Pray

December 11...
Enter...final's week

''...So too, how often we throw dirt in the air and wail and moan, ripping our clothes and crying, 'where are You, Lord'? - when He's right in our midst, working everything out perfectly..."
- Jon Courson

It is for this week of the semester that my title 'Glimpses of Grace' was coined. It is when grace is most evident, most needed, and most lacking in many lives including my own.
It is just not fun.

And this particular week I solicit your help. We all could use prayer. There is the obvious need of course - supernatural test taking abilities. But with age and responsibility comes a steeper road. There are folks who aren't achieving, rumors of 'dishonesty', troubled relationships, misunderstood intentions, hurt feelings, restless sleep, aching bodies. Our fuses are short and our tanks are empty. Even our favorite soccer field has become a hostile environment.... I got sidelined last game... oops

Pray that I - and WE - remember that He's right in our midst. That all this stress and pain and ugliness can be transformed to a tapestry of beautiful talent, skill and grace - hard won by God's grace and power.

Help us remember to seek Him.
Pray.

Introducing Mt. Hood

Classmate Jess & her husband Tim and I soaked up the spring-like conditions as we trekked through the backcountry at the base of Mt. Hood. A spectacular day of God's creation.

 

Introducing Mt. Hood

This Saturday I was introduced to a new and beautiful Mountain. I come from the land of Mt. Rainier - pretty high standards. As you can see...The smaller more humble Hood was still able to take our breath away. 

Sacred Touch

It's been a pretty big week for us PA students. Particularly this student.
We've completed the majority of two classes, took several exams and geared down to slip quietly into a week of turkey, long lost friends, family dysfunction, the occasional assignment, uninterrupted guiltless sleep and perhaps most importantly -
giving thanks.

As I've shared previously, this fall has dramatically taken its toll and consumed our lives as individuals. I don't think I've been on such a rapid journey of ups and downs, victories and defeats as I have this fall. Each week is its own lifetime beginning with challenging Monday exams and ending with weekends full of studying at every local coffee shop we can find.
It's quite relentless.

Thanksgiving this year includes:
we have succeeded thus far.
we are alive, as are our patients
we are playing soccer, going to the beach, playing pick-up basketball and having baby showers - [short ones]
I still fit into my clothes
I'm still married to my husband
he still likes me
God is faithful - I am healthy
I have clean clothes most of the time
my friends mostly remember me
and...
I've actually learned a few things

I can share that last line with confidence because it was evidenced this Monday night.
Each month we volunteer at a free community clinic where low income migrants and local citizens can receive healthcare - from both STUDENTS and practitioners of all kinds. Upon arriving this week I was quickly ushered to join a Nurse Practitioner whom I'd worked with before. She's a very no-nonsense HANDS ON instructor.
So - she made me get my hands on.
And I don't just mean the basic 'open and say ahhh' - I mean the 'turn your head and cough'.
As amusing or scary or unbelievable it is - the truth is - I've seen my first few patients.
I know I'm not ready or competent or legal.
But for 2 hours the other night that didn't matter. From start to finish I questioned, listened and responded to patient's stories. I then performed exams, postulated, came to conclusions and elicited treatment.
And I performed it.
Under strict supervision of course.
But I did it.
I was allowed to place my hands on someone's body. It's the only precious thing each of us own - whom nobody else [sans God] lays claim - and as a stranger, I touched them.
Humbling isn't the word.
It was sacred.

As the Hippocratic oath implies, we're being taught an art. It's a beautiful, complex art of listening, processing, integrating, touching, testing, challenging - distilling and discerning - the state of your health. My hand will touch and assess you different than his hand, or her hand. It is connected to my brain, to my experience, to my faith and my very heart.
You are being touched by ME.
And those two unsuspecting gentlemen who came in Monday night, with garden variety complaints - painful this and frustrating that - have no idea what kind of impact they had on this young lady.

Their bodies
Their property
Their health
My brain
My heart
My being
Sacred

Mighty Masticators - Team 8

I seem to remember a post on this blog - not too long ago that thoughtfully ended with - "thank you for the rain...let it come".
Well it has come.
Both literally and figuratively.
I don't have any statistics for you regarding record rain fall in Porland Oregon this week or month or season. Or if there even IS record rain fall. All I know is it's raining and it's raining a lot. I thought Seattle was pretty wet or at least very damp - but I must be mistaken. The other night's weather segment involved a guy (in makeup and a bad blue suit) pointing at a picture of the 'low pressure' off the Oregon coast with clouds streaming straight into our state. Not streaming into Washington, not into California. Just us.
It literally looked like the water from a fire hose shooting straight for the big Port Land.
It has been hard to handle.

