Svikki

So many choices

June 24, 2021 1 Comment

It has been a great 7 weeks so far as a mother. We took a two-week trip to Wisconsin to visit family and have been back in Ohio for almost two weeks now. There has been some increased crying over the past two weeks but the nights are still very manageable. We’ve applied for the American and German passports and received the American one in the mail yesterday!

Ok, so let’s talk about the process of how I got pregnant a bit more. I’ll share different parts of the journey with each post. I already shared why I decided to become a single mother by choice in my previous post. As I had mentioned, I happened to meet a reproductive endocrinology and infertility doctor during residency. She gave me some recommendations on sperm banks she liked working with. That is where I began the journey.

Choosing a Donor

If you were to line up the men I dated over the past 10 years, you’d notice they are quite the diverse group of fellas. They all had fairly similar personalities, however. Something obvious would be that the majority of them were black. Over the past 10 years, when envisioning my future children, I often envisioned them to be mix-raced due to the men I was dating. When it came to choosing a sperm donor, however, I decided to choose a caucasian donor.

Although I mainly dated black men in my life, I did not think it was fair for me to have a mixed-race child that society would see as black and not have a partner present to help that child navigate the world (especially in the USA) as a black child. I don’t know what it’s like to be black. I’m aware I live in a world that (besides my gender identity), is built for me to thrive in and I do not have the same obstacles. Although I intend to adopt in the future and there is a chance my adopted child will be black, they already exist in the world and I am giving them a loving home to grow up in. In that case, I will also make sure they have exposure and connections to that community.

So once I decided on my donor being caucasian, I narrowed down the list with a few aspects. I wanted the donor’s description to be as close as possible to someone I would be attracted to. I first narrowed it down to donors who are taller than me. Then, I eliminated the blondes. Although I’ve dated a blonde or two, they usually aren’t what I’m attracted to. That narrowed the list down to around 10 donors. I requested extended profiles for each of them.

Tell me everything!

The extended profiles were about 30 pages worth of information on each donor. They covered information including:

Donor Fertility History
Donor Health History
Nutrition
Exercise
Medical History
Exposure History
Tobacco Use
Alcohol Use
Caffeine Use
Work History/Experience
Sexual History and Relationships
Family Health History
Ancestry
Children’s Medical History
Personal Essays
Personal Characteristics
Physical Features
Psychological Profile
Detailed Family History of Father, Mother, Siblings, Grandparents, Aunt and Uncles

As you can see, that’s a lot of information. I’d venture to bet that is more than some people know about the person they decided to procreate with.

My donor was the third profile I read from the ten I requested. Everything was perfect for me except for a cat allergy (and there is loratadine for that should my child inherit that particular trait). Some important aspects for me were Family Medical History, Psychological Profile and Physical Features. His personality is similar to mine and we have many of the same interests. The personal essays were interesting to read. While my donor had a very genuine and kind reason for wanting to be a sperm donor, others were less impressive. My favorite answer from one of the donors when asked why he wanted to be a sperm donor was “honestly, I didn’t know I could get paid for this!”. While I appreciate your honesty, bro, no thanks.

I was visiting my father at the time I was vetting through the profiles and would read them out loud to him. When I excitedly read my donor’s profile to him, he asked if I was choosing a donor or my next boyfriend. I guess that is a good sign.

Show me the money!

You can spend a fortune on choosing a donor if you so please. Firstly, different sperm banks have different prices for a vial of sperm. It was recommended that I order 4 vials. I only ordered two, but more on that in a later post when I talk about the process. The sperm bank I went with charges $500/vial. There are sperm banks that charge upwards of $1000/vial.

Besides the extended profile, the other extra thing I paid for was some childhood pictures of my donor. My sperm bank does not provide current photos of their donors but does mention celebrity look-a-likes. Other sperm banks do supply a current photo for a fee. The only other extra item my sperm bank offers is an audio file of the donor. I opted not to purchase that (although maybe I will in the future). Other sperm banks have a plethora of extras you can purchase. This can quickly make the sperm donor choosing process an expensive one.

Call me, maybe?

One last thing that was very important to me: an open donor. This was important to me and also strongly recommended by the reproductive psychologist I had an appointment with (more on that in a future post). This means that my child will have the option to contact the sperm bank and obtain contact information of the donor when they turn 18. In a day and age of DNA test kits, the last thing you want is your child to take a test, find their biological father and that person wants nothing to do with them. I will support my child’s decision, whichever way they decide to go with this.

What’s in a name?

That which we call a rose, by any other name would smell as sweet. That might work for Shakespeare and his Montague and Capulets. But what do you or your child call the sperm donor? Do you always say “sperm donor”? I don’t really want my child to refer to that person as “the sperm donor”. I still have a bit of time before this actually becomes a topic of discussion with my child, but currently, I am leaning towards referring to the sperm donor as their father when talking to others. When it comes to talking with my child about it, I still haven’t decided how exactly I’ll refer to the sperm donor. Supposedly there are children’s books available for these situations. I’ll have to find and buy them soon.

I feel father is a formal name for a person whose DNA helped create a child. The term “Dad”, in my opinion, is reserved for the person who raises the child. There are many different family structures in the world and I’m interested to know how other families have decided to handle their titles.

Gratitude for the Donor

My fertility journey could not have gone more perfectly than it did. I had an amazing pregnancy, wonderful delivery experience and now have a beautiful, healthy child to hold and call my own. Although I don’t know who the sperm donor is, I am grateful for him. I’m grateful that he decided to become a donor. The other candidates I looked through weren’t nearly as great on paper. In a way, I know a lot about this man from the information in his extended profile (granted he was truthful about his supplied information).

Potentially I’ll get to know more about him in 18 years if my child decides to reach out. But even if that doesn’t happen, I am content with the information I do know and believe that he is a person I would enjoy being around. I’m sure I will see glimpses of him and his family in my child when I don’t recognize certain aspects as being from me or my family.

One thing I do know, is that I will speak kindly about this man to my child because without him, my child wouldn’t be who they are.

mfg

Happiness, Motherhood

My newest adventure and greatest responsibility

June 1, 2021 5 Comments

For those who follow my Instagram feed, you probably already know where this is headed. At the beginning of last month, I was fortunate to experience something truly amazing. I gave birth to a healthy baby!

Many are probably asking themselves, “wait…what? I didn’t even know she was pregnant.” That was intentional. I really wanted to enjoy my pregnancy for myself, my family, and my close circle of friends and coworkers. Although I have a blog and social media accounts, I actually believe it is really important (and a luxury) to have some privacy and just enjoy life without being worried about posting or comments. This is obviously a personal decision and some people want to share every step of the pregnancy on social media.

I don’t think either way is right or wrong, it should be whatever the pregnant person is most comfortable with. As the belly grows and you begin to show, society already thinks they have a right to comment on your body and give you unsolicited advice. It’s up to you if you want to open that forum up on social media as well.

As a physician, I also am aware of what a miracle it is to actually become pregnant and then stay pregnant and ultimately deliver a healthy baby safely. There are a thousand things that can go wrong along the way. A danger of oversharing is possibly having to confront curious people if the posts suddenly stop because something went wrong. I was cautiously excited with every new milestone of the pregnancy: the positive pregnancy test, the 12-week mark, the genetic testing, the 20-week anatomy ultrasound, the 24-week viability mark, making it to full term. With each milestone, I became more excited. I was still cautious about my excitement until I held my healthy baby after delivery.

