarillo, texas. we parked in front of dillard's and were in the store for 30 minutes. when we came back out, it was to a broken passenger side window with the trunk popped. along with our purses, all my bags with my clothing were gone. i lost a lot of valuables but the most priceless of all was my tádídíín bag that was an heirloom. it belonged to my cheii who had sewn the buckskin together with tendon. it had been the pouch from which he made his offerings to the gods at dawn. it was the pouch from which i made my offerings to the gods at dawn. that was such a disheartening hit. to add injury to insult, my daughter's tádídíín bag which i had sewn for her along with an arrowhead her father had given her were also in the purse she had stolen from her. much of my turquoise and coral jewelry is gone. never to be recovered. "it could have been worst. the car could have been stolen. or worst, the car could have been jacked with you and you daughter in it." given those scenarios, i am thankful that it was not as bad as it could have been but i cannot help but feel violated.
with the window busted & our tádídíín bags gone, i was not in a state of mind to continue. fortunately, i was able to bow out of my interviews and was instructed to reschedule them. which all remained to be seen... a huge risk for any 4th year podiatric medicine student to take knowing fully that their chance of getting into a residency rides on their interviews in frisco, texas. this seems to be one of those moments in time that changes the course of every subsequent event. for better or for worst, it is now part of my journey.

rez-momma style

2010-12-17T00:22:00.002-07:00

someone remind me to breath. one - one thousand. two - one thousand. three - one thousand. back from my son's turning blue ceremony and boot camp graduation. all that was said fresh in my mind. completely in mommy mode. hyper-protective mom mode. and... there is this little miss thang sending, "i miss you," messages. ugh! if this girl had not already broken up with my son because he told her he was leaving for boot camp, i might not feel as i do. this girl has no idea exactly how focused my son needs to be. as a mom, i want not one floozy to be contaminating my son's mind nor messing with his emotions. he says he knows how to handle it and has in no uncertain terms told me, "mom, i love you. but... please butt out!" i have to admit i did something i am not proud of as i have always prided myself of being a non-meddling let them learn on their own type of mom. tonight, i posted a comment to little miss thang's, "come back already! i miss you!" comment. bleh! as a mom, i only want my son to be happy but even more, i want someone who will value and honor him as the kind-hearted young man that he is. because... i know that my son will treat the woman he loves &/ marries with respect. it pains and frustrates me to see him being entranced by someone who i believe is not good for him. after a long text conversation... yes... a text conversation... honestly, as hotheaded as we both can be, it was for the best. in any event, after a long text conversation, i agreed to butt out and reminded him i only have his best interests at heart. and, he conceded and admitted to knowing she is not good for him but implored me to allow him to handle his own affairs as a man. yes... he said, "mom, i will always be your baby. but... please let me handle my personal life as a man." as a man, he said. oh... my poor heart... god, i pray... please... let me have the strength to keep my piece and patience to allow my son who is now a young man to live his life. of course, after our conversation, i went and erased my comment. i am pretty certain she read it already but no one else needs to see it. it was not mean or anything. i even said thank you. but... of course, to the young navajo women of today, i am sure it is worst to her than it was "coming out of my mouth". and, truthfully... i was being a bit of a bully. rez-momma style.

with my daughter, i am just as bad. it is so hard to not want to cushion every fall. for that reason, i now know she keeps a lot from me, which is unfortunate. it pains me to see her struggle and to know that i am in many ways responsible for the way she handles her emotions. it has taught me a lot about myself to see my minime struggle through her first semester at college. it has also taught me a lot about just how determined & committed she is to developing her craft. she is truly talented. i am in awe of her gifts. of course, i worry about her partnering with a bad man just as much as i worry after my son. my concern is so intense that i even broached the idea of an arranged marriage. my poor baby girl. the incredulous expression! along with the, "mom... what happened to your liberalism? so... you are liberal when it comes to other peoples' kids but very conservative with your own. oh my god, mom... you are a hypocrite!" all i could do was blush and sheepishly agree to assessment of me as a mom. then she asked, "don't you trust me to pick my own husband?" to which, i said, "of course. i was just asking if you are open to the idea of being arranged?" to which, she said, "mom... please trust me." i am a meddling mom. so... rez-momma style.

my heart melts and bleeds for my children. i pray for their successes. i pray for their happiness. i pray for their well-being. i pray for nothing but goodness for them. however, i realize there has to be some hits to the ground for them to learn to get back up and dust themselves off and keep on keeping on.

being a mom is the toughest job i will ever love.

interlude

2010-12-09T06:14:00.000-07:00

december 1st, i showed up ready to work. it was a full clinic schedule in addition to surgeries on the board for that day. suffice it to say, it was one busy day. the attending and residents were happy to have an extra warm body that could simply roll up her sleeves and work. being new, i had no computer access and no id badge. this is a bit limiting but i worked anyway. after clinic, we rounded on patients. and then, home we went.

this pattern is pretty much the same each rotation. it is usually peppered with presentations, workshops and conferences. presentations off-site are nice because they feed you well, and they're usually done by vendors. everyone wants you to know about the new gadget, be it internal fixation plates, screws, rods, anchors, "skin" grafts... etc. when you're a student, you are so broke all the time that you take any food that is offered free. i am not as principled as some who will opt not to participate in these free meals. there is a story there. a worthy one. but no time for that now.

the proximity to my daughter who is finishing up her first semester at i.a.i.a. in santa fe, is a blessing. this evening, i will be going to pick her up. yay! albuquerque is big enough to remain anonymous but small enough to enjoy. being a rez chick from the boondocks, admittedly i have a small town mentality. as such, i enjoy smaller towns which enable me to establish some rapport and intimacy with it. so far... new mexico... is a fit. and, i am loving it here!

change

2010-11-30T04:01:00.024-07:00

changes aplenty. it is easier to instigate change. once the effects of change begin to tumble like dominos, it presents more challenges. the only thing that motivates me is the peace & harmony i want in my life. ☼

skin-to-skin

2010-11-18T17:29:00.073-07:00

something exciting happened for me today. it was a complete surprise. the patient went under general and we anesthetized both his lower extremities. one a popliteal block and the other a mayo block. we applied the tourniquets and positioned the patient. then went out to scrub. rub-a-dub-dub-dub. suds as we scrubbed. got into o.r. 9. gowned and gloved. draped. ready. set. go. i got the skin hooks ready to retract when dr. g asked if i had my step stool ready and took the skin hooks from me and handed me the 15 blade. immediately, i retrieved pick-ups from the table and dry cut along the marked out incision line. then, a soft incision to which dr. g reacted, "get through the skin," with bovie in one hand. so... i cut through the subcutaneous tissue, using cautery as necessary. cleared the subcutaneous tissue and incised through the capsule of the 1st mp joint, and underscored osseous attachments away and exposed the met head and base of the proximal phalanx. then... dr. g retracted with holmann's while i used the saw blade to take off the base of the phalanx. used the towel clamp to get a solid grasp of the resected bone and used the blade to underscore plantar osseous attachments. wa la... the bone came out. evaluated if more bone needed to come out before suturing capsule back together with a 3-0 vicryl which dr. g did. then, i used a 3-0 prolene to sew up the incision. applied dry dressing and created a temporary anchor while dr. f finished up with the right foot which went through a transmetatarsal amputation (tma). instructed the anesthetist, "tourniquet down on blue," which he confirmed, "tourniquet down on blue." tourniquet time was 37 minutes. a fist pump and, "duuude..." from dr. g as we walked out of the o-r when i told him that was my very first skin-to-skin. then, dr. g inquired, "what are you thinking?" first and foremost on my mind was my silent prayer... "holy people, the o-r gods, lord... calling on all of you to please help heal our patient." trailing behind that thought was, "did i really do that procedure?" with my eyes still somewhat glazed with surprise and hidden pride. *slapping down the ego* as i offer my prayers of appreciation for this seemingly charmed existence in my tiny corner of this blessed universe. ahxééh nisin. my audible response to dr. g, "i am still processing it..."

moving on

2010-11-10T01:20:00.057-07:00

"success is not final, failure is not fatal: it is the courage to continue that counts."

~winston s. churchill~

i wonder what good old winston might have been thinking of or speaking to at the time he said this. i am sure there is some historian out there that would delight in schooling me. in any event, whatever the case was... it sure applies to all that is happening in my world.

my question is... is it my failure if i tried my best to make something work which the other contractee took for granted and dishonored with lies & cheating ways? i think not. the stigma associated with being divorce & the humiliation of having to admit to another separation and the impending ugly "d" initially almost paralyzed me to just leave my status in limbo while living solo since june 1st. in other words, stay "married" to avoid having to admit that i have had another failed marriage. i wish i could simply blink my eyes & undo the marriage... actually... the entire relationship altogether. what a colossal mistake! bleh! bleh! bleh! bleh! my only objective with respect to this situation is to legally extricate myself from the mess of it all and pah! pah! pah! pah! it all away!

and... move on.

... time flies!

2010-09-01T19:16:00.000-06:00

how many times in the last year, i wonder, have i said, "time flies!" another year older as of yesterday. not exactly sure if i feel a year wiser. in any event, my special day was spent getting back into the mix as i was on a REZcation for the month of august. it is a staycation only on the rez. no smog. no police sirens. no concrete. it was a wonderful way to get rejuvenated before i begin my next rotation. yesterday was my first day at the tuba city regional health care corporation. the one thing i like best is that i can speak navajo to my patients. some of the navajo staff appeared somewhat surprised by my appearance in the o.r. scrubbing and assisting but already today, the scrub techs knew to ask my glove size and have a gown ready for me. it feels so good to feel needed and wanted and appreciated... especially by my own people. there are many thoughts going through my noggin but too early to say one way or another how i feel about certain things. most definitely going in the to be continued category. as such... more to come on this later. =)

r + r on the rez = a happy rejuvenated me

2010-08-20T19:00:00.000-06:00

not doing much other than relaxing and hanging out with my sister or mom. after signing the necessary documents for my minime, i got on the road back home. made a few detours before i pulled in around 0030 hours tuesday morning. crawled into bed and slept.

tuesday morning, because it rained a lot the night before and the roads to my sister's place were a mess, i volunteered to drive her to work. while she put in her hours, i changed and packed my water bag and headed down the white house trail. tracks of other people ahead of me, i began down the hill. 1/3 of the way down, a group waited as the one who i assumed is the father took picture after picture of the canyon. passed them and saw only two other pairs of footprints as i made my way down the hill. 2/3 down the way, passed another "photographer" walking in flip-flops, not exactly the kind of shoes one ought to be wearing on a dirt trail especially this one. oh well... *snap* here and *snap* there, zipping and zapping photos with my mobile phone. made it down to the bottom near the vendor stands, ruins and the outhouses. having had lots of fluids prior to my arrival, i made a bee line for the outhouses. whew... backtracked to the vendors. ooh'd and aah'd at several turquoise necklaces that caught my eyes. got back on the trail with plans to visit spider rock overlook. once back on top, my car would not start. brilliant me... left the headlights on and killed the battery. fortunately, two of my sisters and one of my best friends work in the community of chinle who all got a sheepish somewhat frantic call from me. there i sat in the sun, tanning. hahahaha! much to my mom's chagrin. much to our dismay, the battery would not recharge though we attempted to jump it. even the local garage was unable to recharge the battery and deemed it permanently dead. a new battery later, gassed up and visited the vital records office to get new copies of c.i.b. for myself and daughter. by that time, it was almost time to pick up my sister so... i waited for her. as it turns out there is a name for one who sits and waits in the parking lot, ... ésdáhí. that evening on the way home, we shoveled dirt into the ruts on the hillsides created by the run-off. as we toiled with our shovels, we recalled how our yáázh who has passed on used to make sure the roads were driveable even though he did not own a vehicle of his own.