In addition to the actual H2O that flows from heaven there are dark clouds over the land of PA school. These pre-holiday weeks are dark days. The classes, the lectures, the drugs, the mechanisms, the systems, the tests, the examinations, the heartsounds, bowel sounds, lung sounds ... it's pouring. It's these days that they warned us about way back when - those days so long ago - June I think it was, where they said it would 'get bad'.
Don't get me wrong. I love it.... I hate it. I am schizophrenic, manic, paranoid. I have thoracic outlet syndrome, seasonal affect disorder, fibro myalgia from sitting, lordosis from standing, I have antiretrograde amnesia, crepitus joints, sciatica, hypochondria.....

okay.
I'm back now.

What I really wanted to share this time was my thankfulness for a team - my classmates who inspire me, instruct me and take me down on the soccer field each week. There is something so healthy about being in relationship, fellowship, worship and physically harmful sports with folks who are working toward the same goal as you. Struggling, succeeding, overcoming all hardships and doubt to become clinicians. Each with our school faces on each day, stethoscope around our necks, white coats and dress slacks to complete the 'professional' picture.
...and then on Fridays - get out the shin guards - because you'll need 'em with these hard kickers.

I can't begin to say how freeing and refreshing it is to kick and run and yell and sweat and take a hard kicked ball to the kidney. (don't worry - no hematuria here, kidney's fine) Or watch the otherwise quiet classmates take charge of the field and charge the goal running as fast as they can to score - possibly taking an opponent out in the process. Amazing!

It is medicine, the best medicine for learning the art of medicine.
addictive
therapeutic
exhilarating

The Amazing Anus

** Not intended for all audiences. Viewer Discression Advised. **

It's such a pleasure to study medicine.

Daily we dive head first into the ultimate taboo subjects. I get to spend ALL day talking about people's unmentionables - their body parts, personal functions and intimate habbits. Topics the average american rarely speaks of - or at least rarely mentions outside their Dr.'s office.

Well I'm happy to announce - Here I am world - ready to hear about your bodily dysfunctions.

[insert picture of Lucy from Charlie Brown - 5cents per session in front of her wooden booth]

Yesterday at 8am we were introduced to the tall, strong, confident, deep voiced Dr. C - the only female MD at a prominent Colon and Rectal clinic in Oregon. Truly a fascinating lecture - the most intrigued I've been all year. Surprise? Not really. As most of you know, stories of gross and interesting bodily behaviors have always been my favorite - much to your expense during meal time stories.

Sitting in lecture was truly a pleasure! 4 hours straight of colons, pruritis ani, fissures, hemorrhoids, fecal incontinence, prolapses, abscesses, sphincter pressure and the amazing anus.
Complete with pictures.

Pure Fun.

Let's all take a moment and celebrate the anus (techically the rectum I should say). It's a medical term so I'll use it unashamedly - you all need to get more comfortable with these words. Imagine life without our fair friend - the few inches of highly innervated circular tissue at the bottom of our long tortuous food canal. It's constantly acting as a reservoir - at the end of which is the little, tightly wound sphincter muscle - the famous gatekeeper - our friend every minute of everyday.

(In case you didn't know, sphincter is my favorite word)

Our anus and its best friend sphincter are a specialized team. The dream team. One of the smartest muscle teams in the body. Think about it. Open your mouth - insert a cookie, an ounce of milk, and some helium gas. Not so hard, huh?

Now bend over forward and let ONLY the gas escape from your lips without losing any of the other contents.

Pretty impossible. Well - this is what your anus and sphincter do EVERY DAY!! A miracle, don't you think?

So let's all pause to take a second and thank our little (or big) back sides - for all the work they do day and night to keep us clean and dry.

For your reading pleasure I took it upon myself to record the best nuggets of insight straight from the fabulous Dr. C....enjoy!

"...I know the butt like the back of my hand..."
"Your rectum is truly one of the smartest parts of your body..."
"...you can only stretch your butt so much with out it hurting..."
"... doc ... I got a pull tab down by my anus..."
" ...they can be little, they can be big, but if you see a big red butt cheek - then holy hannah - send them away..."
..."use a little needle...but brace yourself - it'll hurts like heck..."
"...found impacted stool the size of your head....weighed it....unfortunately we don't get paid by the pound...she was so thankful...."
"...just cut the edges....leave a little sac...let the puss drain out....don't need to torment them...."
"...she said "I feel like I have a twinky in my butt....".... I looked ... and in fact it was like a monster twinky hanging outside her butt....I told her .... we have a date in the operating room later today...."
"...the procedure...it's basically like hotwelding the vessels...to the sides of the anus..."
"....it was a larger man...absess....literally 1 liter of puss....yes, I measured it...."
"...bad butt organisms killing your tissue...we tried to save the testicles...it was a hard surgery"
"...I filleted open her rectum....I cut through her sphincter...then I basically had to reupholstered them...."
"....now you go out and save the bottoms of the world..."

