We're coming, Sonal!

Grogginess has set in hard at the 30-hour mark. A 2-hour delay leaving Toronto meant we missed our Rome --> Cairo flight. That Rome airport is a crazy situation full of empty help desks and poor signage. The tears only rolled all the way down my face once when I thought we had to buy our whole ticket again. Our friendly ally at EgyptAir battled for us and we think we'll make it exactly 24 hours late for 100 Euro each. Could be so much worse!

So we've popped into Rome for the night and, thanks to Rick Steves, have found a cute little hotel/hostel (private room, comfy bed) near the Metro Termini (The Beehive). We're showering, finding a slice of square pizza, hitting the sack, and heading back to the airport in the morning.

Later!

Lizzy teaches me about the bees and the blogs.

7 hours: House to Canadian lunch

And it begins! Elliott's drawing summarizes out first 7 hours.

At 7:45 we took off headed South from Sea-Tac with the Islands and Olympics mostly shrouded in cloud to our right (our side), then swooped East to cross the snow-peaked Cascades bound for Canada. After a couple morning granola bars and the initial excitement of really leaving on this trip, identifying missing items (Liz's sunglasses, that little travel toothpaste I bought yesterday), practicing with the money belt ("Oh, this is a really comfy money belt!") and realizing that Air Canada is a (today, critically useful) subsidiary of United, we headed off to dreamland in the air. Neither of us slept particularly well last night despite reading Uncle Elephant in bed. We had gone out for a goodbye pizza dinner with a big group of friends -- KP and Tobias of Ithaca fame, Matt, Nancy, Kevin, Bielak from Swedish (and so much more) and Brita, Amos, Aditieh, and Stevenson, Elliott's wonderful old buddies -- and then it took me until 11 to feel comfortably packed. We were up at 3 (in Elliott's case) and 5:10 for the alarm to make coffee, finalize the carry-on bag allocations (Barbara's fig cookies, spearmint gum, 100 Years of Solitude, My Left Foot on loan from Al, sleeping pills, ant-acids, fresh socks and undies, laptop, headphones, etc.), and hit the road.

Our roommate, Matt Schlough cordially dropped us at the Mount Baker Lightrail station before heading in to work at 6 at the hospital. Thanks, Schlough! The night before I worked a blissfully quiet overnight with six total patients, one simple admission, and a comfy pillow on the call bed so got 3 1/2 hours of sleep which, coupled with my previous afternoon's 3-hour nap, got me through a sunny day of packing, washing clothes, adding stuff to our registry with Elliott, reserving wedding port-a-potties and dance floor sections, having a dress fitting in my mom's wedding dress, getting a hair cut, and picking up tuberculosis masks and gloves for me and Sonal.

So finally on the plane, my sweetie's cheek resting on a travel pillow in front of me and the cloud bank obscuring all topography, my Seattle to-do lists faded away. My patient with mystery trans-aminitis, my overdue obstetric patient, the scheduling responsibilities for next year's residents: these are no longer my responsibilities (go, BaiVal!).

I am going to Rome, Cairo, Addis Ababa, and Gondar to explore, to feel, to learn, to teach, to be humbled, to cook, to sniff, to climb in the mountains (when we get used to the altitude), to make friends, and to be far, far away from daily life with my Love. I feel so, so lucky. Let's see if I still do in 30 hours when, wearing my back-up socks and undies, sick of Barbara's fig bars, dehydrated, unshowered (brought baby wipes!), and walking on swollen feet in Addis as we find Sonal (hopefully) and anticipate boarding a mini turbo-prop puddle jumper to Gondar. I bet I will. That sounds awesome.

Meanwhile, here in the Toronto airport we found a Best Buy vending machine and bought a snazzy camera so you won't have to put up with this iPhone nonsense for 5 weeks.

More exciting updates to come! I hear Rome's even more beautiful than the Toronto airport.

xo, liz

Preparing for Gondar

Wow. It's been a solid three years since I last wrote here. In that wildly full interim I've fallen in love with the man I'll marry this August, almost finished my residency in family medicine, made a wonderful home in Seattle, and managed not to leave North America... at all...

I started this blog in my last year of medical school when I spent a long month in a small hospital in Lesotho. I remember that experience as the first time I felt like a doctor (read: medically useful and marginally independent) and as a period of time that reinvigorated me personally and academically. I'm curious and hopeful about the ways international medicine will feel different in a new country, in a new period of my life, and with new training under my belt. Am I ready to work without attendings over my shoulder? Is medicine as big and wonderful as I hoped it would be when I started this training project a decade ago? Will international travel be a part of our lives in the future? Will I get sick of eating injera? Will we elope into Ethiopia's Simien mountains and abandon wedding planning? Only time will tell...

Elliott and I are heading out on March 27th from Seattle bound for Gondar, Ethiopia with brief stop-overs in Rome, Cairo, and Addis Ababa. I'll be working in a hospital for four weeks and Elliott will be exploring "The Camelot of Ethiopia" for both of us. We'll be staying in a guest house with our dear friend Sonal Patel, a resident colleague of mine. After our time is up Elliott and I will meet my mom in Rome and its environs for a week-long vacation full of wine and square pizza, beautiful hill-top towns, and sun-kissed adventuring.