the next day, my sister took a day off from work and we started our day off with a lengthy walk down and back up the hill to her place. one of the tires had flattened on her car so we fought and beat the darn tire off. let me tell you... those nuts were screwed on so tight that no amount of jumping up and down on the crowbar made two budge. finally getting smart, we found a metal pole to attach to the one end of the crowbar to extend the lever arm which loosened the nuts like cutting soft butter! holy... it was just as funny & fun putting that darn tire back on.

when we were kids, my sister and i were inseparable. it is said that i was the naat'áanii of mischief! my sister who is 1.5 years younger than i, followed me and pretty much would mimic my lead, and oh... the trouble i got her into... she could always just say, "q.... áníigo..." and get a get-out-of-jail-free card, and i would be the one getting a stern talking to... a long winded lecture. in one ear and out the other, and out back doin' my thang... i was probably the ch'ízhii jaany female version of dennis the menace out in the boondocks! hahahaha! thinking back... all we can do is laugh recalling the hilarity. bead up my nostrils to save my necklace... a visit to the emergency room for extraction. ayá! scar on my left thumb from a cut by a razor blade cutting sand cakes. haha!

simply vegged the next day. did absolutely nothing. not even a walk. the only thing i did was cook dinner. hot tortillas. potatoes, spam and onions. it rained, again.

before the sun rose, i set out on my walk. initially, i planned to walk out to the trading post and make my way back up. then... the fog set in. as the sun rose over the horizon, the condensation between the sky and earth resulted in a thick fog. instead, i turned around and went back. after my walk, i readied and drove down to my mom's. she had plans to visit the school, and i accompanied her. we visited the classrooms at the high school, jr. high and elementary schools. we observed and spoke with some of the teachers, employees and administrators. one teacher expressed concern about the disrepair of the stone building. this is the first school building in rock point. an idea is brewing in my head. a project. all about giving back to the school that contributed much to my foundation as a person. more to come on this...

hágo shíí...

going back...

2010-08-20T17:38:00.013-06:00

though i had been back for various events at my old elementary & secondary school, it was not quite like today's visit. i followed my mom in her capacity as a school board member. i went in my capacity as a former student of the school. it was nice to see familiar faces and old places. my heart is tethered to this place. my conscience. the tune & beat of me as a diné asdzání professional was set by the beautiful people and teachings of this place. ♫♪♫♪ it

a view through this momma's heart

2010-08-15T19:00:00.003-06:00

TIME FLIES!! 13 years ago, i was meeting with the principal of tsaile elementary school to convince him to take my 4-year old, soon-to-be 5 years old because her birthday was after the september 1st deadline to which the public schools in arizona adhere for kindergarten matriculation. memories of my beaming girl walking out of the interview shaking hands with the principal, and turning to tell me that the principal told her she has a million dollar smile, flood my mind as we unload her belongings off the cart in her college bedroom. as i sit here writing this entry, she unpacks in her room. i choose to be visibly absent as she needs to assert her space. she needs to ground herself to this place and let these new surroundings know she is here to stay and that she will not leave without her bachelor of fine arts degree in 4 years. after my meeting with the financial aid and scholarship people tomorrow, i will head back to the rez. over dinner last night, my minime tells me, "mom... i would like to go to most of the orientation stuff by myself. i need to make friends and find my footing. it's hard to do when you're around. you overshadow me. even when you just sit there quietly, you have a presence." in other words, "it's about me, mom..." throughout her high school years, i stayed as far in the background because 1) i wanted her to have her own experiences; 2) i never wanted her to feel i was trying to re-live high school through her; 3) i wanted her to have her own space; and 4) i wanted her to get a sense of herself. and... this college experience is no different. this is her time. her time to shine. her time to succeed. her time to live. her time to determine her journey. her time to pursue her dream. my time to beam my million dollar so-proud-of-my-baby smile from front row seat.

tomorrow as i drive away from this place, i will have left a huge chunk of all that i am in santa fe, new mexico. once again, i will offer my corn pollen prayers for my yazhi to be of clear mind, body, soul & heart.

installment 1

2010-08-11T12:25:00.009-06:00

where to begin?...

denver was an awesome experience. not only was the clinical experience awesome but the personal experience was wonderful. each week, we had 7-8 journal articles to read, present & discuss for journal club. we each were required to present on a topic during a luncheon with one of the attendings who was an incredible teacher. each day, there was something new. a lot of pimping. a challenge that was most definitely worth anyone's time. outside the clinical rotation... there were so many places to see & to go. outdoors. indoors. it never occurred to me that i had so many friends in the outlying denver area. as my month progressed, my weekend calendar filled with invitations for overnight weekend visits. though i missed my children, i did not have a whole lot of time to feel "all lonely" and get into the "woe is me" rut.

just a few highlights. dinner at deene's. dinner at the willink's. stay-over at the sauer's and an attempt to ride my bike with a bum knee through the garden of the gods. a trek up to mt evans on my last day in denver. omg... now, cresting mt. evans was incredible and exhilarating. actually... quite spiritual. made an offering with my tadidiin at 14,130 feet.

the best way to describe the drive through wyoming is rolling hills, ranch country & cowboys. :) as i drove through and crossed numerous rivers and traveled through towns, the lyrics of chris ledoux songs resonated so profoundly. in kaycee, wyoming, there is the chris ledoux memorial park which i stopped to visit & pay homage to the man whose concert was my son's first at age 5 years old. forever branded in my mind is my 5 yo son dudded in his western shirt, kiddy wranglers, cowboy boots & straw hat so excited to see chris ledoux. he lasted through one song & layed curled up in my arms the rest of the concert. sweet memory.

with hopes of crow agency being right up there, i trekked on.

to be continued...

"it's your heritage...." and other rumblings...

2010-07-26T23:06:00.002-06:00

while in locker room changing out of scrubs into o.r. scrubs, got into a conversation with a bilagáana woman. she was raving about the movie, "eclipse". she asked if i had seen it, to which i told her, "no... the 2nd one was such a disappointment that i didn't want to waste money on this installment." so... she proceeds to tell me about how the tribe convenes in council, etc.... etc.... and then... she proceeds with, "well... you know... it's your heritage. you understand. you really have to see it. i don't think you'll be disappointed. btw... the wolves are way hotter than the vampires." all i could do was nod my head and smile. honestly, i did not even know how to respond nor react. as clueless as she was, i had to give her lots of credit for being nice & conversing with me. as a student, especially as a person of color, a minority, i almost feel invisible & i have to find ways to be noticed in a positive light. and, simple, lighthearted, mindless chatter can lift the spirit. :) actually... while on this topic, i have to add that it cracks me up even more when people reference tony hillerman as their source of knowledge about the southwest and especially the navajos. they almost believe jim chee and joe leaphorn exist in real life. hahahaha!

otherwise... today was surgery day & i stayed in clinic instead. why aren't you in surgery? well... o.r. 2 is crowded. a 1st year resident and a 2nd year resident on the case with dr. b, and a 3rd year resident floating, in addition to the anesthesiologist, scrub nurse & float nurse and there seemed to be additional people in that tiny space. the closest i would have gotten was probably at best a visual from 5 feet a way. i much prefer to scrub and at least hold the retractor and observe all that is happening. i suppose i could have just watched and listened but i know myself well enough to know i would have been bored to tears and i would most likely have been yawning. that would have left a not so good impression.

this is my last week in denver. my stuff is spread out across the room. every time, i come back into my room, the realization that i will be packing & moving on again to another location becomes that much more stark. though i am quite adaptable, these changes i have been processing for the last 2-3 months have not been easy to make peace with in my heart. on the surface, i may look fine and unaffected but deep in my heart & soul, i yearn and ache for the times when my family was all under one roof. *sigh*

when i crashed on my bicycle on the gravel road, i think i caused more damage than the superficial scratches and gashes. the scratches have healed & epithelialized. the gashes still gape but are shrinking in size and depth. however, now that the pain associated with the cutaneous lesions have subsided, the instability & discomfort in my knee joint is more noticeable. i am hoping with all toes & fingers crossed that it is a minor inflammatory reaction to the trauma that will remit with some rest. inactivity sucks! so... naturally, i will be giving the temporarily gimpy knee a trial in the morning. i thought about getting one of those otc knee stabilizers but then i would not be challenging the muscles to work and they will certainly atrophy some and then my knees will be even more asymmetrical. hoping for the best. =)

friends

2010-07-25T19:05:00.009-06:00

friends. are necessary. they are family that i have chosen for myself. my friends have made the changes that i am going through bearable. i offer my prayer of appreciation for friends. ☺

dinner at deene's

2010-07-18T22:33:00.068-06:00

got going a bit late but made it after a few missed turns. the navigator on my phone kept wanting to take me down a closed road & like an idiot, i did. fortunately, there was not a discontinuity in pavement where i needed to go. things i read about, i finally experienced. first off, kita is the cutest dog ever but scared the living daylights out of me. so... i kept my eyes averted and did my best to ignore his presence. the mango salsa was a definite hit with my taste buds. i could have just taken a fork to it and ate it like a salad. it was that gooood. deene usually describes her little family as "the kid" and "the hub". her family is way cool. her daughter is very sweet & hospitable, also kept an eye on kita. :) her hub suggested i go up to mt. evans, the peak that deene blogged about going up a few weeks back. apparently, it is the highest paved road in north america! cool! see... now, i will most likely get up there. i think i was already up there back when i was a teenager participating in the aiub science & self-determination program at cu-boulder. the food was great. it was the conversation that was the best -- going from food to her parents to the doctor being a bit confounded about the fbg and hgb a1c not trending the same way we are taught they should to the brains only currency glucose to things baked with splenda turning out pale to trying stevia and finally the politics back home on the rez. yeah... another smarty kin łichíi'nii sister. :D after dinner, they gave me instructions to the easiest way home and before i knew it, i was "home". unfortunately, when i checked if the primary election ballot was online, i learned that the application to request one is due at the navajo election administration office TODAY. argh! this means... i will not be able to vote unless i amend my trip itinerary and go home earlier to vote instead. dilemma.

in any event, it was a great way to wrap up my weekend. thank you for the awesome food & your hospitality, deene. :) i hope to one day return the favor when you decide to visit to the southern edge of the rez, and i hope my home will be back in order by then, too.

life teaches me ...

2010-07-17T11:13:00.047-06:00

"the weak can never forgive. forgiveness is the attribute of the strong."
~ mahatma gandhi ~

when i come across a quote such as this one by good old mahatma gandhi, i realize just so how humanly flawed & weak i am. in my own little way, i really try to aspire to peace, humility & compassion. even towards people who most would consider as bad & possibly irredeemable. by no means am i perfect, nor do i try to be. the only thing i can do is try to be a good human being everyday & not hurt people needlessly. there are days when i am so prickly, judgmental & impatient. then... i remind myself, in the grand scheme of things... this too shall pass & ask myself... what will i gain from blowing a gasket? aaarrrggghhh... i try. and... i try. :)

crunch...