Man I love PA school

Break From Reality

Everyone needs a break now and then.

Whether you're busy or bored, stressed or stagnant - there's health and vitality in stepping from your narrow world - to the full-sized world of someone else.
Even in the midst of PA school - a touch of reality is necessary.
With only ONE exam this week - instead of the usual two or three - Chris and I seized the opportunity to catch up (for 12 hours) with the dearly loved folks of Washington.

Saturday proved to be a whirlwind of a day.
I won't include the plethora of details - but it was a great day.

Sunny. Warm. SEATTLE.

Things we learned or did while on our 12 hour tour...
~ Chris and I were in the same room/vehicle for > 4 hours in a row...first time while conscious in many weeks
~ I had (several) fabulous Mimosas before noon - thanks Lacey
~ my big brother Brian is House Hunting! Good luck, bro
~ bridal showers are MUCH different and less mysterious as a wife than as a fiance'
~ little Brother-in-law Ryan has a girlfriend! woohoo!
~ my medical stories are becoming rated PG-13 - and are officialy inappropriate for dinner table conversation
~ inappropriate medical stories are best told using your INSIDE voice....especially in restaurants
~ Seattle will always be our true home - what a pleasure it is to know our way around
~ but....Hillsboro is starting to feel quite cozy
~ we miss everyone dearly

There is life outside Pacific University.
I can't wait to be reintroduced to society someday...

(the above picture is Bride-To-Be Lacey (middle), with proud Mother-in-law Joyce )

A fraction of the way...

October 12

a random day
a chilly fall day
a Wednesday
hump day
a tired day
a day of pure fatigue
a day of CHF, antacids, chemotheraputic agents & a 4 hour exam
a day of difficulty

a day completed
a day of hope
a glimmer of light...

THE 1/2 WAY POINT

Can you believe it?
Can I believe it?
It is true.

I am officially 1/2 way done with my first year

the supposed WORST year -
of physician assistant school.

Praise be to GOD.
I think I need a drink.

Sunday

"...beyond the passion
and fatigue
I know You're there
and that the spirit is
leading me
somewhere
beyond all this..."

~Rich Mullins

Do you ever have one of those amazing mornings - Sunday Mornings - where you feel like God orchestrated this intentional constelation of ideas, stories, songs, Words, people - all into one great 3 hour stretch?

Well that was me today.

It started with a great autumn run, a thoughtful story on 'this american life', a devotion, an old friend at church, a new friend at church, a perfectly sung version of U2's "I still haven't found what I'm looking for" ...
random but excellent...
and it was all capped off by the BEST sermon ever - written by God - and delivered from the heart and mouth of
my husband Chris.

Perfect

It is mornings like this that I can't believe I'm here.
I am reminded that there is a HUGE plan at work - I'm just a tiny but precious player in it all.

Starbucks Wisdom #1

"Embrace this right now life while it's dripping, while the flavors are excellently woesome. Take your bites with bravery and boldness since the learning and the growing are here in these times, these exact right nows. Capture these times.
Hold and kiss them because it will soon be very different".

~ Jill Scott , Musician
back of my starbucks cup today

Since becoming a triple grande girl, my cups are larger - more room for great quotes. I know it's cheesy to view life through the secular kaleidoscope offered on the cup of coffee I drink each day - but gosh - some of these quotes are worth reading.

keep an eye out
starbucks wisdom is not to be ignored

Rain

"To be interested in the changing seasons is ... a happier state of mind than to be hopelessly in love with spring"
- George Santayana

There is a special tree - deep down in the rural Northern California Valley - that sits humbly in front of 1518 Norden Way. A Special Tree. It was MY tree. I rode (the parents still deny it) in the back of the old chevy pickup in 1981 as we brought it home from the nursery. I watched as it found a new home in our front yard - then watched as it grew, as I did, into a taller and fuller version of itself. And like me - the tree was always wonderfully beholden to the seasons. I loved to sit and gaze at it from my big bedroom windows - each month as the leaves went from deep green of lush spring, to the bright yellow-green of hot summer, to the dusty red of fall - then to finally succomb to the power of winter's pull as they fell to the ground.
The thin wiry branches that remained braced for the rain - and on went the persistent cycle as my childhood spilled into adulthood.