My Journey to Motherhood

A year ago today is when this journey officially started. It started with a telemedicine call with the University Hospital Fertility Center in Cleveland. I was visiting my father in Wisconsin at the time, it was the early days of the pandemic, so the newly widely available telemedicine really worked in my favor.

Although June 1st, 2020 was the official start, I have wanted to be a mother for as long as I can remember. I put it off during medical school and residency because I didn’t have the time or the means to have a child. Nor did I want to have a maternity leave of just 6 weeks. I also wanted to completely focus on medical school and residency because there was a lot to focus on. My plan had been to become pregnant about a year out of residency. However, my plan was also to travel a lot during that first year out. With the Covid-19 pandemic, that wasn’t really an option. So I figured, if I can’t travel, I can be pregnant instead and pulled by timeline up by a year.

The birds and the bees

A rather common first question after sharing that you are pregnant is “who is the father?”. Although I completely understand why that is the case, it was not the question I focused on when deciding to try to conceive. At least not so much WHO the father is but rather, WHAT his genetics are like.

You see, I’ve always envisioned myself as a mother, but not necessarily as a wife or partner. Sure, if I found the right person to raise children with, I wouldn’t be opposed to a relationship. However, I can’t say I was actively working on making that scenario happen. I’ve dated various men but rarely was it anything serious. And with those with whom it was, it didn’t work out for different reasons. That was never a major concern for me though. I have said for many years that I would use a sperm donor to conceive if the right man wasn’t in my life at the time that I was ready to have kids.

I’m very happy with my life not being in a partnership, I am grateful to be able to travel for work and I have a ton of projects I want to do around the world. Throw in having a strong personality, being a doctor, and a global pandemic, and the pool of potential candidates dwindles very quickly. But that’s perfectly ok by me.

Unconventional but On-brand

When I first started telling my family and friends that I was seriously considering a sperm donor pregnancy, I received a lot of support. I typically had to elaborate on my reasoning. Afterward, everyone could see why this was a good option for me. (At least to my face… who knows what was said when I wasn’t around.) Many weren’t phased at all by my plans because they had heard me talk about it before. I thought I’d get different reactions from people who didn’t know me that well, but to my surprise, many women said I was a genius and they wish they had done it that way. Baby-daddy drama is real, y’all.

I didn’t know anyone personally who had had a donor pregnancy though so I had a lot to learn. Luckily, a lovely woman I met a couple of years ago is a reproductive endocrinologist and infertility specialist. She was just finishing up her fellowship in Cleveland. She set me up with her good friend and co-fellow for my first consultation. Prior to my appointment, she gave me recommendations for sperm banks so that I could do a little research.

Sharing the Journey

I want to share my journey to motherhood on this site because I think its important for people trying to conceive to know that this is an option. Its definitely not for everyone but it might be for someone reading this that didn’t realize it was an option. It might also be educational for the rest. To protect my child’s privacy, I will not be sharing very specific information regarding the donor or my child. I will also not be sharing pictures of my child on any social media platforms that show their face. I grew up without an internet presence until about middle school at which point I was able to share what I wanted about myself (for better or for worse). I’d like to give my child that same opportunity. Although I realize it’ll be a lot harder in this technological day and age.

I’m pretty much an open book otherwise and happy to answer questions or help with information should you need some help. I am not shy about the fact that I used a donor (as evident by this public post) and actually am quite proud of it. So please don’t feel like it’s an awkward situation. As long as you are coming from a sincere place of wanting to understand and learn, I welcome any questions.

So over the next couple of months, I will share the various stages of my journey on this site as I enjoy time off of work and raise a baby!

Svikki MD

In terms of work, I plan on starting part time in September. I’m hoping to find a job for the rest of the year near my mother in Ohio. Starting January 2022, I’ll start 4-6 month assignments again. At which point, I would like to have a live-in German Au Pair nanny. I’ll give updates on jobs as they come.

mfg

Happiness, Mother Nature

Amateur Advocate

April 25, 2021 No Comments

Today, April 25th, is World Malaria Day. Earth Day was just a couple days ago. Two causes that are important to me. So let’s dive in!

World Malaria Day

Malaria is a parasitic infection that is transmitted by the bite of the female Anopheles mosquito. Nearly half of the world’s population is at risk of malaria. Refugees, pregnant women, and children are most vulnerable to the disease. In fact, every 2 minutes, a child dies of malaria. The disease is preventable and treatable! In 2019 however, there were still 219 million new cases and 435,000 deaths. Children under the age of five made up 70% of those deaths.

There is good news though. About a century ago, malaria was nearly everywhere in the world. Through innovation, scientific progress, financial investments, and governmental/non-governmental programs, more and more countries are being declared malaria-free! Just recently, Algeria, Argentina, and El Salvador were declared malaria-free!

Malaria Fun Fact: the word “Malaria” comes from the Italian “mala aria” or “bad air”. It used to be believed that the disease was caused by bad air around marshes.

Nothing But Nets

I don’t just happen to know all these facts and figures out of nowhere. I’ve traveled to malaria-endemic countries, like Ghana, and was placed on preventative medications at the time. During medical school, I learned about the disease. What really got me in-the-know was something much more recent. A friend of mine posted about the Nothing But Nets Leadership Summit on Instagram that was planned for April 18th-20th.

Since I am currently on a break from work and wanted to fill my time with interesting things, I signed up for the summit. I’ve always had an interest in Global Health and plan on doing international work in the future, so it seemed like a good fit. Part of the sign-up process asked if I’d be willing to speak to my members of Congress on the issue. I haven’t done a lot of formal advocacy work so I thought this would be a good opportunity to get my feet wet.

In the weeks leading up to the summit, there were a couple of virtual meetings that were held going over the congressional meetings and the summit lineup. I researched the pages of Nothing But Nets, the Presidential Malaria Initiative (PMI), the Global Fund, and the members of Congress I’d be involved with. All of the organizations do amazing work and have continued to do so during the pandemic as well. Set up a successful system to combat one disease and you are ahead of the game to help combat another!

The first two days of the summit were a few hours each afternoon and had all sorts of speakers associated with the Nothing But Nets organization. There was representation from the WHO, the PMI, the Global Fund, the Luol Deng Foundation, artists, models, activists, etc. Videos transported us to the frontlines of where the work is being done. It was pretty cool.

Congressional Meetings

The last day was our day of meetings! I was in a group with 5 other people representing Ohio. There were four virtual meetings lined up with the two Ohio senators and two Ohio representatives. We spoke with members of their staff rather than the Congress Senators and Reps themselves. We had a script of information we divided up amongst the six of us. Every office was receptive to what we had to say and appreciated hearing from constituents on the matter. Each of us had a different reason why Malaria elimination was important to us. Some are survivors of the disease, some are part of Model UN, and some like myself, are avid travelers interested in Global Health.

Our goal was to get them interested (many offices already were) in the fight against Malaria. But also, to ask for two main things while Congress continues considerations of the fiscal year 2022 appropriations. The first being flat funding for the Global Fund at $1.56 billion. This ask is in line with the three-year commitment that the U.S. Congress made around the Global Fund replenishment conference in October 2019. This will allow the Global Fund to save an additional 16 million lives. Secondly, we are seeking an increase for the President’s Malaria Initiative (PMI) from $770 million to $902.5 million so that PMI can do three main things:

A) increase procurement of next generation bed nets to overcome insecticide resistance,

B) train and deploy more community health workers to reach at-risk populations, and,

C) address global supply chain disruptions caused by COVID-19 that led to increased manufacturing and freight costs for malaria commodities.