Stay tuned for stories, pictures, and pithy revelations over the next couple months. We're anticipating infectious diseases (not in us; we got vaccinated for everything), monkeys, mountains, monks, mothers, and meatless merriment (Sonal's vegetarian and we all want to learn how to cook Ethiopian food).

xoxo, Liz

The real deal

I'm sitting out on my back deck with Paul Simon singing to me and the mountains hidden in darkness on three sides beyond my cute neighborhood. Happy birthday to Jill who is now asleep because she's on call tomorrow morning. My sweatshirt smells like the fire I've been sitting around for the last few hours celebrating her birthday, playing hilariously dangerous dusk baseball, and sharing beers with First Hill and Cherry Hill folks at Golden Gardens, a beautiful beach overlooking the Olympic peninsula. I can't believe I live here.

OK: Learning to be a good doctor is really hard; that's now a given. What did I actually expect? I don't think I thought much about the specifics of it, which is strange. I found out where I matched on my way to Africa, a pair of months which blew my mind to such a wonderful, global awareness mind-fu@k degree that I thought about little but AIDS, the wonderful people dying of its indiscriminate reach, and the ways I could learn to help. My sense of doctorhood grew beyond any Paul Farmer dreams I had for myself into something totally UNdreamy and core-dedicatedly and life-span-exceedingly passionate. That's a lot to experience in a couple months (refer to previous posts for the blowing of my mind) and I didn't find many ways to anticipate residency while learning to treat and just BE WITH patients dying of pericardial effusions from tuberculosis or AIDS-associated cryptococcal meningitis - oh, sweet boys! I wish that learning how to dose and administer IV fluconazole had done more, but medicine is too late. Then I flew back for a whirl-wind party, packing, and graduation-filled short week in Boston, hung with my week-short-of-adolescence brother, welcomed my high school friend's baby into the world, and drove everything I thought I needed across the country in three and a half days to the other side of this massive continent to meet my future. This all sounds super dramatic... but it was. really. This is a whole lot to ingest. I was about to say, "I've been wondering if I enjoy stability or if I prefer to thrive on change" but the truth is I haven't wondered much of anything for a while. I'm a wondering kind of person, was a kid who thought too much to the point of others' nausea and my own exhaustion until I learned to temper it for the sake of functional human life. I baffle myself still, though, driving myself semi-consciously towards busy situations in which I'm forced to live in the present but yearning at all pauses for a more contemplative existance. I think this is my lot and I think I love it, find a mostly-beautiful balance of practical productivity and romantic thought, and cherish the people who can appreciate that in me.

Last night I was on call and a 55-year-old woman came into the emergency room. 2 and a half years ago she noticed a lump in her left breast. She had stopped using heroin heavily 15 years before, was periodically homeless, and was (and still is) a fiercely independent and hilarious woman. She declined treatment after receiving a tissue diagnosis of invasive ductal carcinoma. Two years later -- last October -- she was in a great deal of pain from the tumor growing in her breast and made a rare visit to a doctor. This oncologist got a PET-CT scan and saw 10 little metastases light up in her lungs, gave her a lidocaine patch for pain and scheduled a follow-up appointment to start palliative treatment which she decided not to keep. She spent this last winter and fall living with her boyfriend, occasionally hussling for heroin for pain control, and taking in homeless people to feed and house. She feels confident that, in her afterlife, she will return to be guardian angel to these people. Two days ago when her sometimes estranged but loving daughter visited her, she was house-bound with a productive cough and a 10 centimeter tumor splittling out of the skin and oozing pus onto her chest wall. The pain had become too much and she agreed to come into the hospital. It's late now, after a long week, and I don't have enough energy to give this story right now, but I'm swimming in sadness and admiration for this woman. She wants me to control her pain and her cough and allow her to die at home with sufficient lucidity to know what's going on and to say goodbye to her family. When I met her, surrounded on all sides by her family, I felt a barely-containable rush of the heat of emotion surging through me. I saw my role, saw that I could help this funny, tough woman exit life on her own terms and felt desperately sad and deeply touched that she was trusting me with this job. She doesn't have a doctor and she would love for me "more than anyone in the world" to be her doctor while she dies. Good lord.

So glad I have tomorrow off to mountain bike, try to catch a Sounders soccer game, cook a real dinner, clean the bathroom, and get a good sleep. Good night.

Yikers!

This is a wild ride! I had three outpatient visits at clinic today --cystic acne, immunizations to start nursing school, late menses and denial of serious depression-- and felt like a wonderful doctor: quite a contrast to my perceived incompetence of Monday. I need to get some sleep after a lovely night of earning second place at pub trivia with folks from both First and Cherry Hill residencies (First Cherry) at the Kangaroo and Kiwi. It'll take it's time but everything's gonna be wonderful. The tree of tomorrow on call may not be so sweet, but the forest is all honey.