I am thankful for my perspective of seasons. I'm now in Oregon, a grown woman, far from home and far from my tree. And recently my own 'leaves' have turned dusty red and are beginning to succomb to the pull of winter - the pain and trials of a new season. I realized early on that life was full of them, each waxing and waning into one another. One season cannot be rich or delightful unless it had been purchased by the one before it. For the last few years I have been purchasing this season - I had a wonderful courtship, a fullfilling job, an exciting wedding, a rich & relaxing first year, and an amazing acceptance letter to Pacific University.
So now I change seasons - embracing trials, sacrifice, painful truths and wonderful lessons.

Lord help me to keep my eyes on you as my thin branches brace for the rain. Be thou my vision and my perspective as I feel pressures of selfishness, of pride, of inadequacy. Remind me of Colossians - that I'm 'chosen, holy and dearly loved'. Remind me to keep my eyes on my fellow students around me - on the seasons they will endure during this time as well. We'll all have winter - and for some it will be long. Let me be your light. Clothe me with compassion, kindness, humility, gentleness, patience. Give us grace to bear with one another.
And on my barren branches cloak me with love, which binds them all together in unity.

Thank you for the rain.
Let it come.

Triple Grande

I admit it. I have no shame. I won’t make excuses. I cannot hide it any longer … I am a Triple Grande girl. There was a certain level of guilt or wonderment or incredulity when I finally admitted to myself one day that PA school has taken me to a new place - a place where I no longer am satisfied by my double tall sugar free hazelnut. It ran dry on a recent busy morning - right in between Common Ocular Disorders and Staging for Malignant Lung Neoplasms.

I looked at my empty cup, then my watch - it was only 9am - I resolved be proactive.
I wasn’t sure if I should take the leap - both emotionally or financially. Was there embarrassment involved? Should I be afraid that this is a ‘gateway beverage’ choice that would only lead to outrageous habits like bar hopping after school, having a ‘1950’s nightcap’ or worse - developing into a TWO a DAY kind of girl. Could I handle what the future would bring? Should I be praying about this?

With confidence I pulled into my usual Starbuck’s the next morning on Highway 8.
I opened the door and approached the counter. The barista smiled, greeted me as if it was an ordinary day, with an ordinary customer. She didn’t know it was such a big day for me - a Graduation day. I ordered…‘a triple grande, non-fat, sugarfree hazelnut latte’.
She took my debit card, didn’t blink, didn’t flinch, didn’t know.
Then - she looked up, smiled, cocked her blond head to one side and said, “has anyone told you…. you look like Jennifer Garner?”

Ahh, A sign….
All will be well.

Gross Anatomy

Written 07-23-05
We officially finished our cadaver experience – our much touted GROSS anatomy. Some of it was rather anti-climactic – the bodies were so dry and so dead and so old and so misshapen with giant livers, and square hearts and full cecums. But I guess that’s what we all are anyway. We always wanted more – more time with them, more flesh, more freshness, more structures that looked like the paintings in the books. But then we wanted less; less time, less smell of formaldehyde, less exam questions, less forced time in a cold room with dead bodies and itchy faces. So we got what we wished for and I’m a better person because of it. That first day of introduction was oh so long ago – and I’m ready to move on.

As we cleaned up the bodies – I was forced into song – literally - by the Lord I’m sure.
My voice began singing to them –quietly of course – but very distinct songs. I was singing for my old lady with the entire face and the obese guy with the large omentum and the muscular lady with the purple finger nails and the amazing quadratus lumborum. I was worshipping for them – in our wild and chaotic funeral service we had for them as we cleaned up the room, scouring the tables and ridding the room of liquid fat, old organs and pieces of lost flesh – I really couldn’t help singing. I hope my lady was looking at us – they almost seemed to be gazing down – relieved that they were done with their work on earth – they had one last noble job to do – to teach us what their insides really were – for better or worse – and they were finally finished. Revealing to us every internal secret, all the bottles of jack daniels they ever downed, the nasty midnight McDonald's runs - we could see it. We saw those stitches form the open heart surgery –the staples from the missing gallbladder - or that uterus that bore them their 3 children and remained intact through it all – complete w/ large fibroids. I really think our lady was watching and she was hanging out with us as we cleaned her up, stacked her with the rest and got them ready for the incinerator in their clean black plastic bags. They were done.
Officially done. Just like us. We all celebrated together.
And I sang.