Bottom line: Advocacy is fun and important!

The meetings were totally not intimidating and the staffers really enjoyed hearing from us. We had former congressional staffers working for Nothing But Nets now that reported that they really liked talking with constituents while on the Hill. So if you find a cause you are passionate about and can get involved with congressional meetings, do! Hopefully next year, I’ll actually be able to go to Washington D.C. and show up in person for the meetings.

If you’d like to learn more or even donate to the good cause, check out these links:

Nothing But Nets: https://nothingbutnets.net
The Global Fund: https://www.theglobalfund.org/en/
The President’s Malaria Initiative: https://www.pmi.gov

Earth Day

I could write a whole blog of its own on the topic of saving the beautiful planet we live on. So, I will keep it short here and keep content for future posts. Short and simple, we need to care about our planet and climate change. We need to care NOW and act NOW. Limiting climate change isn’t just selflessly for the planet but also very much selfishly to keep the human race alive. Many humans, mostly in the poorer regions of the world, are already suffering greatly from global warming. The cruel irony is that the people who contribute the least to the problem are the ones most imminently and strongly effected by it.

Live Earth Concert – Wembley Stadium London, UK – One of eleven benefit concerts held across the globe to help raise funds to help combat climate change. It’s hard to imagine being in such a packed crowd now, but that was an amazing concert to attend!

I have been interested in living in a more sustainable and environmentally friendly way for a long time. I remember buying books about the subject in my teenage years. It started off with an awareness of turning off the faucet when not in use, turning off lights, unplugging electronics, and recycling appropriately. My vegetarianism was not initially motivated by the environmental impact but it solidified my stance when I learned about how many resources the meat industry uses to produce a pound of meat.

Over the course of the my life, I have taken opportunities to learn more about what needs to be done. I continuously analyze different aspects of my life and think about how I can live a more sustainable, environmentally friendly life. I’ve swapped out various products for environmentally friendly, plastic free alternatives (I’ll share some of my favorites in the future!). I try to reduce my consumption of goods, reuse items I have or buy second hand, and try to recycle everything that is recyclable. If I can, I walk everywhere I can instead of getting into the car. If public transportation is available, I try to utilize it. There really are limitless ways to help and many have the added bonus of being good for you or your wallet.

As I said, I will touch on the subject more in future posts. I believe everyone can change little things in their life if they are made aware of them! It is not hard implementing measures but you first have to be consciously aware of them. Once you are, it becomes second nature. It’s becoming more prevalent in the mainstream as well with more car companies reporting converting their fleets to electronic cars and President Biden’s commitment to combating climate change at the recent Climate Summit that included 40 world leaders. It’s happening and it needs to! We need to be better residents of this precious planet. Mars doesn’t look very inviting yet.

mfg

Uncategorized

Goodbye and Hello!

April 12, 2021 No Comments

Leaving Rapid City, South Dakota

Svikki MD

I officially wrapped up my first assignment as a locum physician! It was a great experience and I am glad I headed out to South Dakota for 6 months. Sure, it would’ve been even nicer in a non-pandemic world but even with a raging pandemic, I had a really good time.

On my last day in front of the critical access Lead-Deadwood Hospital

Each assignment I do will teach me new things about life, medicine, travel, people, and so much more. Even though it was only my first assignment, I’ve learned a few things for future assignments.

Luggage: I arrived at the airport in Rapid City back in October with a full suitcase, a full weekender bag, a full carry-on suitcase, and my purse. I left with the same amount of luggage. However, I shipped three medium-sized boxes of stuff to my dad’s and mom’s places. I really didn’t buy much on my own (except several books) but with Christmas and my birthday occurring during my assignment, a few extra items accumulated. Lesson learned: leave some breathing room in your luggage on the way there to allow for room for items that will accumulate.
Wardrobe: I packed about two weeks’ worth of business casual clothing. Only a few items were for casual wear. I really should’ve asked what the dress code was, especially during a pandemic. I ended up wearing scrubs to work every day! At some point, I stopped wearing my fancy Fig scrubs because I didn’t want to have to run to the laundromat and do laundry constantly. So I wore hospital scrubs daily. I could’ve left all those business casual clothes at home which were most of the contents of my large suitcase. Lesson learned: inquire about dress code. If business casual is required, curate a week’s worth of wardrobe that mixes and matches to minimize items packed.
Textbooks: I packed about 6 medical textbooks with the intention of working through them during the 6 months. I at least opened each book, some more than others. It was too many options though. I also packed several reference books. As you can imagine, this led to a pretty heavy weekender bag. Lesson learned: focus on 1 or 2 books to work through so it’s more realistic it’ll be done. I found that many of my reference books come with online access, so I activated them all and can access them through an app on my phone or computer in the future instead of schlepping them with me! Also, UpToDate is usually my first stop anyways… if you know, you know.
Hobbies: similar to my textbook situation…I packed too many different art supplies: acrylic paints, watercolors, India ink pens, pastels. When faced with too many options, it felt intimidating to start anything legitimate. I did use some of the items for Christmas and Birthday cards but not enough to justify packing all those things. Lesson learned: limit art medium to 1 or 2 options and focus on improving those skills during the assignment.

Family Time

Due to the pandemic, friends and family weren’t as free to come to visit me in South Dakota as they otherwise may have been. Two friends did make it out and I am grateful for that. It was fun showing them the area. Now, I’m happy to have some time with my family before my next assignment starts.

Dairyland

I flew to Wisconsin from South Dakota to visit my father and his wife. It also happened to be Easter weekend so my father’s wife’s children plus partners came to visit. It was a great feeling being surrounded by a fully vaccinated crew of people (except the two small children… but children probably won’t have to wait too much longer to get vaccinated hopefully). The weather was gorgeous and we even went on a boat ride on the lake. I stepped into my role as Easter bunny once again (it has been a while) and hid the eggs for the kiddos. Being able to sit around a table and have conversations with people was so lovely.

After that weekend, I headed towards Ohio. I made a pitstop for the night at my friend/co-resident’s home about halfway along the route. She has an adorable golden retriever that loves to cuddle… bliss!

Buckeye State

Now, I’m spending time at my mom’s place in Ohio. We’ve had a couple of days of really nice weather. I’ve already visited my peeps at my residency. It in no way feels like I graduated 8 months ago. Talking with the other residents about their clinic schedules, I can still very viscerally feel the anxiety associated with 15-minute appointments, precepting, and trying to stay sane. It gets better, my friends!

My mother and I did a little Goodwill run yesterday. I’ve mentioned before how much I love thrift stores. The environmental benefit of reusing clothing, the wallet-friendly prices, and supporting local organizations are just a few of the perks. It’s also so fun not knowing what you’ll find! I found a viscose H&M dress that still had the original tag. The original cost of that dress was more than I spent on my whole purchase. The other purchases were a beautiful rayon jumpsuit from Lucky Brand, two super soft cotton tank tops from Old Navy, and a cotton pajama set from Victoria’s Secret. At retail prices, that would all cost at least $190 (estimated from a quick online search of comparable products on the company websites). I paid $27 for everything. Each piece fits perfectly into my existing wardrobe and fills a void.

I would rather go thrift shopping than go to a mall any day! Macklemore, hit me up!

mfg

Locum

Wrapping It Up

March 28, 2021 No Comments

As this month comes to an end, so does my assignment out here in South Dakota. It seems like 6 months flew by!