2010-07-15T22:38:00.000-06:00

what a strange day... when they call it complex clinic, they really mean it. first hour, we had journal club. blew through 7 articles and ended it by talking about how biomechanics is such a strange animal. and... a quarter of our lunch hour was spent on the racket that custom orthotics can be for some private practices. so... the sentiment by the time lunch time ended was that otc orthotics were just as good as custom orthotics. then... crunch happened. a male pt in his late 40s presented with pain localized to his rearfoot bilaterally. the forefoot was in valgus and his arch were high. when all the physical exams were done and radiographic images reviewed, we were still a bit confounded. crunch had a cavus foot type with forefoot valgus and mild equinus. interestingly... this is the one time the attending on for the day retracted his position on custom orthotics and proposed custom orthotics as a conservative method of treatment before any surgical options are even considered. initially, we thought perhaps crunch had sinus tarsi syndrome and the resident i was with wanted to inject local anesthesia for diagnostic purposes. however, we ended up digitally casting crunch. the decision to obtain digital casts of crunch's feet was a bit of a surprise to me as i thought cavus foot type was one time that you actually used plaster to create negative casts. apparently, not always so. anyhow... crunch was a bit of a weirdo. while i was shaving a callus & wielding a sharp blade around the bottom of his heel he asks if i am married as he could not tell whether or not i was sportin' a wedding ring underneath my gloves. wah! i politely answered yes and also immediately pulled off my left glove & waved my ring at him. fortunately, he behaved himself the rest of the visit. patients like this, i prefer to have another person in the room with me. his sister was there but that didn't stop him. yáadi lá! t'óó bił crunch, ya'? hahaha!

nothing but...

2010-07-14T23:49:00.004-06:00

"better a cruel truth than a comfortable delusion." ~ edward abbey

suffice this quote to sum up my sentiments regarding a compartment of my life. enough said. g'night.

still arriving...

2010-07-12T23:00:00.027-06:00

"A good traveler has no fixed plans and is not intent on arriving." — Lao Tzu

sometimes i wonder if i will ever arrive. for the last few years, i have been working towards a goal which i believed would help me arrive. now, i realize there is still much work & learning to be done before i can even really feel comfortable and lay claim to having arrived. however, i can also admit that as i near arrival, there will be presence of more exploration and learning which will surely be added to the itinerary. the journey is endless.

warped

2010-07-08T22:44:00.080-06:00

30th june - tucson, az - 2410 ft - 110.3°f
30th june - phoenix, az - 1214 ft - 115.2°f

1st july - flagstaff, az - 6960 ft - 89.2°f

2nd july - gallup, nm - 6469 ft - 90°f

3rd july - rock point, az - 6037 ft - 86°f

3rd july - towaoc, co - 5919 ft - 89°f

4th july - albuquerque, nm - 4999 ft - 91°f

5th july - santa fe, nm - 7020 ft - 81°f

5th july - taos, nm - 7249 ft - 83°f

5th july - angel fire/eagle nest, nm - 8379 ft - 80°f

5th july - trinidad, co - 6124 ft - 85°f

5th july - colorado springs, co - 6012 ft - 79°f

5th july - denver, co - 5370 ft - 83°f

6th july - boulder, co - 5430 ft - 90°f

i am not entirely sure why i thought recording the elevation & temperature the day i passed through each town would be of any interest to anyone but myself. but... i did it anyway. and... there is probably a great idea behind this tedious record, long forgotten, as i am already onto something gooder & better. hahaha! i wish! as we used to say in boarding school. speaking of boarding school... as i type the words, "boarding school," in my head it sounds a lot like the way vincent craig used to say "boarding school" in his bestest mutton man accent. may he rest in peace.

2010-07-07T23:01:00.000-06:00

"My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style" ~ Maya Angelou ~

one would think at a certain age, one should have it figured out and all working as it should. by it, i mean life and all that it encompasses. when i was 17 years old, i knew exactly what i did not want in my life but was not too sure entirely what i wanted. the adults in my life had it figured out and i merely went through the motions. not really have a purpose or direction though i did have a lot, and i mean A LOT, of opinions about how life should not be. as way leads to way, i meandered and ambled. here i am in my 40s finishing one thing that i did know i wanted to do in life. initially, it was to make my mom proud. so proud that she would beam for days. so i thought. med school has a way of teaching you a lot of things about yourself that you thought you already knew & put in your personal statement. if not there, at least, you divulged in your interview. anyway... i learned pretty quickly that i had better be doing the med school for myself or i would float to the top of the tank with belly to the sky and eyes rolled back. or does that really happen? so... as i was saying... one learns that one must accept the process of med school and love it and really want it. and... i mean... reeeaaalllyyyy waaaant it in order to have a fighting chance in med school. otherwise, why waste time and lots & lots & lots & lots of money to submit yourself to the arduous ordeal that is med school. the entire time i have been in med school, i have clung to the idea of merely surviving because some classes... you are happy just to have survived it and work your little heart out to make up for the dip in grade points for the one you barely passed. at some point, you hit your groove and you want to do more than survive. the idealist in me has always wanted to thrive & have the drive to do more than just survive. maya said it best. :)

1 month down

2010-06-30T06:25:00.112-06:00

today is my last day in tucson. it is wound care day. the best part is that once the last patient has been seen, i will be free to go. and... i must be packed & checked out of the place i have been hibernating.

many thought reel through my head as i try to replay the month to highlight the pros and cons of tucson. being here has been as much my chance to feel out this place as it has been for them to preview me as a potential fit in their residency program. though i love this place, i cannot say with certainty that i feel the affinity reciprocated. i guess it remains to be seen until match day. the huge pros: though there are not a whole lot of surgeries, the residents do much of the procedures, skin-to-skin; residents are cool & laidback but work hard; good friends live here; and i am already familiar with the town. the cons: the approach to wound care is a bit different from what i learned and not as aggressive as it should be; though it should not surprise me... the demographics of the resident: ~70% white, male & conservative; and lastly, the program seems a bit disorganized but i have an appreciation for the hierarchy.

however minute, some of the cool things i got to experience in tucson: (1) maggot therapy to clean out a nasty ulcer with LOTS of fibrotic debris in the wound bed. (2) first cut, albeit into an infected foot with gas gangrene. (3) surgical matrixectomy in clinic. (4) café cosa poca... really good food. seriously! (5) el guero canelo... great place to go for mexican food at lunch time right on the southside. (6) a 2-bedroom apartment all to myself for the bargain rate of $95/month. (7) fast commute (8) i know i am forgetting other stuff.... :(

all in all, tucson was a good month. i will miss the cool & laidback nature of the town. and... i will most definitely miss the awesome mexican food. i am sure i will be saying this again when i am in albuquerque. haha! and... it will all be true as long as i do not declare it as the best. :) for now... i must pack my world back into my war pony, narbona iii, and continue this journey. adiós tucson.

a resurrection, of sorts ...

2010-06-28T20:30:00.001-06:00

at the beginning of the month which was the outset of my 4th year, i committed to write as regularly as possible and that has obviously gone by the way side. much primarily due to changes that have been occurring in certain compartments of my life which i had, to date, chosen not to disclose as they are not happy events however necessary. while i have been grasping at anything to anchor me to this place in which i have some sense of stability, the professional aspect of my life has been going full speed ahead. one thing i learned well in med school is how to triage aspects of my life so that i can assure the survival of the medical student, and this translates by some standards to being labeled selfish or as one of my professors once told me to be, "self-focused." anyway you slice it... i am making choices & decisions that most benefit me as a medical student. for better or worse, it is that way. these changes have made me question my sense of self, my identity, my worth as a woman, as a mother and as a wife. for so long, at times i would feel like i was simply stumbling along, while at other times, i would feel like i am lugging the heaviest stone all the while trying to survive med school. it has been my private battle with the exception of my counselor and my best friend from college, and my sisters who have long since stopped giving me any kind of advice though they have remained my reflecting pool.

having been raised to always put others needs before my own, it has been a tough asserting myself. as my newly graduated from high school child put it, "mom... you have to start looking out for yourself." one day a long time ago, i realized that i was groomed to make a perfect navajo wife circa 1950s. obedient. subservient.

in the past, my professional strong woman persona often clashed with meek dutiful woman that i had & have always been in my personal life. when i went back to school, somehow the strong woman got beat down and all that remained was that woman that toed the line and worried about everyone's needs before her own. until it conflicted with her dream to become a doctor. as i have progressed through each year, bits and pieces of that strong woman that i once was is returning. she is taking up residence, and i find that i am feeling her. she fits. her strength surges through me. reawakening parts that have been dormant so long that they are almost virgin.

though i have missed my children immensely, especially my daughter, this solitary existence has been nourishment for my soul. in a couple of days, i will be making a reacquainting with these other facets of me. honestly, i do find that i am nervous. foremost in my thoughts is... will i continue to honor myself? self-love. one tough lesson to learn especially when existentialism has always been foreign in the teachings of your childhood.

old way vs. new way ... either way... still learning

2010-06-09T00:41:00.063-06:00

casting for orthotics & writing prescription... treating foot pain conservatively is an art & a science. today, we casted one patient for custom molded orthotics capturing the feet in plaster with the ankle joint at 90 degrees and sub-talar joint in neutral position. then a discussion ensued when it came to prescription writing because i thought we would get a low arch fill which translated to as much arch support as possible, but the resident who was writing the 'script wanted to give the patient a normal arch fill which would not bring up the arch fill too much, and all intrinsic posting as she diagnosed the foot pathologies to be localized to the forefoot. being fresher out of biomechanics, i thought throwing the kitchen sink to put this guys feet in the best corrected position was the way to go. however, the resident having more experience treating real patients not theories, explained to me that we do not want to hurt the feet as too much change in 50+ year old feet was probably not the best treatment option. as it was, the foot pathologies prompting the new changes in orthotics were primarily in the forefoot such as a morton's extension to bring the ground closer the 1st metatarsophalangeal joint.

the second patient we casted, we did by digital casting with the pedalign digital casting scanner. being taught old-school with old-school dogma which has pretty much remained to have prophetic value, it is strange to accept the use of equipment which allows for too many shortcuts and no real foot impressions. the digital cast from what i know is not in 3d. whereas, the capture of foot impressions in actual plaster is much more specific capturing skin lines, bony prominences and any dermatological lesions secondary to abnormal gait. there had to have been comparison studies concerning efficiency & efficacy of the two methods of casting. it still takes the company 6-8 weeks to get the orthotics out to the patient. my only hope is this patient gets orthotics that will surely work to minimize the pain.

in clinic today, a light bulb flickered in my noggin. it was not so much an aha! moment but more like an argh! noise which will only be cured by minimizing the deficits in my knowledge concerning physical therapy treatment modalities. this may actually be an appropriate topic on which i can present to satisfy my clerkship presentation requirement. it will serve 2 purposes. the 1st, my hope that others learn from my presentation but 2nd, mainly... that i learn so that i can help my patients be well-informed consumers of physical therapy.