Svikki MD

The past two weeks have once again been a mix of hospital work and jumping in at the clinic several days. On the floors, we had a lower census for most of the time. That changed some with three admissions at once Friday afternoon and an admission yesterday bringing our census to eight. For my friends who work in large hospitals, a census of eight sounds like nothing. It’s 2/3 of our capacity though in our little critical access hospital with 12 beds.

Walking in halls filled with history

I was given the opportunity to have a look at the unfinished document that will become a booklet about the history of medicine in the Black Hills. Although I work in a small critical access hospital, this particular one has a pretty interesting history. Deadwood and the neighboring town Lead are at the center of what once was the Homestake gold mines. With an influx of people looking for gold followed an influx of nuns and doctors looking to take care of the people working in the mines and the towns. Multiple hospital buildings have existed over the years, each growing in size and sophistication with every new building/renovation.

At one point, everyone in the area wanted their healthcare performed in my current hospital because healthcare was free to the people working for Homestake. They would have a copay if they went somewhere else. One of the docs I work with has told me stories of how he assisted in his patient’s open-heart surgeries, orthopedic surgeries, delivered uncountable babies, and did all kinds of procedures. A real badass doctor if you ask me! I’m sure that was a super interesting time to be working as a doctor. Kinda bummed I missed out on it!

After the Homestake mine closed, more and more business left town, and it’s down to a skeleton crew in the hospital these days. Babies are only delivered if they show up in the ED. Endoscopies and vasectomies are the extents of surgery. A few specialties are located in Spearfish, a 20 min drive away. Most are located in Rapid City, however.

Reflections

Looking back at the six months of my time here, let me share some thoughts.

The Medicine

Medicine is the reason I came here. Having worked in University Hospitals and a fairly well-sized hospital during residency, it was definitely a change of scenery coming to a critical access hospital. People here are more independent than a lot of their counterparts in larger hospitals. That is because they have to be. In large hospitals, specialists get involved quickly and patient care gets divided up amongst multiple consultants. That definitely has pros and cons. Ideally, it gives you more specialized care. For the primary care provider coordinating the care during a hospital stay, it sometimes feels like coordinating multiple chefs in a kitchen, however.

Here, the providers in the ED and clinic have to make a decision early on: can we handle this here or does it need to be shipped out. That decision takes into account staffing, therapeutic possibilities, and the need for specialized consultation. I’ve had some interesting case presentations come through but we had to transport the patients to Rapid City because our facility was not appropriate for the care. As a doctor, you miss out on managing some interesting and more complex cases because of it. When they do stay, however, it’s you managing everything which is a good experience to have.

The ED is staffed by mid-level providers (Physician Assistants and Nurse Practitioners). I have respect for the work they do. It is them and a nurse on shift and one of us docs on call as back up. They assess, stabilize and transfer patients to the appropriate level of care. I respect the stabilization part of that the most. Patients can come in in cardiac arrest or as trauma patients and they have to stabilize the patient for transport. That is a lot of responsibility. There are some great providers working in that ED and I’ve enjoyed helping them out and learning from them during the past couple of months.

The People

The majority of people I have encountered here have been delightful and friendly. They are down-to-earth and easygoing. Many are interested in my thoughts of the area and they feel proud about what the area has to offer. Due to the pandemic, I did not socialize with anyone outside of work.

When I initially arrived, the Covid-19 virus was just starting to pick up in the community. I became very frustrated with “the South Dakotans” because I saw masses of mask-less people in the restaurants/bars/casinos on my drive home, mask-less people in the grocery stores, ads on the radio for parties on every holiday. I had several encounters in the clinic with people who contracted the virus and either didn’t want to believe it or didn’t want to be tested. There were even some very unpleasant encounters where it took a lot of strength to remain professional. Announcements from the state’s governor and establishments not following CDC guidelines added fuel to my fire.

Then I started noticing how many people were coming in to get their influenza shot. Once the Covid vaccine became available, I saw how high the demand was. I noticed how afraid many patients were to come to the clinic because they were isolating at home. I realized that the people I called “the South Dakotans” and was mad at, did not represent all South Dakotans. There is a large proportion of sensible people here, I just wasn’t seeing them because they were staying home, avoiding crowds, and using telemedicine for their healthcare to reduce their risk of exposure. Additionally, I realized many of the maskless people and people in crowds weren’t even from here! They came from out of state due to the relatively non-existent restrictions.

So, I apologize to South Dakotans for generalizing my frustration at first and thank you to those who have been helping combat this pandemic.

The Area

Talk about wide-open spaces! From the Badlands to the Black Hills, the landscape is beautiful out here. I would’ve explored more of it had it been the other 6 months of the year that I was here. I got a few nice hikes in at Spearfish Canyon when I first got here. On the two occasions I had visitors, we explored various national parks that supplied us with grand views and up-close encounters with wildlife. Again, if it weren’t for the pandemic, I would’ve looked into doing more things like finding some horses to ride, festivals to attend, and maybe would’ve checked out the notorious Terry Peak mountain that has supplied us with so many orthopedic injuries.

Since the weather has gotten warmer on occasion over the past few weeks, I’ve really enjoyed going on hikes at Lookout Mountain in Spearfish. I don’t overdo it or wander into the forest too deep since I’m by myself. I know I haven’t even begun to see what the area has to offer on trails. I’ll have to come back in the summer months and with some friends or family to explore some more.

Speaking of wide-open spaces. The area was featured in the movie Nomadland (streaming on Hulu and nominated for various awards). It’s worth watching. If you watch it, pay attention to the hospital scene when the characters are in South Dakota working at Wall Drug and one of them gets ill. The nursing station you see at 57:21 is the place I work at! Shout out to nurse Courtney and PCT Karin for making it into an Oscar-nominated movie (their names are seen on the board in the shot).

The Culture

Not to sound like a broken record, but the pandemic sort of ruined this one for me. I really wanted to learn so much first-hand about the indigenous people of the area. Due to the pandemic, museums, attractions, and reservations were closed. I did read a few books which helped me gain a little insight into the Lakota culture. The books helped me understand some of the things I saw at Crazy Horse Memorial and in the Adam’s Museum. I wanted to immerse myself so much more though. I had several Native American patients and some did share insights but I did not press others for information. They were there to heal, not to educate me.

I also didn’t experience much of the Cowboy culture you might expect out here. I did have some tough-as-rocks ranchers as patients though. One is a nonagenarian lady and is tougher than several 30 something year olds I saw. I’ll have to come back to get on a horse and ride out on a ranch sometime.

The Coworkers

This is truly the saddest part about my assignment being over here. The people who work in this small hospital and clinic have been amazing. They took me up in their work-family and made me feel exceptionally welcome. Over the months, I got to know the majority of the people working in the hospital and know everyone in the clinic. I was invited to Thanksgiving and Christmas family dinners. I received flowers on my birthday. They even organized a get-together tomorrow afternoon in the clinic in my honor before I head out later this week.

I’ve had some great laughs with the people here. We’ve worked through some tough cases together.

I have to move on because my wanderlust demands it and the next job is lined up to start in the next couple of weeks (more details about this once the start date and details have been solidified). Aside from that, I definitely could’ve continued working in this environment. So, thank you to everyone in Deadwood and the greater area for making my time here great despite it being during a pandemic. I look forward to coming back in the future to visit, explore, and catch up!

mfg

Locum

You look tired.

March 14, 2021 No Comments

The past two weeks were quite busy. Apparently it showed in my face since a pediatric patient told me I looked tired during our encounter. Gotta love children’s honesty.

Svikki MD

March Week 1

The first week of March, I spent most of my time in the hospital. I had a quiet call on Tuesday. We cleared house pretty well throughout the week as many of my swing bed patients were either discharged to nursing homes or were able to go home. Wednesday, I gave a virtual lecture about fatigue to the South Dakota Academy of Physicians Assistants via Zoom. Thursday, I had another STEM mentoring meeting… also via Zoom. Due to some shortages of staff in the clinic, I helped out Thursday and Friday afternoon. The other Family Medicine doc was headed off for a week-long vacation and signed out an acute care patient to me on Friday. This bought me the second weekend in a row of coming in to see patients.

March Week 2

This past week was even busier. Since we had cleared the house the week before, we were due to increase our census again. A few of those swing bed admissions didn’t arrive from Rapid City until about 4 or 5 PM, which kept me there late to see them and get all the orders placed. On Wednesday, they were short providers in the clinic and I headed over to help out with walk-ins. On Thursday, one of the clinic providers had to go home due to their child being sick. I discharged a patient and saw two of my inpatients and then headed over to the clinic at 9 AM to see walk-ins for the rest of the day.

As so many times before, there was a walk-in at 4:45 PM for a skiing accident from the nearby mountain. They reported the accident had happened within the hour….it is odd how these accidents keep happening right at the closing time of the mountain at 4 PM. This late walk-in again necessitated a nurse to stay late with me and the radiology tech to stay late for imagining. I was pretty sure the bone wasn’t broken when I saw the image but I always wait for the official radiology read to be sure. It wasn’t broken. I let the nurse leave to get to an appointment she was running late to and ace wrapped the injury myself and got the family out of the office by 6 PM.

I drove home to have dinner and spent the rest of the evening finishing up charts from that day (I hate carrying unfinished charts over to the next day).

A Holiday Weekend that didn’t need to happen IMHO

Friday is really when the madness started. This past weekend was St. Patty’s Day weekend in Deadwood. It is essentially a huge drinking festival all weekend. Although I was told it was a bit scaled back from the normal due to Covid, the radio ads for the pub crawl and party announcements made me think it still wasn’t going to be low-key. I was on call all weekend and I feared I would be called in because the ED would be overrun by drunken people. Luckily, they doubled up on ED providers for the weekend. I started the day with discharging a patient and then had two swing bed admits lined up to arrive.

After the first had arrived, the ED called regarding an intoxicated patient that needed admission. Simultaneously, I was trying to field several prescription requests that were pouring in Friday afternoon. I was the only doctor in the hospital and clinic that day and I was on call, so I got all of the patient messages and prescription requests. Many of them were for controlled substances….which aren’t quick click-of-the-button refills. I make sure the refill is appropriate, check drug monitoring programs, calling pharmacies, and having to decide the minimum amount I can prescribe them so that their primary care doctor can continue the refills if they deem them appropriate. That all takes some time.

In the midst of all of that, I received a text from the office asking if I could come to see patients because two of the three mid-level providers that were working that day had to go home. They were either sick themselves or had a sick child. That left only one mid-level in the office. I was able to find an hour to pop over and help out before the clinic closed. Afterward, I still had my second swing bed admission to take care of. The acute care admission bought me my third weekend in a row of rounding.

Saturday

Throughout Friday night, I received several calls from the ED to go over patients. Saturday morning, the calls from the hospital started regarding the intoxicated patient. The treatment plan wasn’t working properly. I was on the phone 4 or 5 times before I quickly hopped into the shower before heading to the hospital. A call came in the middle of shampooing my hair. I thought it was the hospital nurse again and it would be a quick call. However, it was the call center and a patient’s daughter wanted to speak to the on-call provider. So I hopped out of the shower, shampoo in my hair and dripping wet to go grab something to write down some information. For the next 10 minutes, I was dripping all over the floor while taking care of the call. I quickly finished my shower afterward and headed to the hospital.

For the next 5 hours, I worked on adequately managing the patient going through withdrawal. I was able to take care of a few other tasks with other patients in that time as well before finally going home. I was exhausted and took a nap. My first nap in a really long time.

Sunday

Last night was also interrupted a couple of times with calls. Needless to say, I didn’t feel particularly refreshed this morning. Luckily, I had implemented a functional plan for the withdrawal patient and didn’t receive any calls related to them. I spent a few hours this morning in the hospital and then returned home for another power nap. Since then, it’s been pretty quiet.

Indecisive weather

The weather has been sort of wild these past two weeks as well. During the first weekend, it was 68 degrees Fahrenheit! I went on a beautiful hike at Look Out Mountain in Spearfish. Over the past week, the temperatures have dropped again and as I type this, a winter storm is moving in and it’s snowing out with multiple inches expected to fall.

One thing I love: Working with great nurses. It’s been busy and I’ve worked with some great nurses to get through it. Experienced nurses are such a valuable resource for physicians, especially new grads. We also laugh a lot together which makes the work environment so pleasant here.

One thing I ate: Coconut Miso Ramen from Purple Carrot… nothing like slurping down delicious Ramen in between seeing patients to keep you going!

One thing I’m grateful for: the vaccine rollout going as well as it is and President Biden’s announcement that all adults will be eligible to receive the vaccine by May 1st,… Hallelujah!

mfg

Locum

Thank u, next.

February 28, 2021 No Comments

Unlike Ariana Grande, I’m not referring to men. The past two weeks have been rather uneventful. It all seemed rather routine… which is also why I’m starting to itch for a change of scenery.

Svikki MD

My patient census number has grown a bit over the past two weeks. There was a steady turnover of patients, nothing too stressful. There were definitely some characters in the mix but for the most part, the patient panel was nice. I was out on time most of the days. A few evenings, I stayed late helping out in the clinic.

Weight-based everything

I had my first pediatric admission this past Friday. I had gone over to the clinic around 3 PM to help the nurse practitioner with a patient. Then, there were a couple of late walk-ins so I offered to see them. That kept me busy until about 6 PM. On my way back to my hospital office, I ran into one of the nurses. She was telling me that they might have an admission. I inquired what the case was and she told me it was a child. My follow-up question was who the physician on-call was. It was one of the internists. I told her they probably wouldn’t be allowed to admit, Internal medicine takes care of patients 18+ years of age. Family medicine sees all ages.

I made a call to the regional president to ensure that I had pediatric admission privileges. Turns out, I do. So then, I had to make sure I had nurses that felt comfortable with a pediatric patient. Once that was all in place, I went and assessed the patient for myself. The orders took a while to enter because medications and IV fluids for pediatric patients are weight-based. Since I don’t admit pediatric patients often, I double-checked every order.

By the time this was all done, it was 8 PM. I drove home to eat some dinner (Girl Scout cookies are not an appropriate dinner… that’s all I had around in the hospital). The admission History and Physical note was submitted at 10 PM and I was spent.

The late evening Friday acute care admission also won me a weekend of rounding. Luckily, kiddos are usually pretty quick to turn around and the patient was ready to go home by Saturday afternoon. That spared me a trip to the hospital today.

Change of Scenery

I’ve been on this assignment in South Dakota for 5 months now, I have one more to go. A workflow is in place and I know most people at the hospital and all the people in the clinic. The work environment is lovely and my co-workers make my job enjoyable. So, now I feel like I’m ready for a change.