sleep is upon me. zzzzzzzzz

back on the trail

2010-06-07T19:21:00.032-06:00

oh my gosh... i have been a slug for so long that it has become 2nd nature to me. in so long, i mean approximately 8-9 months. getting out of slug mode is not an easy feat especially if one has been stagnant for more than 1/2 a year. the excuses are too numerous for print but it all comes down to one deplorable trait: iłhóyéé'. lazy-ness! in an effort to rectify this mess, i finally laced up & got my idle behind back on the trail. starting out slow & on a well-maintained fairly flat trail. nothing like the rocky hills i enjoyed at thunderbird park or the white house trail at canyon de chelly. :(

2.0 miles.

surviving empty nest

2010-06-06T12:54:00.023-06:00

i survived. enough said. but... my heart gurgles & hiccups. this was the first week & weekend i have been without my family. the feelings are indescribable which i do not particularly enjoy, nor do i see myself embracing it. being without my family especially my children is a state of circumstances i detest but must tolerate & endure as a consequence of what i must do for myself as a 4th year pod med student living on the road. bleh!

first cut

2010-06-04T23:37:00.041-06:00

we divvied the surgeries yesterday and settled on me scrubbing on the first case and my classmate would get the two remaining cases. then a case requiring an emergent i & d procedure came in. when the resident got called to the e.r., i followed as there weren't any patients in clinic at the moment. my 1 surgery day turned into a 2 procedure day. yeah...

the best part was the attending offered the blade and asked, "have you ever cut before?" and when i answered, "no..." he said, "there's always a first for everything."

albeit it was an already messed up foot, it was an exhilarating experience to cut on a live foot. on a cadaver, of course your expected to not mess up but no one cares if you do. whereas, a cut on living tissue is a completely different story.

all i can say is... i wish i discovered i was meant to be in the o.r. with a blade in hand a lot sooner. holy... what a feeling... however, i must remind myself that humility is a virtue. as getting a blown head can be a double-edged sword, as the saying goes. :/

need a routine

2010-06-04T00:10:00.026-06:00

still slowly decompressing... and, catching up on sleep. my internal clock is completely messed up. when i get home, i am so worn that i crash & wake at around 2200 hours with renewed energy. which explains why i am still up. so... i would not necessary label this insomnia. the circadian rhythm is f'ed up. though thinking back to my study habits, this is really how my patterns have always been. i am most lucid at midnight to 0200 or 0300 hours. however, surviving this year requires a routine that will be conducive to sleeping "normal" hours and making the best of the waking hours. argh! time to make myself go back to sleep. g'night.

decompressing

2010-06-02T20:36:00.142-06:00

where to begin?...

let's start with the 28th of may, 2010, last friday. my daughter graduated from high school. of course like any proud mother would, i beamed with pride & happiness. her father was there as well. the next day, she packed up & moved to new mexico to live with her father for the summer. my minime and i have never been apart for more than a month. though i knew she is only going to be a few hours away and we knew this was coming, it was still heartwrenching. my poor little jéí felt as if it was physically tearing. my sisters came over to keep me company & help me pack. and i was fine as long as they were there. after they left, it hit me that i was alone. ALONE. this is a bit of shameful admission especially since i am usually quite stoic, but... i bawled. then i remembered the teachings of my cheii & másání, "doo t'áá 'ádzaagóó jicha da!," and i stopped & regrouped by rolling my tobacco and prayed. what's a momma to do?

sunday & monday, my youngest sister and both brothers came over to help me move stuff out of the bedroom and pack away stuff which i will not see for another year. it dawned on me how much i hoard. yíiyá! łé'étsoh nahalingo ts'iilzéí áłah áshłaa lá. what a horrifying realization! lots went in the trash. there was simply no time to run & donate stuff to the shelter or any other place. to make matters worst, there was absolutely no room in the chídii to hang onto the stuff until i passed a donation bin. :( so... the hub & his crew finally showed up a little past 1800 hours on monday to pack up the rest into a moving van. with lots still needing to be done, the housing director stopped by shortly after 2000 hours to get me checked out with my promise to clean up. when we moved in, the place was a mess & i was so tempted to leave the place as such but my conscience would not allow it. this meant that i was still there to 0130 of june 1st scrubbing the place down. omg... i was sore & completely worn, physically and emotionally. a short prayer of thanks in the place one last time as it has been our home these last 3 years. it was our anchor, albeit temporary.

then... the silliest thing happened. it took me 1.5 hours to get to my sister's place on the other side of town when it should have at the most taken 30 minutes. tired & just hanging on, i got lost 2x! unbelievable. my sister who i call my human gps especially in phoenix, had to redirect both times. i love my baby sister. she is always there for me. i finally hit the bed at 0300 hours. the last i remember was telling her i was now too wired to sleep. not even a minute later, i was out for the count.

at 0700 hours, i notice the sunlight streaming through the blinds! OMG! panic mode! i overslept! my sis left after giving me hug & wishing me well. and... i could not find my phone. i could not find anything. i felt like chicken little. the sky is falling! and, it was still too early. ha! shower at super uber warped speed. ironed clothes on make-shift ironing board & dressed in a flash. then woke my little brother from his somber to help me carry 2 more boxes out. no room in the car but we made them fit. haha! on i-10 and i could not see at all out the back via rearview mirror, and semi-obstructed view with sideview mirror. praying like a revivalist (no offense intended)... i begged all the gods i believe in that i make it to tucson with some time to spare to unload a few items so i can see where the heck the other cars are in traffic, and that i not get stopped by the police for there were way too many issues for which to be cited. seriously... 1. windshield cracked all the way across the front. 2. registration is expired 2 months ago! uh-oh! 3. car packed to the gills & obstructing views to back & passenger side. 4. i am brown to boot & my id was way in the back. you better bet your shiniest silver dollar that i was shaking in me breeches. ha!

so... i got into the tucson city limits with time to spare so i stopped to check in. got my keys & access card. zipped to apartment & lugged 2 boxes in. back on the road & i could not remember the turn off as i had not reviewed map to va hospital. with no human gps and faulty operator error my navigator took me east rather than west. somehow, i ended up at the entrance to the davis-monthan afb. holy! i knew for sure i had gone wrong. parked and rechecked addresses. as it turned out, i had put in 'street' instead of 'avenue'. got back on track but i was 1 hour late to first appointment so i went directly to second appointment. fingerprinting. woohoo! i love getting fingerprinted. my hands were dry from cleaning and kept absorbing the glycerin that the fingerprint guy kept rubbing into my finger tips. strange... i know. i suppose he should have allowed me to do but he kept rubbing my fingers and i just allowed it. i didn't even think anything of it until i am writing this. i must have been just too tired & frazzled to care one way or another. after that, i went to find the computer guy and resigned some documents and got a quick tour to the computer training site with specific instructions to return at 1330 hours to get trained on charting using the electronic medical records system. excruciatingly sloooow... my eyelids were open but noone paying attention inside. survived to 1600 hours! believe it! done, i drove home & got bed made and zzzzzzzzzzz. i woke at 2200 hours and found out i had missed numerous calls. aaaaarrrrrggghhhh... important ones, too. went food shopping. went back to sleep.

overslept, again! no lunch packed. but... was on time. even got my calls, personal & professional, completed. wound care clinic. yeah! not as crazy as wound care days at the phoenix va but one exciting case where we applied medical maggots to debride a stank wound with a thick scuzzy fibrotic wound bed.

we were done by 1330 hours today! holy cow... all that time on my hands. took care of some important business & took another nap. yeah! and... this is an abridged censored version. thank goodness. now, i can breathe. whew...

... was born that way

2010-05-27T00:21:00.119-06:00

"I've run into more discrimination as a woman than as an Indian."

~Wilma Mankiller, former Principal Chief of Cherokee Nation

* * * *

my sister is a nurse. i have lots of friends who are nurses. i worked as a nursing assistant before going to medical school and i know nurses are the ones providing care 24/7. so... i should be honored someone would mistake me for a nurse, right? yet it irks me!

while treating patients, especially male patients, they call me, "nurse... nurse..." and if i do not respond, they switch to, "young lady...." and if that still does not work, the ultimate insult, "hon... honey..." are you kidding me?! we are a decade into the 21st century!

as a medical student, you work your butt off and pay all kinds of dues, monetary & otherwise, for that title. with intent for one day to be called, "doctor ...." certainly, i am grounded and know that what i have worked hard for does not define me as a person, the bíla' ashdla'ii that i am. yet, perplexingly... it matters that i am extended modicum respect and appropriately called, "student doctor ...." and eventually, "doctor ...."

now, in my personal life, i am "m...., q...., mom... etc..." i am me. the rez ch'ízhii. the girl, now woman, from dził abe'ii. i am rosie's daughter. i know the pecking order in my personal life, and i accept what that entails for me being the wife of a bilagáana attorney. i also know my place when i go home to the rez, not being the honored first-born granddaughter, although my másaní treated me as such when she was alive. even as the first-born of my family, i have learned to defer because i do not live there on the rez and as such, somewhat "voiceless". and, even that does not affect as being a woman in the bilagáana world does.

the intricacies of being born a woman in a bilagáana world. and still, i would never trade places with a man. nor another woman in another country like afghanistan or any country that subjugates their female population and relegates women to 2nd class citizens if that. discussion for another time. not even for a minute. heck no! i like being a woman. it is being a woman in a profession that is dominated by men that throws a wrench into the mix, and you must learn to find a balance. that spot on the fence where you allow your femininity to work in your favor when it does not bite you in the hiney down the road and when you do not allow it to work to your detriment which it will try to constantly and you must oppose it like crazy mad. this goes on until you have proven yourself to an extent that you don't have to worry so much about being a woman doing what was thought to be a man's job.

one of the residents at my last rotation jokingly says to me, "m.... you know... no matter how hard you work, the fact of the matter is that men make better doctors. you do know that, don't you?" my response, "is that all you got? i am a mother of 2 teenagers. i am a wife of a man who likes being the axis of our world. and... to top that off, i am also a medical student. if you think you are going to ruffle my feathers by your assertion, have at it." and... smiled and got back to my cubicle. deep down at my inner core, i was rattling.... with fear. but... no way in hell i was going to wear that on the sleeves of my white coat.

being called a nurse plagued me and i was telling of this experience to another resident, and he shared this with me which gave me a glimmer of, dare i say... hope? dr. g, "it always makes me feel bad and funny when i'm in a room with a female attending, and the patient continues to address me even though they see that the female attending is the one answering his questions and obviously giving the orders. all i can say is... do your job well, and let that speak for itself. and not get hung up on the other stuff. it is easy for me to say as a man but that's all i can say to you." you know what? he's right.

i am not going to change minds by hanging onto grudges and doing subpar work. however, i will keep in the back of my mind that i will probably run into discrimination more as a woman than as an indian because of the nature of the work i am going into. and, just work at being a good doctor providing compassionate care. .... saving soles. :)

last day of 3rd year ...