I don’t know how much the pandemic plays into this itch for something new. If life was like the “before times”, I would probably be visiting the local movie theater every weekend (one of my favorite activities during residency besides horseback riding). However, I’m not a bargoer and I hardly eat out, so that wouldn’t be any different. Maybe I’d visit a few more of the local museums and attractions if it weren’t for the pandemic.

The major difference in activities would be traveling. If I could take a trip once or twice a month somewhere, I probably wouldn’t be antsy. With the pandemic and (necessary) restrictions currently still in place, that’s not the most feasible option.

Moving forward, assignments that are 4-6 months will probably be ideal depending on workload and where they are. I’m really trying to go to Hawaii for locums and am willing to go there for a year. People have warned me of island fever, and maybe I’ll regret my current stance, but there are many islands to keep me occupied. I’m willing to take that risk 😉

One thing I love: Sunny days after snowfall. We hardly had any snow on the ground last week and then overnight, several inches of snow came down. However, it’s sunny and lovely out today! I’ve already been on a walk.

One thing I ate: Samoas and Tagalong Girl Scout cookies. As a former Girl Scout, I had to support the cause… and my occasional sweet tooth.

One thing I’m grateful for: Books. I feel there is such a slump in interesting shows to watch. Not that there is a lack of content, just a lack of content that interests me. I bought Bill Gate’s new book How to Avoid a Climate Disaster yesterday and look forward to having it on rotation with my medical and finance books!

mfg

Happiness, Locum

On the Search for Warmth and Financial Freedom

February 15, 2021 No Comments

For all those people who want to start singing “I’ve been looking for freedom” to me

Greetings from what feels like the arctic! With temperatures as low as -18°F/-28°C this past week, South Dakota, like much of the country, has been a bit chilly. Next week we should maintain above 0°F at least. We didn’t get nearly as much snow as other places though. The roads have been decent for the most part (thank goodness for the SUV with 4W drive). Getting into the car in the morning feels like sitting down in a freezer. The condensation from my breath was freezing on the inside of my wind shield!

Reminiscing about last week when socks were optional

Svikki MD

Maintenance was nice enough to install a heating element in my office space this week. The existing heating structures weren’t functional anymore. Unfortunately, I’m not sure the new heating element ever actually started working. Luckily, I wear multiple layers of clothing to work to keep me warm.

Patient numbers were down, across the region, this week. I did have a few new swing bed admissions but for the most part, it was rather quiet. I helped out in the clinic a bit as well.

Casual morning commute in -13°F/-25°C weather

There is a skiing/snowboarding area just 8 miles from work. Something really strange must happen around 4 PM up there. We will start seeing walk-ins to the clinic for ski/snowboarding accidents around 4:30 PM. We had 3 of them Friday evening. Of course they aren’t all tipping over and hurting themselves at 4 PM… the ski lifts close at 4 PM. So, they will fully maximize their ski pass and then head to the clinic. By the time we see them, have X-rays done, wait for the X-ray reads, consult with ortho for broken bones and splint them… it’s 7 PM.

As a locum provider with nobody waiting on me at home, I don’t mind the extra hours. I do feel bad for the rest of the crew though. They have kids to pick up, family waiting at home and have to work overtime. All because people don’t want to leave the lift at the time of injury.

Weekend To-Do List

I make myself a weekend to-do list just about every weekend. It gives me a structure of what I want to accomplish over the next 48 hours. This weekend, it included items such as Hawaii Medical License research (since I reaaaaally want to work there some day), looking over my finances, doing laundry, working on a presentation for a conference in a few weeks, and getting my taxes done.

As a locum physician, I am an independent contractor. That has led to me needing to learn some things about taxes I didn’t need to know as an employee. I’ve learned how to pay estimated quarterly income taxes on the federal, state and local level. That is because as an independent contractor, my paychecks have no taxes deducted from them. Which means, I need to pay the government income taxes quarterly. There are certain deductions I can make that an employee can’t. But I also have to pay taxes an employee doesn’t, like the self-employment tax. Having been both an employee (as a resident and part time faculty at Youngstown State University) and an independent contractor last year, I had to learn to cover both bases.

Working on my financial education

I actually really enjoy working with numbers. Every Friday, I go over my finances after receiving my paycheck. The money is allocated to savings accounts for various purposes. The largest portion is put aside for those quarterly tax payments. I only allow myself to use 12% of my paycheck. Almost everything I purchase is bought with a credit card to earn points/cash back. I pay off the standing balance every week. Whatever is left of those 12% after paying off the credit cards is mine to use. I continue to live almost as frugally as I did as a resident, so a portion of that money still ends up in savings.

I’ve been reading books lately about investing as that is something I definitely want to get into soon. Unfortunately, financial education is not something that is well integrated into our public education system,… although it totally should be! (As should more home ec classes… I mean “Family and Consumer Science” classes as they are now called apparently.) So, I am continuously trying to further my own financial education.

Lit List

Some of the books I’ve read and really enjoyed so far include:

Rich Dad, Poor Dad by Robert Kiyosaki
The Millionaire Next Door by Thomas J Stanley & William D Danko
Cash Flow Quadrant by Robert Kiyosaki
The ABCs of Real Estate Investing by Ken McElroy

I’m currently working through Robert Kiyosaki’s Rich Dad’s Guide to Investing and Ken McElroy’s The ABCs of Buying Rental Property. The goal of all of this is to be informed and someday achieve financial freedom. That financial freedom will then give me the freedom to spend time with family and friends, work when I want to and free up enough time so that I can work as a doctor in various parts of the world in underserved communities while not getting paid for that work.

Have you read any great personal finance books? Please do share! Leave a comment below with the title so I can check it out!

One thing I love: FaceTime. It just really makes long distance not feel so long at all <3

One thing I ate: vegan chocolate mug cake,… throw a few ingredients in a microwavable mug, stir it up and microwave for a minute to enjoy. Far less mess than making a whole cake and fewer tempting calories lying around.

One thing I’m grateful for: having a warm place to live. The temperatures are crazy low across the country. I hope people who don’t have a warm place to live are finding enough safe places to stay warm. Unfortunately, I know that’s not the reality for everyone.

mfg

Happiness, Herstory, Locum, Travel

Chronicles of a Friendship

February 8, 2021 No Comments

Svikki MD

The last week of January was less eventful than the one before. There wasn’t so much unsolved mystery surrounding my patients. I did end up having to transfer one of the patients out to a higher level of care hospital in the middle of the night though. We had hit the point where we were no longer able to escalate our care in our facility.

Beyond that though, I was preparing my patient panel to be handed off while I take a week off. I was supposed to be going to Brazil for two weeks for a friend’s wedding but,… you know…. the pandemic. So instead of taking two weeks off, I just decided to take off one to visit my family back in Ohio for a few days and increase my Vitamin D level in Miami for a few days. As always, I try to do everything (short of not going) to reduce my risk of exposure during a pandemic. I try to be as diligent as I am in the hospital out in the real world. That means wearing my N95 during the entire duration of the flight, sanitizing high-touch surfaces, frequent hand washing and sanitizing, and distancing myself as much as I can from others around me.

Brrrr…it’s cold out here

I thought my winter in South Dakota would be heavier than winters in Ohio. Thus far, that hasn’t really been the case. Ohio winters are unfortunately very grey. One of the first things I looked up when I was considering South Dakota as an assignment was the days of sun during the winter. Lucky for me, I found that they averaged more than they did in Wisconsin (a winter location I tend to enjoy) and way more sun than Ohio. I arrived in Ohio shortly before the snow began to come down. Nothing close to what Chicago and the North East were dealing with but it laid a pretty nice blanket over the area. I certainly got my share of winter feeling in during the few days there.

While in Ohio, I stopped by my residency to say hello. It’s crazy to me that graduation was already 5 months ago. It sort of feels like I’ve just been on an away rotation. It felt so good seeing my residency family again; the front desk ladies, the MA’s, the residents, and the attendings. I’m really fortunate that my residency is such a lovely place to return to. I know many people do not have enjoyable residency experiences. The crew in Boardman, Ohio is definitely a special group of people.

Hello Sunshine

I have visited Miami countless times. These trips started during medical school when a German friend and I would fly to Miami and stay with one of my friends in Miami. Some of those trips were pretty wild and served up almost all the components of a good rap song. My Miami Friend has become one of my best friends over the years. I can’t thank her enough for her hospitality, kindness and generosity over the years. We have met up in several places around the world and I can always count on her to be down to travel somewhere. More on her in a bit.

Miami is open

In terms of the pandemic, Miami felt quite different from the places I have been spending my time at over the last several months. People are out in clubs, restaurants and bars like the pandemic doesn’t exist. To their credit, most people I saw walking around in public places were wearing a face mask. Miami also has the advantage of the weather and outdoor venues which are safer in regards to viral transmission than being indoors at a restaurant in say, South Dakota.

However, I still avoided the masses. My friend and I were mainly at her place. We spent an early morning on the beach when there was hardly anyone else around. The Rubell Contemporary Art Museum that we visited had limited visitors. If we ate at a restaurant, it was outdoors and well spaced from other guests. The days of going to the big clubs packed like sardines has been over for us for a while now, so I didn’t really miss that former staple of a Miami visit.

Keith Haring at the Rubell Museum in Miami

It was nice to spend a few days with family and close friends after not having much of any social interactions in South Dakota over the past several months. At the same time, I look forward to returning to work tomorrow in Deadwood. I’ve only got 7.5 weeks left of my assignment in South Dakota and I am sure they will fly by.

The Web

I often like to reflect on my life thus far and the experiences I’ve been fortunate to have. This often happens when I am on trips. It’s fun for me to run through the sequence of events that led me to that particular moment, that connection with someone, or the opportunity that presented itself.

Let’s take my Miami Friend as an example. Because of her, I have had amazing life experiences, met fabulous people I now call my friends and opportunities that I would not have had without her. But what needed to happen for me to meet her?

The Origin Story

Well, when I was about 14-15 years old, my younger sister and I did a photoshoot at home for fun. I showed the pictures to my father who suggested I research local modeling agencies to see if that would be something I could pursue. The Rock Agency in Madison Wisconsin is what I found. I called them and set up an appointment with their New Faces Director. After a short introduction of the agency for all people present at the New Faces Open Call, I met with the New Faces director individually. She saw potential and had me set up my first photoshoot. [The agency owner is one of my best friends now and she has created a whole web of connections and experiences in my life as well.]

My first photoshoot was a blast. I ended up befriending the photographer and make up artist and my family’s home was used as the location for a modeling shoot a few years later. Following the first, I had another photoshoot to build up my portfolio. Then, I was invited to attend a modeling convention in New York City that summer called IMTA. It’s a huge convention with hopeful models and actors from around the United States that participate in various competitions that are judged by model and acting agents from around the world. This lead to my first modeling contract in Milan. [I met one of my other best friends on this first contract in Milan, so our friendship’s origin story is the same up to this point.]

Photographer: Jeff Wilson || Make-Up: Anja Epkes

Ciao Milano

Two years later in 2008, I was back in Milan for my second contract. I was originally put into an apartment with a bunch of girls. However, I quickly befriended one of the other models from the agency who was living in a 2 model apartment in China Town. This model was my now best friend from Miami. We orchestrated a switch between her roommate and myself so that we could live together (the agency wasn’t very happy with us when they found out we did this without telling them…oops.) We would cook together, shop together and travel to other Italian cities. After our contract, she went back to Miami and I returned to Wisconsin. The only connection we continued to have back in that era was being friends on Facebook.

This is easily where our story could’ve ended and my life would be completely different if it had. Seriously, I could draw up a whole web of how many of the major experiences in my life and opportunities that I have had would never have happened the way they did if it wasn’t for having met her in Milan.

The Reconnection

Luckily, it didn’t end there. It was several years later, in 2013 while I was in medical school and wanting to do a bit of modeling on the side, that I had to fill out a form listing agencies I’ve worked with. I couldn’t remember the one we were with however, so I facebook messaged her. We briefly caught up on what the other one has been doing over the past several years. In this conversation, she recommended I come visit Miami if I ever needed a vacation from medical school. In 2014, I took her up on that offer. A German friend and I visited her for a week.

Welcome to Miami

My Miami Friend had worked in nightlife for years. At the time, she was working in the hottest club there was, LIV in the Fontainebleau Hotel. You know, one of the only clubs you will find multiple rap/hip-hop songs referencing? The club that gave the world LIV on Sunday which was THE place to be seen as a rapper or hip-hop artist. Depending on the night and who was performing, the admission rate to the club for general admission was upwards of $300. The amount of money spent on bottles of champagne or just thrown in the air to make it rain was insane. Yes, she worked there.

She introduced my German friend and I to the best nights of our lives. We were introduced to all of her friends who worked at LIV as well. Having worked in nightlife for so long, she had vetted her friends so the ones I ended up meeting and becoming friends with were all awesome, kind and genuine. (Kind and genuine is not always easy to find in a setting like Miami, so I was fortunate that she had done the weeding out beforehand).

The Miami Crew

This group of amazing people not only made sure my German friend and I had nights we will never forget, but they also kept us safe. We were only ever introduced to other good people. The bottle girls, bartenders, security guards, managers, promoters and bus boys I was introduced to became my second Miami family and LIV became my second Miami home. I could walk into a full lobby of people waiting to get into the club, bypass them all and be greeted by my name by the bouncer and let in. It felt unreal.

All thanks to my Miami Friend. And it didn’t stop at LIV, the people who worked there were wildly connected to other people working in Miami which led to great nights at other clubs, comps at restaurants, sporting events and concerts. I was given the opportunity to experience Miami totally different than your average Miami tourist. I can’t even list all the artists I saw perform live at LIV of Sunday but to name a few; Drake, Lil Wayne, Chris Brown, 2 Chainz, Fabolous, DJ Khalid, Trey Songz and so many more. Thanks to the girls, I always had VIP access and drank the yummiest champagne. I’ve partied at the same table as Lil Wayne. I’m telling you, Miami was a different world back then and I am so grateful I was invited into it by my Miami Friend.

Beyond the party

It wasn’t only partying that she made possible for me, through meeting her friends and becoming friends with them myself, many experiences and opportunities started to branch off of me knowing her. After graduating from medical school, I took a year off before starting residency. My goal of that year was to work in a job that made good money so that I could travel around the world for about 4 months prior to starting residency.

Where else in the world would I go but Miami for this?! I knew the greatest people who knew the right people. With the help of my Miami crew, I secured an interview and subsequently job at the second place I worked and ultimately exclusively worked at, Hyde Beach Miami. I’ll share more about that year in particular at a later time but that year created a multitude of new connections, friendships and opportunities for me. For instance, because one of my friends in Miami invited me out to dinner one night with some of her friends, I met my now friend who helped me plan my one-of-a-kind 3 week trip to India! One of the greatest trips of my life! The web is big, my friends.