2010-05-25T22:51:00.123-06:00

i am still sloooow. my goal was to reach an average of 12 patients a day at my last rotation. in the real world, 12 patients a day is nothing. one of my preceptors easily saw 50-60 patients a day.

the clinic seemed to be extra busy today though it probably the same as it was before but it seemed especially so today. it was our last day at this rotation, and they were not taking it easy. as a matter of fact, the residency director was not pleased by the fact that it was the last day of this rotation for everyone from my school. for a moment, i thought about staying on an extra 2 days but i didn't. i am sure that will make a difference come match day. :/

memorable patients from this day were... a guy in his late 50s and he looks older than my parents who are in their 60s. blah blah blah blah blah ... second guy was a young guy, inpatient. blah blah blah blah blah ... as it turns out... way too much info on each case. enough to make both identifiable. believe it or not. so... i deleted a chunk of writing here. i have to be more careful in how much detail i divulge even if i am not obviously posting blatant identifiers. argh! as such, that wrapped the day at the "office".

the best part of the last day was hanging out with dw, a classmate who i knew very little about. as it turned out, he is a really cool guy. he's married to a woman from thailand. he speaks thai. his father once worked with the canadian government as the guy who distributed checks to the natives. do not recall what he called the checks but i joking told him his father had truly been a "great white father". heheheh! he is mormon, which was a surprise. and, no... he did not do his mission in thailand. and, he is so not a proselytizer. the other two in the dinner party was dr. t, our preceptor, and b. the new dude from scholl. b. is from washington state and is a mix of japanese and regular white american as he put it. hahahaha! we all got a laugh out of "regular white american". dr. t is a cool dude. notre dame guy. let's rephrase that... nd fanatic! a very good teacher.

the food at thai e-san was fabulous. dw ordered #s 57 and 59, and shared. yummm... being on a tight budget, i ordered #7, and it was really good. i shared with dr. t as he had never had fresh spring rolls thai style. he had ordered the regular egg rolls which i got a taste of but the fresh spring rolls were the way to go.

when i got home, i crawled onto the bed and snuggled up to the husband who was watching the suns vs. lakers game. before the game was over, i was out for the count. ...zzzzzzzzzzzzzz! no kidding.

changes... they is a coming... believe that...

2010-05-22T22:26:00.040-06:00

trying to savor the moments as i wrap my head around the changes that are happening way to dang fast! let's just make the list which i will surely revisit as i sit in my room alone in tucson one evening.

my baby girl, my minime, is done with all her high school classes. she officially graduates on may 28th. where did the time go?! the darn sand keeps flowing in that hour glass. and, she will be moving to gallup, nm, to spend the summer with her father before she starts her freshman year at the institute of american indian arts at santa fe, nm, come fall. she's ecstatic. as am i. god... how much i will miss my best friend & daughter, and so love my minime. so much hope wrapped up in that bundle.

my yáázh is officially enlisted and scheduled to report for basic training on september 7th, the day before his 20th birthday! he's fast tracked himself & is getting trained to be a squad leader. no idea what that means, but... he is focused on recruiting at least 2 more people before he starts basic. he is running everyday & working out. he has had his prayer to which i could not even go because i am here. guilt ridden. but... i pray for him everyday. god... how i love my yáázh. so much positive energy wrapped in that bundle.

i pray for both my babies. everyday. i always wondered why my grandma would sit and talk about each of her children, and say, "áshinee' she'awéé'..." as a kid, i would think, "awéé'? but... he's old!" now... i know.

on june 1st, i officially start my 4th year as a podiatric medical student. for the next year, i will be going from tucson to denver to billings to tuba city to new orange to tuba city to albuquerque to tuba city. there's another board exam and interviews and match day somewhere in there in the mix. all i know is, i must be back at midwestern university in glendale on june 3rd to receive my $200k degree. yeah... sally mae will be my bff.

what a day...

2010-05-21T23:23:00.005-06:00

as fridays go, it was a busy one. normally, it is an easy, let's get 'em done, clip, clip, clip, clip nails prevention afternoon. not sure who booked all these new consults on a friday afternoon. the extra 10-15 minutes it takes to establish each patient before doing a diabetic foot evaluation, manually debriding & sharply debriding hyperkeratoses & impressing upon patients the importance of well controlled glucose, self-exams, blah... blah... blah... it sure makes it seem busier when it really isn't. ha!

so... the other day... i had a perv-y patient & i most definitely felt like i should jump in the shower after i was done with the patient. what the #%@*?! he was my dad's age. vietnam vet, just like my dad. he has venous stasis ulcers with lots of edema in his feet & legs. to treat the ulcers and provide compression, the unna boot was being applied 1x every 3 weeks in podiatry clinic. he needs to have the unna boot reapplied at least 2x a week to effectively treat his condition. so... dispensed some supplies and requested a consult for skilled nursing care through home health care. after all that... as i was rewrapping him with an unna boot & compression with coban, not having an extra pair of hands to hold up his leg as i applied the dressings, i anchored his scuzzy foot on my chest to hold up his skanky leg as i wrapped it. he starts giggling... all somehow... and, of course, i was clueless. as usual... though, i should have had a clue the way he kept asking me personal questions. such as... are you married? you mean, your husband lets you work here with all these men? which i dismissed. until... he is giggling, and i just had to know what was so damn funny.

me: what's so funny?

scuzzy legged old enough to be my dad guy: the one time i wish i could have sensation in my foot is right at this moment. (and... he's wiggling his eyebrows because his toes are misshapen & cannot wiggle)

me: not funny. and... so not cool...

by this time, i was fuming. but... i held it together and wrapped up the visit with a smile and sent him on his merry way. so... when one of my classmates inquires about my afternoon, this conversation ensues.

me: had a perv-y moment (and retell my experience & shudder. really hoping for sympathy. ha!)

th in his 'bama accent: what do you expect, m....? this is a v.a. clinic. most of our patients are men. this is probably the only time these men get a pretty woman to give them any attention. positive, caring attention, to boot. just let it go. it won't be the last time it happens. i assure you, m.... (and... he chuckles) you might want to rethink how you wrap the next guy. (and... chuckles some more)

what exactly did i expect?! when i share what happened with my husband, he just laughs & laughs! and... says... "you are a good doctor, baby. you made a patient's day." hahahaha! and he adds, "if some crazed man is stalking you, that's when we'll worry. just let it roll off your shoulders." true. but... no sympathy... even then, i was entitled my whine about my icky patient moment. done. now... i am over it & plowing ahead. i says, "bring it!" =P

full plate, full... full... full...

2010-05-04T00:12:00.017-06:00

10 may 2010 it appears my plate was full last monday, too, when i first began this blog entry. it most likely means i have been slacking and have allowed a heaping pile to form. ugh! however, it is not the full plate which bothers me.

17 may 2010 the pile on my plate just never seems to cease. wondering what it was that bothered me about not having a full plate. i must have been rationalizing with myself, reassuring myself that things have not gotten to f.u.b.a.r. yet.

24 may 2010 the pile is ever higher and sad to admit, i am submerged & suckin' in air through a straw. ha! what the friedbread?! man!... not sure anyone ever has these moments but... if i was one of those strange folk that refer to themselves in the 3rd person, i would totally be flicking the back of m....'s noggin for allowing this to happen to her. sheesh! instead... i will make chocolate chip cookies which i promised my classmates for tomorrow. it is our last day as 3rd year medical students. can you believe it?! holy cow! though i believed i could do it. and... i convinced myself each and everyday as i was wading through basic sciences when all seemed to whir by a blur, you can do this $#!t, m....! this is still quite surreal! you know?! =)

kill joy

2010-05-02T20:31:00.012-06:00

it was a special dark chocolate kind of day. dove chocolates has these messages in them. it is like opening a fortune cookie. not sure about you, but i start opening more just to read the messages. at dovechocolate.com, anyone can submit a special inspirational message. here are some i came across.

"don't stress -- think, and this too shall pass." ~j., walterboro, sc. closed my eyes and took deep breath x10, and reminded myself like everything else... this too shall pass. :/

"compromise is a sign of strength not weakness." ~c., suitland, md. under certain circumstances this has application. however, when you find yourself always compromising so much, including pieces of yourself, it is not at all a strength.

"wisdom grows with age." ~v., alexandria, va. dunno. perhaps, for some there is truth in this.

"inspire others to be their best by being your best." ~c., new york, ny. i try. i keep trying. i am trying. i will continue to try. does trying count for anything?

"celebrate the small victories in your life." ~d., fairfield, oh. small victory x small victory = bigger victory somewhere down the road. hopefully...

forrest gump once said his momma said, "life is like a box of chocolates. you never know what you're going to get." in this case... you know what you're going to get. a serving size is 5 pieces of silky smooth dark chocolate promises which also equals 40g. 210 calories. 13g total fat. 8g saturated fat. 19g sugar. 0mg sodium. 24g total carbs. 3g dietary fibers. 2g protein. 6% iron.

label reading can be a real kill joy but it should deter one from gorging on what may taste good with awareness of what is going down the gullet. right?

... hear my prayer

2010-05-01T05:09:00.050-06:00

"im a us soldier" - l.a. redhouse, 30 april 2010

while i anticipated this moment for a long time, i was still unprepared for its impact. the comment i made about my heart stopping for 7.5 seconds during one of my son's bull rides now pales by comparison. my heart is even more humbled. my big mouth more reticent.

lord, god, holy people, all the deities & omniscient entities of this universe... i am on my knees before you this morning, calling upon you. humbly and respectfully. with. all. my. being. i plead for blessings of faith and fortitude for myself, my yáázh, my family. .... .... .... .... hózhó náháshdlíí', hózhó náháshdlíí', hózhó náháshdlíí', hózhó náháshdlíí'.

humbled...

2010-04-29T06:39:00.220-06:00

monday. is. a. blur. it was manic. that's all i remember. patients were almost all new to the clinic. it seemed everyone, their mamas, papas, sibs, cousins, aunties, uncles & grammies was having foot pain. the business of foot care was hoppin'.

tuesday. was. disastrous. first off... i completely forgot to ask what time the day was starting for my preceptor. nor where i was supposed to be. this definitely goes down as one of the absolute worsts that could possibly happen to a medical student. i was supposed to be ready to go into surgery at 0800. and... as luck would have it, the scheduled surgeries all started on time & went w/o a hitch. i showed up at 0825 at the office, happy & raring to get a start on my day. the other preceptor asked, "m... aren't you supposed to be at the surgery center right now? the first surgery was at 0800." my stomach bottomed out. my heart stopped. my noggin drained of all blood. all i could do was stand there clutching to the edge of the writing desk & wait to regain consciousness. as soon as i could think clearly again, i grabbed my bag, ran out the door, jumped into my chídii bang bang & gassed it down the road. as i grabbed my badge & a pen to write with, and bounded out of the car... if things were not already bad as they were... i locked myself out. aaaarrrrgggghhh!! i had no time to feel sorry for myself. my nerves were literally rattling as i scuttled into the building. my writing hand was shaking like mad as i tried to sign in for a visitor's badge. i changed into scrubs, pulled a bouffant on my head & covered my shoes. then scurried into the o.r. with my tails way between my legs, spine all noodle-y, head hanging close to my ankles. the doctor said, "m... did you know we started at 0800 today?" what am i supposed to say but the truth, "i had no idea. i should have asked before i left the office yesterday." by the way... she had been long gone home by the time i was trudging out the door the day before. :/ so... the next case, i got pimped! i was so humbled & intimidated by then that every time i answered her questions, the inflection in my responses all stank of insecurity. i survived one more surgery after that. the only saving grace in the day, if i could even call it that, happened here -- the aaa guy showed up in 5 minutes after i called in my dilemma. the guy proceeded to give me a bit of a hard time for not having my driver license on me. he would not accept my student id which was on my person. it was all a bit surreal especially with the immigration law having been signed a few days before and i was just about to blurt something to the effect when he assured me it was aaa's policy. the irony in that moment was that he was obviously of mexican american descent. luckily, he was pressed for time as he was on his way to 2 other calls and accepted there was just no way i was going to show him my driver license with my purse in the car so he unlocked my car in less than 1 minute. i flashed him my driver license and gave him my aaa membership number. and... back to the office i went... where there were more patients with sick feet. the afternoon was cruising along and i was even feeling a little better. until, of course, another malfunction. this teeny bopper came in with his mother. he apparently fractured a bone in his big toe on saturday. although he complained to his mother about the pain and could not walk right on his foot, she did not take him to the clinic until tuesday. the x-rays revealed a non-displaced fracture in the proximal phalanx of his right hallux. ecchymosis & edema. and... there i was poking around his big toe to see if he has tenderness & pain upon palpation, and the poor kid was shrieking. the shameful part is i was impatient & intolerant with his whimpering. and... that's not even the worst... the worst was that this kid had already told me he was currently on medication for adhd. as an adult and as an aspiring professional, i should have known to be more understanding and unruffled. where was my compassion? what made this visit even more taxing on my nerves was the mother sat there with a compact mirror in one hand and make-up in the other touching up her face as she gasped loudly each time my hand came in the vicinity of her son's big toe which only added to her son's anxiety and further heighten his hyper-reaction. i finally had to signal to her to keep quiet, which helped because the kid relaxed and got brave enough to let me examine his foot. but... o. m. g. that was my terrible tumultuous tuesday during daylight hours. it would have been such a relief if the day ended there. but... then... i had to prep & review for cbe #4 and written final. exhausted as i was... my day never really ended. it simply blended into the next day.

wednesday. written exam at 0930. practical cbe at 1400. i was the last on for group b, and just wanted to get my exam done and over with. when i was done, i went home and plopped into my desk chair and began watching episodes of in plain sight that i had not seen. then... my phone alarm buzzes only to remind me that there was a mandatory meeting i needed to go to at 1800. i dragged there only to listen to a presenter that droned and if i was no sitting up front in the first row, i would have seriously just gone to sleep. when the meeting was finally over, that is exactly what i did. sleep. for. 10. hours.

thursday. is only beginning. but after having slept 10 hours, i am ready to deal with what... whatever... may come.

not all that random

2010-04-24T00:18:00.052-06:00

what the frybread?! i have no idea what was the non-random random issue that was plaguing my mind on both days. today... it's the immigration thing in arizona. not exactly random because it has made the national news. i have not even turned on the news channels at all today. i get enough news on the computer. and my blackberry. what the frickin' frybread?! seriously... i know i am overreacting when i say this but... tent city is going to be a lot like a concentration camp. they, meaning the us government, rounded up the japanese people in the late 1930s and 1940s during the 2nd world war and put them in concentration camps in arizona, new mexico and some other remote locations abutting indian country. if you have ever wondered why some natives from the southwest look very asian even when they swear up and down with their cib and proclaim they are full-blood, this just might make you wonder if some tent creeping occurred. in all seriousness, i think this means anyone who is brown in arizona & especially if they cannot make you out to be a native, you will be stopped and asked to produce proof of your identity and reason for being. can you imagine what that will feel like? or if you have no id on you & you get taken down to the can simply because you rushed out the door and left your wallet at home? which i have been known to do on occasion. i may have to laminate my cib and pen it to my bra. :/

many years ago, when i was newly married to my ex, we temporarily lived in california. during a traffic stop, the cop that stopped us asked my husband to show his green card. oh my goodness... my ex was seething but he showed some serious restraint and pulled out his arizona driver license and diplomatically informed the cop he is NATIVE american. thankfully, he let us go only with a warning. but... i can't even imagine what might have transpired if my ex did not have his driver license. nuts!

but... sadly & quite unfortunately, it is going to happen here. it is bad enough natives get profiled in border towns. now... they will get stopped simply for looking foreign. when did we become a foreign entity in our own homeland?

04/19/2010

it looks like i started this blog entry on 03/20/2010, and never got beyond the title. i am wondering what was not all that random that was nagging my noggin a month ago.

what the quartzsite?

2010-04-16T20:31:00.068-06:00

we drove out to quartzsite for a day of rural foot care clinic. quartzsite is approximately 15 miles from the arizona-california border off the i-10. it is primarily a transient migratory destination for snowbirds escaping the blistering cold of their northern abodes. every patient we saw was in for one last foot exam before hitting the road until october or november.

not a whole lot of permanent structures unless you count the mobile homes which are no longer on wheels are jacked up. seeing all those mobile homes reminded me of kayenta, arizona, which is a town on the navajo reservation. lots of trailer homes pepper the hillsides in kayenta. there is no rhyme nor reason to the pattern the mobile homes. it is as if some giant kid dumped out his monopoly trailer homes on the ground haphazardly & left them where they fell. the only difference was the trailer homes in quartzsite were organized in rows and had tiny yards. a bit eery. quartzsite has its own rock & gem show. next one is january 7-16, 2011. it is highly recommended by quartzsiteans.

i cannot even remember the name of the place we ate at. but... it is your standard roadside greasy spoon. my favorite was their ice tea. they have these books at each table and we were pretty amused by them. my pick was... how to stay humble when you're smarter than everyone else. not that i ever feel that way but... i have come in contact with lots of people that are this way, meaning smart but with absolutely no humility. not even a modicum. i suppose that is the way of most doctors. or maybe they were just born that way.

do not come all the way out to quartzsite just for the sake of quartzsite. but, it is an interesting stop if you are on the i-10 between southern cali and somewhere, arizona. =)

reality fix ... & mutton time

2010-04-05T23:00:00.254-06:00

reality fix. is what my preceptor's mother calls her visits to the navajo rez for her visits with friends out at the sheep camp. as a rez-grown ch'ízhii, having learned to go with relative ease between the world of my childhood & all that is diné in me and the bilagáana world where i now reside, the stark discrepancy in conveniences is sometimes lost on me. until i spend some time to mull it over.

reality bit. right off. at home. having downed a huge cup of coffee from kayenta, the bladder was full by the time we pulled up in front of mom's. so... of course, i ran up the hill to the outhouse. only when i crested the sand dune, the outhouse was laying on its side. holy! the strong wóózhch'ííd winds had blown over the outpost. i trudged back down the hill to retrieve some tp and ran back up the hill to take care of business. ok... in my "third world" squat. there. problem solved. my minime who grew up where outhouses never blew over and where she has a bathroom all to herself, was a bit frustrated. as was my new sister-in-law. it is moments like this that i realize how easy we all have it in the city where we do not have to don a jacket and shoes and brave the cold winds to trudge up the hill in middle of the night to take care of business. we get up and walk barefooted a few feet into a room to take care of business and we still feel inconvenience for having our sleep interrupted.

reality bit, again. on saturday, we got up early to get the butchering going. i was jonesing for some strong coffee. but... mom has this tiny coffee maker that only makes a 12-oz cup if she wants brewed coffee. however, it seems she usually makes instant coffee because she is the only coffee drinker in the house. we could have just got the fire going outside and put on a pot. since neither of us had yet to have our morning coffee, my sister r and i drove down to the trading post just to get coffee. a great excuse to get in some sister time and most definitely, sáanii talk. =)

mutton fix. was my primary objective for this trip home to the rez. when we got back from the trading post, the butchering was in progress. i started making the dough and my sister r started cleaning off the tables and prepping for the meat to be brought in. when the innards were brought in, we began cleaning the intestines out and wrapping them into ach'íí' & prepping the meat to be grilled outside on an open grill.

attitude adjustment. my all knowing aunt came in to tell us how to wrap the ach'íí' and which parts to use to make adił as if it was the first time we were all butchering. in my mom's absence, our aunt appoints herself our mother & tries to boss us around. we did not let her bully us though she rattled. we simply toned her out & kept to the task at hand -- prepping the meat to be cooked outside.

kinłichíi'nii women rule. when we got outside to check on the fire that our brother started, we saw that there was just not enough cinders to start the cooking. we put more wood on the fire & skooled our brother on the appropriate amount of cinders for navajo outdoor cooking. each know-it-all big sister contributing her bit & our brother just did as we instructed. our new sister-in-law watched & learned some communication tricks re: our brother. heheh...

mutton jones rectified. once all the mutton was cooked and the tortillas made and a prayer for blessings, we all munched in silence. the mutton was so tender. the tortillas were soft.

mutton blessings. more prayers offered by anointing ourselves with the mutton grease. hózhóo naasháa doo...

ch'ízhii = rough & chappy
bilagáana = anglo
wóózhch'ííd = march
sáanii = women
ach'íí' = intestines
adił = blood sausage
hózhóo naasháa doo = may i walk in beauty

evolution

2010-03-28T06:17:00.012-06:00

there are several incomplete blog entries sitting in the bay. argh! sometimes, it takes forever to formulate my thoughts into some cohesion. a couple of my new goals... okay... a few new goals in my blog writing are: (1) to provide a glossary for all the navajo words, phrases, sentences, etc used in text. my goal is not to alienate non-navajo readers nor novice navajo readers. (2) candor. as much as possible. and (3) tell a story. rereading prior post & i put myself to sleep. hahaha! improvement. evolution. perpetual. seemingly stagnant at times. but... believe it or not, it is happening. =)

new waters are always flowing

2010-03-27T07:00:00.009-06:00

"no man ever steps in the same river twice, for it's not the same river and he's not the same man."

~ heraclitus of ephesus, greek philosopher, 540-480 bc ~

yesterday, while dashing around like mad in my war pony, narbona iii, i made sure i took a moment to just feel that being on the rez vibe. i was in chinle. it had not changed. it felt so familiar & comfortable. i was happy. i was home. i belonged. i could have taken off my shoes, taken a load off & stayed. but... i couldn't.

while working at dna legal services, i was so emotionally vested in everything i could do to help my clients obtain the desired beneficial outcome. i loved being in chinle. i loved the people i served. i just loved being there. and, i believe chinle loved me.

in my absence, chinle had moved on. it had continued to do what it has always done. move on. after each well-meaning, well-intentioned do-gooder has come, served & left, chinle simply keeps on keeping on. what a bittersweet realization. no wonder people immortalize themselves by creating, donating, anything to have their namesake a legacy.

it was not the same chinle i left more than 10 years ago. there were new faces. new names. new energy. similar dedication to serve our people. and... i am not the same person i was 10 years ago. in that time, i have rediscovered myself. i have recycled myself. i am still remaking myself into the diné woman i have always aspired to be. i am still gathering my tools so i can build onto what my ancestors have begun.

the needs of my people have not changed. my commitment to returning home still has not waned. i am not ready to go back, just yet. in time, i will be home within the four sacred mountains. i will be in dinétah with renewed energy. renewed focus.

sitting on the fence

2010-03-22T19:15:00.027-06:00

ambushed. is the only word i can think of to describe how i felt today in clinic today. the endocrinology fellow i was following uttered a bitter declaration. "i hate democrats!" previously, she rattled on a bit about how the practice of medicine is now ruined for doctors and proceeded to hand me a copy of an article from forbes magazine pertaining to the federal health care bill that the u.s. house of representatives just passed last night. and... i just sat there rendered speechless. it should not have been a surprise but i was still taken aback. furthermore, as a medical student, realizing my worth or lack thereof according to those higher along the food change, i know full well to keep my thoughts to myself especially pertaining to politics. most times, i wear my poker face. sometimes, i just "uh huh..." or "oh really? as if humming along aimlessly not really knowing the lyrics.

confused. describes how i feel about the uproar over health care reform. i am embarrassed to admit i do not know anymore about it than the sound bites i hear from both sides of the fence. the rhetoric of those championing the health care reform has reached an almost intolerable level for me & i find it to be somewhat grating. the unfortunate & sad consequence is that i simply nod and "uh huh" along somewhat cluelessly. it is all the same to me. as a bilagáana friend of ours opined during our last baseball outing, "the native americans have had the short end of the stick from both political parties. the democrats are just as guilty for legislating policies which have adversely impacted the native people of this country."

uncertain. are the ramifications and full effects coming down the pike of the newly passed health care bill. its affects on my future practice of podiatric medicine remains to be seen. as it is already, podiatrists have had an uphill battle even over the definition of a physician which previously only included allopaths and osteopaths even though we go through comparable medical training.

alarmed. by the hatred that some patients drivel is unbelievable but mostly quite frightening. all it has done is magnified the partisan chasm and incited riots resembling kkk marches sans headdress and robes. the prejudices which laid dormant have been resurrected.

disenchanted. is a sentiment which i hope never to feel no matter how many more times my beliefs are assaulted. perhaps it is a bit naive but i cannot help but to cling to altruistic notions which lead me down this road. that is all i have with which to motivate myself to keep on this journey. along with the glimmer of hope which resides in my heart for the betterment of mankind by helping others. and the faith in others to step up. that is sih hasin.

navajo tacos on a friday night

2010-03-20T00:35:00.008-06:00

what possessed me to google "navajo tacos"? i do not know. however, the results were 10,000+. many recipes. many stories. many photos. since i could not get myself to sleep, i began reading the blog entries. some simply shared the recipes with photos. the recipes that garnered the most attention were those with accompanying stories. it became important to learn how the writers came upon navajo tacos. here are some links with a bit of commentary.

while reading this recipe for navajo tacos, it took me back to the evening of march 11th, when my niece gathered some of her friends for a fried bread making workshop. "DON'T WORK THE DOUGH TOO MUCH!" she says, which can never be stressed enough.

these navajo tacos are not what i expected but was pleasantly & sweetly surprised. :)

this recipe for navajo tacos uses a recipe for the dough which comes from a book, the feast of santa fe: cooking of the american southwest. the recipe calls for using a fork to mix the dough. and highlights that the dough should not be kneaded to avoid making a heavy frybread. i am actually thinking of following her recipe the next time i make some tacos just to see if the tacos will be received with the same enthusiasm as tacos made the navajo way. however, i feel i may become impatient because i like eyeballing measurements and tweaking every recipe i try. hmmm...

in this entry about navajo tacos, the youngster obviously loves navajo tacos as it is the meal which she requests for her birthday meal. how lucky is she to have a native american stepmom to make this meal for her? aaaawww... lucky chica.

now, i laughed my hiney off so bad as i read this entry sharing a navajo tacos recipe. instead of making dough, she uses rhodes rolls which she says is much faster. then she proceeds to say, "don't tell the navajo indians though, because i'm sure my method is on the brink of being deemed sacrilegious." and... that's not even the funniest part. anyone who's been around bilagáana people living among the diné knows of their curiosity about everything and their search for meaning in every last little thing. here's one explanation for why we put small holes in the center of the frybread, "... i still follow [n]avajo tradition by making a small hole in my dough before i fry it to "let the evil spirits out". try it, it's fun!" now if you believe that, as my uncle george likes to say, "i'll throw the golden gate in free." *lol*

this ranch gal has me convinced that indigenous people tacos is indeed a mouthful. it may enrage some of my activist sisters when i say this but political correctness does not really change the deep seeded attitudes and learned behaviors. that said, i wonder why navajos are such perfectionists when it comes to the shape of the fried bread? it appears most other people don't care if the darn fried bread is a perfect circle. the geographic shapes could make for great dinner conversation re: countries which the fried bread shapes resemble.

now if you would rather not go through the trouble of cooking beans for hours, having your house smell of fried bread grease, making a mess in the kitchen, or just plain lazy like me... go out to any place that has indian tacos or navajo tacos on their recipe. enjoy!

sisterhood of the traveling frybread pan

2010-03-12T11:58:00.304-07:00

the workshop had just begun when i showed up. the bowls were out with a big sack of blue bird flour in the center of the table. ingredients assembled. no measuring tools. 3-4 heaping handfuls or cups of flour. 2 3-fingered scoops of baking powder. a loose handful of powdered milk. a pinch of salt. a "cup" of warm water. the eyeballing technique used by frybread masters were shared and passed on. the pupils, zealous & diligent in their efforts began kneading their individual dough. one of the participants though embarrassed, shared that her grandma had started the frybread making contest at the navajo nation fair. i was quite in awe of the tale of the frybread making legend. seriously... ☺ happy, peaceful thoughts and using tlc during the kneading process was beseechingly advised. once the doughs were moulded, they were covered by plastic grocery bags to retain the moisture and allow it to set. after approximately 15 minutes, the grease was heated and the dough flapping began. a palm size piece of dough was first pinched off and shaped into a ball before the flattening process. the dough is stretched and evenly pressed out into a flat circle before placed in the hot grease. the tortilla shaped dough is slowly lowered into the hot grease and while the dough is frying, it is closely observed to avoid burning. once one side is nicely browned to a crisp, it is turned over for the other side to cook. this process is repeated until the dough is all gone.

my sister, glee, was the master instructor. we are sisters by clan -- kin łichíi'nii, and come from the same community. we had not seen each other in a long time so it was good to visit with her. i have beaucoup respect for her. to my knowledge, she is the first from our community to plow through both undergrad and grad school uninterrupted. she also works in a field that can be quite contentious due to the prevailing political whims -- which quite frankly leans towards industrial development that results in disruption of the ecosystem to employ .20% of the navajo population at best. if that is not enough, she is also a single mother of three intelligent kin łichíi'nii beauties. and when she goes to law school, she will indubitably rock it. in a nutshell, my lil' sister is bad@$$.

then, there's my niece. she's the one responsible for organizing and hosting the frybread making workshop. when i happened upon blogging, her blog was the first i came upon that tugged at my heart strings. though at the time, i had not met her, she definitely struck me as another kick butt kin łichíi'nii chick. she is also a smarty pants that gives a damn about the environment. i also meant my nephew-in-law for the first time. he reminded me a lot of one of my cousins -- definitely in the nerd-smart sense. it will be an adventure to vicariously follow her artistic venture. i should start a savings fund so i will be able to afford her work when she takes the art world by storm. yeah... you read the prognostication here first.

my biggest faux pas of the evening was i did not properly introduce myself nor allowed the other young women i did not know who were in attendance. :( instead, i was like the ma'ii coming on the scene when the workshop was already in progress. at least, i had sense enough not to take over. but i have this tendency to auto-pilot into navajo as soon as i am in a room with one or more navajos. how readily i switch right into navajo is my comfort gauge. apparently, i felt right at home as i kept blabbing in navajo like a real jaan. yáadi lá!

the funniest fbook comment i saw posted today after the blue bird flour dust had long settled was by my sister, glee, stating, "i need my pan! i left it at your [place]." thus... the sisterhood of the traveling frybread pan. it would be awesome to see these workshops expand to cover a complete traditional navajo menu, such as blue corn mush, sumac pudding, navajo cake, kneel down bread, ach'íí' wrapping, grilling sheep ribs on open grill, tortillas made on a fireside grill, and the list goes on and on.

we could make our own advertisement for mastercard. blue bird flour ... $8. baking powder ... $3. powdered milk ... $5. crisco ... $4. frying skillet ... $30. a sisterhood of professional navajo women sharing traditional cooking skills and the stories & humor that are shared around the cooking table and fireside. priceless. :D

my brothers

2010-03-11T23:53:00.125-07:00

on this day 30 years ago, my brothers graced us with their presence. my sister, stephe, was supposed to be the son that completed my mom's package. then came my youngest sis, leigh. finally... my twin brothers came on the scene. jerm and jerl, otherwise known as bigger and skinner. no matter how old they get, the image i have of them frozen in my mind is of them at five years old when i left home.

my mom worries after my brothers. why aren't they this, that, this, that? not in a bad way but always concerned. a few years back, i finally said to to her, "mom... they are doing fine. be happy that they are living independently. be happy they are not fathering children out of wedlock all over the rez & shirking their responsibility. and... please leave them be about getting married and grandchildren. it will happen in their own time."

one of my brothers got married in a civil jp procedure last year, but... our family still wants a traditional navajo wedding. he and his wife are expecting a baby. we are all excited. oh... that rugrat is going to be spoiled by all of us aunties and his nali asdzaa. my youngest brother is still a goof ball. he's got the company of his computer games and his freedom. for now, that seems to be enough.

áshinee' shitsilíké, happy birthday!

a prescient moment

2010-03-06T23:48:00.000-07:00

last evening while i sat alone at my dinner table, it dawned on me how much my life is going to change starting june. up to this point, i have had the luxury of having my family with me every step of my pod med school journey. when i am here, there and ober dere *pointing with lips, navajo style* running across the u.s. and back to my beloved southwest, i will most definitely miss my family.

shut up

2010-03-03T06:48:00.001-07:00

the rotation i am currently on required that i sign a confidentiality agreement that precludes me from even talking about my days in clinic to my family & friends. it is amazing what i have learned in three days. this preceptor is a fabulous physician and an awesome teacher. who would have thought... i was going to like rheumatology this much?

cleansing

2010-02-24T06:00:00.047-07:00

my bff from undergrad called me last night. it is comforting to know that our friendship has transcended time and space. in that safe place, i cried. buckets of tears with snots and all. then i slept. and... what do you know? i woke up feeling brand new. perhaps, one purging bawl was all i needed. somewhere i read that crying is therapeutic. but... the navajo teaching about crying for no reason always beats in the back of my mind. the rains have come to wash my tears away. pah! pah! pah! pah!

last night, my sister sends a text message informing me that the ceremony has been postponed. my other sister at least asked why for. darn... i was really looking forward to having my fill of mutton stew. then going home just for the sake of going home sounded like a plan until i learned my mom was not going to be home. it is not the same without mom at home. now... why couldn't she be coming south to the valley?

so... it looks like we will be hanging out downtown for the matsuri festival. yeah! my youngest sister and daughter are crazy about all things asian, especially japanese. do not ask, why? because i have no clue! all i know is that i love sushi! yummmm... oh... and... i love saki! yes. unfiltered and chilled. yeah...

back to mutton... now i am wishing i had mutton stew at the chasing the sun powwow market. i held off thinking i was going home this weekend. as silly as this may sound, i really believe a bowl of stew may be the remedy for this persistent cough that i have developed that no amount of chicken soup will cure. help me find my cold remedy! anyone know of any mutton stew stands in the valley? or a butcher shop that sells really goot mutton like tsé niit'aa ak'ah? hahaha... :)

bleh!

2010-02-23T19:00:00.001-07:00

it sucks the life out of me. s.o.b. like you would not believe. you know, the first time i saw s.o.b. on a medical chart, the first thing that came to mind was not shortness of breath. it was s-o-b. hahahaha... this s.o.b. i was experiencing was not pathological nor physiological. every time i took a breath, a swallowed silent sob fighting to escape crowded the air i was trying to breath in. i am not going to cry. dammit!

walk, rain, therapy ...

2010-02-22T12:32:00.053-07:00

needing to clear my head, i laced up, grabbed my sweater and headed out to the trail. originally, i planned to walk 3.5 miles at the most. next thing i knew, i was on the next hill going up the steepest part of the hill. then, i found myself going back up the first hill. albeit slow, i trekked ~9.5 miles. i called it my forrest gump-ish walk. :) at the top of the last hill, i noticed the rain clouds moving in rather quickly. before i knew it, i found myself in a bit of a downpour. my spectacles were covered with rain droplets and fogged. a couple of runners turned around as soon as it started raining. i kept on trekking. i love walking in the rain. i always have. back in undergrad eons ago, while everyone carried umbrellas, i went without. there is something therapeutic about rain drops. instead of chilling me as one might expect, rain warms my soul.

shik'is

2010-02-20T06:38:00.039-07:00

"one great, strong, unselfish soul in every community could actually redeem the world." ~elbert hubbard~

this is the quote i would use to aptly describe one of my best friends. a compassionate wise soul making a difference in her community. yet, so humble. she is one of those incredible people that inspire you to be a better person. i am happy to be one of her friends and incredibly fortunate to have her counsel.

we spoke today. it was as if time had not transpired. as if there was no distance between us. we talked for close to two hours. happy birthday my dear friend. may we have many more birthday conversations. as i began offering my prayers of appreciation for the blessing of such a wonderful friend, i began thinking of the travels we have shared where our respective journeys have intersected. ahéhee' diyin dine'é, shik'is baa ahééh nisin. náásgóó shá bik'i náádajodlíi dooleeł.

young love

2010-02-19T17:20:00.056-07:00

a 74-year old man came into clinic today. he was in for a follow up visit. prior to going in, i had an opportunity to look at his file and learned that he was working two jobs. TWO jobs! one of which is 40 hours a week. with the exception of a few medical issues, he looks great for his age. he brought his wife with him and it was just so cute how he kept referring to her as, "my bride". definitely one of those situations when you want to aaaaaawwww... i could not help but notice that she looked older. and, it was just so adorable how she blushed and looked at her groom endearingly every time he spoke of her. after we left the room, i commented to dr. r about how cute i thought it was that he would still refer to his wife as his bride after all these years. dr. r chuckled and shared that they are newlyweds. as it turned out, the bride is in her 90s. then dr. r shared a joke that she'd been told by another doctor friend of hers.

where do sun city newlyweds establish their bridal registry?

((((drum roll))))

walgreens drugstore.

hahahahaha...

indian to indian

2010-02-18T17:20:00.074-07:00

my preceptor is an indian. though she did not grow up in india, her roots start there. when she learned i am navajo, she told me that she loves the friedbread that navajos make. she further related how she makes sure she seeks out the navajo friedbread stands at the fairs in phoenix just to get her friedbread fix. it should not have surprised me but i was still a bit taken aback when she asked me for my recipe! why the heck not? right? so... before i rattled down my mixture, i explained the importance of using blue bird flour. she asked where to find this special flour. when i last went in search of bluebird flour, the safeway at 67th avenue and the 101 had it. then she asked if she could use olive oil. since i had not tried it, i explained that back home they used lard but i use canola or safflower oil. over the weekend, curiosity got the best of me & i just had to try olive oil. and you know what? it tasted better, yes... BETTER than friedbread made in canola or safflower oil. just like that i adjusted my friedbread recipe. back on rotation, i updated her on friedbread in olive oil. she was happy to learn she could use olive oil but was disappointed that she still wasn't able to find bluebird flour. i am going to have to find a bag of bluebird flour this weekend and bring it to her with my recipe in writing as a thank you gift for being an awesome preceptor. :)

alternate universe

2010-02-16T23:11:00.201-07:00

today a text message from one of my sisters ticked me off. the one sister who rarely ever calls, sends text or email messages to me unless she needs something from me. of course, i feel a bit used. and then there is our history. we have locked horns not just verbally but physically. and the numerous times she disowned me because i told her what she was doing was wrong. stump on my hallux for caring. sheesh... anyway... after grumbling to myself and stewing for a few, i chastised myself. what is wrong with me?! this is my sister! so... i relented...

she had a question about her blood pressure and heart rate. the readings she shared indicated an elevated bp and abnormally slow heart rate. she wanted me to tell her what that meant. without a proper history and physical, my guess is as good as the 3rd year pod med student as i am. :/ while i am sympathetic to her health problems and as a sister, i am concerned, it really upsets me how she just sends this text message in the middle of the day and expects me to weigh in on her situation long distance and with scant information.

there is also what my other sister said when we got talking and her thoughts were that our sister needed to lose some weight and stop whimpering & lamenting about her problems. my sister carpools with our sister and she related she hears the same melodramatic drone of one of our aunts. with this particular aunt, no one, and i mean NO ONE, has the worst pains and disposition. her problems are the absolute worst, bar none.

since this aunt is my adopted mother, as a child, i witnessed how she operated. she would cry, whine and ball up in pain all day long. then when her man friend showed up, she had no more pains. she would laugh, flirt and disappear into her bedroom with her man friend. and... i was left to fend myself for the weekend. it's just one of those things you learn to live with as a kid because you are powerless, don't know any better and have no other place to go. over a year ago during a lecture on fibromyalgia, a light bulb went off in my head and i thought, "oh my god... there is a name for what i put up with as a kid!"

when my sister made that comparison between our sister and aunt, my sympathy for our sister significantly decreased. given my history with my aunt and my sister's assessment, suddenly that compassion i had previously turned into apathy. someone hit me upside the head. as a future health care provider, i know i should not prejudge my patients. but... i had a neurotic hypochondriac as a (mother). oy vey!

oh shi-heart!

2010-02-14T22:59:00.011-07:00

valentine's day the movie and a red heart shaped sucker, is as good as it gets. mind you, i am not complaining... a few years back, i got a beautiful ring with a pink sapphire and diamonds setting in white gold. i know it costed a pretty penny because i had been looking at it in the store and he saw me admiring it. now i rarely even wear it. :/ i had forgotten i even had it until i started writing this post.

a movie and lots of handholding. me encanta. my heart always warms with reaffirmation of my anchoring. aaaahhhh. a good way to k.i.s.s. and make my jéí go ba-dum, ba-dum, ba-dum, ba-dum-bum, ba-dum, ba-dum, ba-dum, ba-dum. oh shi-♥.it was a sweet movie with plenty of funnies for the romantic soul with a comedic streak. :)

doppelganger

2010-02-12T23:05:00.001-07:00

an elderly japanese woman came into the clinic today for her annual once over. there was an unspoken connection i experienced with her. it warmed my heart for her to pat my arm with inexplicable affinity as she angled her head as she looked at me inquisitively as if she saw someone she knew from another time. and... i kept thinking of how much she resembled my másání.

reminiscing about my másání became the catalyst for my search for an image of a diné asdzání with a tsiiyééł. while searching on the www, i happened upon the following site with cool art by a diné artist whose work is categorized as folk art. whatever the category, i like what i saw. there is this piece titled "a navajo woman's calm" on the 30" x 40" vertical paintings page that i would love to own. it embodies the peaceful, the tranquility and the loving nature of the navajo women who raised me. it brings to mind a quote by indira gandhi. though i know not the circumstances under which she said, "you must learn to be still in the midst of activity and to be vibrantly alive in repose," the quote captures the spirit to which i aspire.

p.s. i really hope i am not violating any copyright laws by cut & pasting the painting as my profile photo. it would be the photo i post as my likeness on fbook. :)

another test

2010-02-11T22:45:00.038-07:00

the 3rd competency-based examination to be exact. a lot like a practical exam which includes a taking a complete history, physically examining a standardized patient, interpreting labs and imaging studies, & writing the s.o.a.p. note.

the inevitable

2010-02-10T21:29:00.004-07:00

"old age though despised, is coveted by all." ~ proverb

an internal medicine doctor is my preceptor for the outpatient medicine rotation. she is one of six physicians at a primary care facility which is part of a larger network. the bulk of her patients are 70 years or older. many octogenarians. quite a few 60 somethings. fewer in the fifties. 40 somethings or younger are a rarity. as a matter of fact, one doctor in this group does not see anyone under the age of 45. in any event, you get the point... the practice sits at the edge of peoria where sun city begins. driving in this area of town, a speed demon must watch out for slow moving traffic. these are folks that actually adhere to the speed limits posted along the roadways. no wonder they are still living. :)

growing up on the reservation back in the 1970s, all our másání wore tiered skirts with velveteen blouses and head scarves over their tsiiyééł. naturally, i have come to expect all grandmas to conform to the másání of old. what i believed as the másání dress code has been completely undone & redone. at this clinic, i see grandmas with nicely done nails. some even wear heels, still... many wear make-up, complete with red lipstick. their hair usually done up in 1960s hairstyles. some wear jeans with cutesy tops. i kid you not.

they come in with their questions written on questions and pens in hand reading for note taking as the doctor explains their lab values, further studies as needed and medication refills or changes as warranted. they are actively involved in their health care. what a difference from what i knew to be the way.

it is really hard to look at these elderly folk without thinking of the way my grandparents were. they slept in separate beds which were at opposite ends of the one room house we lived in. so... you can imagine my surprise when i heard a refill request for viagra for the first time. the patient was definitely in his 80s. my jaw about dropped. it's a good thing that i have learned to keep my poker face in place.

being around elders on a daily basis makes me ponder my own mortality more often than i have in a long time. the fact that i am aging is staring at me, plain and clear. i have never been one to groan or complain about turning a year older with each passing year; instead i embrace each year with gusto appreciatively. however, getting an uncensored, up close and personal view of how real aging is and how it leads us all to that ultimate destination where our journey ends as a mortal, makes me respect its power and wisdom with a sober heart. shamelessly & selfishly, i pray and beg old age to be gentle with me.

small stuff

2010-02-09T12:00:00.022-07:00

someone left the bottle of soda on the kitchen counter with the lid not screwed on tightly. it slipped from my hand and fell to the ground where it shot soda all over the kitchen including on my white blouse. aaaarrrggghhhhh!!!!! strangely enough, no expletives. just... "damn the lazy ... !" simply cleaning the mess up without drama was therapeutic. concentrating & working on not sweating the small stuff. as my son loves to tell me when i get a tad wound, "chillax, mom..." often, easier said than done. especially when it is your lunch time and you are on a mission to complete a few errands and get lunch down before the hour is up. hmph!