Moving on

Over the past several years, I often visited Miami as a little get away from residency. As my Miami Friend transitioned from night life to becoming a manager of an Art Gallery, my visits transitioned to a more feasible wake/sleep schedule. Many of our friends also transitioned out of night life into other careers. So instead of spending our nights in the clubs and sleeping all morning, we were meeting up with friends for brunch, visiting museums and traveling to other parts of the country and the world.

My Miami Friend was the first one to visit me in South Dakota. We met up in New Mexico for New Years last month. I’ve celebrated my last three birthdays with her; three years ago in Miami, last year in Tulum and this year, a bit belated, in Miami again. We are already contemplating when we will see each other again and look forward to the world being safe again for international travel. We have quite the extensive bucket list to work on.

There are so many stories in between that saga that I didn’t even mention. But for me, I trace all of those experiences in my life back to the moment my parents encouraged me to look into finding a modeling agency. You just never know what an experience in life will bring you, so don’t miss an opportunity to do something new, you have no idea how many wonderful consequences can emerge from it!

mfg

Food & Drinks, Happiness, Locum

Chubby Chipmunks and Busy Bison

January 24, 2021 No Comments

Hello beautiful people! I know I’ve sort of been on a bi-weekly schedule with posting but it’s been sort of busier at the hospital lately and I had two friends visiting from Wisconsin last weekend.

Svikki MD

So, after a few weeks of a fairly consistent patient census, there was finally some turn over on my list. I family-medicined (we will pretend that’s an actual verb) the heck out of them. Since many were waiting on placement, they didn’t have acute medical issues. This gave me the opportunity to adjust their medications so that their diabetes, hypertension, etc. were wonderfully controlled before they left my care. Once that was all achieved, however, I was ready for some new challenges. I got what I wished for!

A few patients currently are either badly controlled diabetics or hypertensive patients or ones where there are still big question marks in their medical picture for me… I spent a combined 6 hours chart diving on one of the patients this weekend. There are just unanswered questions and the patient is miserable… I’m channeling my inner Dr. House to try to figure out what is going on sans the narcotic addiction and callous attitude.

I’m really enjoying the close work on the floor with the nurses. I try to keep them in the loop at all times and explain why I am doing what I’m doing. It seems to be resonating well with them. This set up also allows me to take a lot more time with each of the patients and keep them educated and informed about what I am doing.

I’ve only ever been a patient myself once when I badly sprained my ankle. For that, I was only in the emergency room, not even an admitted patient. I can only imagine what it feels like to feel so little autonomy while in the hospital as a patient. Thus, I try to involve my patients in my decisions so they know what’s going on and can give their input. I realize this might be easier for me to do with a max census of 10 patients in a critical access hospital, but I think it is so important to try to do this well.

It resembles Veggie Straws!

As I said, I had two friends visiting from Wisconsin last weekend. They have been super conscious about COVID and frequently get tested so I felt it was a reasonable risk to take having them come visit. The county they live in is pretty strict with COVID regulations. It was a bit of a shock to them as soon as they crossed into South Dakota and stopped at a gas station to find that they were (unfortunately) the only ones wearing masks.

Since I still don’t trust doing anything here that involves being around other people, we headed over to Wyoming the first day to check out Devils Tower.

Located only an hour drive from Spearfish, Devils Tower is a large geologic feature that juts up from the earth surrounded by prairie. It is a sacred structure to Northern Plains Native Americans. It’s apparently one of the most famous rock climbing destinations in Northern America. Much of its origin is agreed on but there are still aspects up for debate in the scientific community. It is formed from rare igneous rock and is the largest example of columnar jointing in the world!

We walked the trail around the base of the structure. Along the way, we hypothesized about its formation, the wildlife, and the surrounding area. The comical thing was that after posing a question, a posted sign along the way would answer the question we had just posed. At some point we made it a game to guess what the next sign would tell us.

Where are the bison at?!?

We did a quick pit stop in Deadwood on our second day so that I could show them the historical downtown main street. I had bought them some local chocolate truffles as a welcome gift and they enjoyed them so much, we stopped by the store for them to buy a stash to take home. The place is called Chubby Chipmunk. I was gifted a few truffles upon my arrival at the hospital. They proudly told me that these truffles have been featured in the gift bags at the Academy Awards! They are really good chocolate truffles and look so pretty!

Check out all their yummy truffles here!

After their chocolate shopping spree, we headed to Custer State Park. The road took us past Crazy Horse Memorial. I stopped and gave them the cliff notes version of its history and purpose. I was so excited to show them Custer State Park. After the amazing time my friend and I had there in November, I felt this was the perfect South Dakota location to take them. The Wildlife loop was a bit of a misnomer this time. Not…a…single…bison!! Not ONE! And let’s be honest, that is the number one animal you want to see. The white-tailed deer may have entertained my friend from Miami, but these Wisconsinites didn’t care about seeing deer.

Luckily, after more than half the drive, we came upon the herd of formerly domesticated donkeys! This time, we got out of the car and hung out with the herd a bit. They were more interested in my car as a salt block and promptly got to work licking it all over.

That was basically all the wildlife we saw… donkeys and deer. Not exactly what I had in mind but they enjoyed the pretty landscape nonetheless.

Veggie Vikki

I have been a vegetarian since I’ve been 9-years-old. Granted, my parents weren’t thrilled at first. I was held hostage at the dinner table until I had a bite of chicken. Luckily, that didn’t last long. People are often intrigued as to why I’m a vegetarian. What about all the delicious burgers, steaks, etc out there?!

I’ve never craved meat. As a 9-year-old, the treatment of the animals was a big factor (and still is). My favorite animal growing up was a pig! I collected about 100 stuffed animal pigs…that didn’t make bacon enticing to me. A few years later, I started getting really interested in the environment. I changed things in my day-to-day to be more eco-friendly. Learning about how many resources a pound of beef uses was mind-blowing. A few years after that, learning about how meat can negatively impact your health just continued to underscore my decision. I’ve never missed it and never craved it.

The transition

A bit over a year ago, I finally made the switch to be as vegan as possible. I don’t like labels. I understand why humans use them, they organize the world around us without getting caught up in details. However, I am still not a fan. I think it’s best to live a life that is kind to your body (you only have one unless you believe in reincarnation) and the world around you as much as possible.

A per-definition vegan would not eat honey since it’s an animal product. However, I still consume honey. I believe in its medicinal benefits besides it just being my preferred sweetener in tea. I will also have the occasional sweet treat which is not always truly vegan. But other than that, I have cut out all dairy products and only eat eggs rarely. If I do, only if they are from happy chickens (pasture-raised and preferably from a farmer I know). My justification there is that chickens lay eggs regardless. If they are living happy pasture lives, my impact is minimal on their lives. (I’m sure there are vegans out there that would disagree with me, and that’s ok. Again, that’s why I’m not a fan of the label.)

Being a vegetarian and traveling has never been easy, but I’ve never starved. I will get full off of sides any day. India was truly the nicest place to travel as a vegetarian. Trying to be vegan definitely ups the ante when trying to find meals outside of the own home.

Dinner time!

The thing I started doing during residency occasionally (on a resident salary) and have increased to fairly consistently now, is using Purple Carrot. Like many meal prep delivery services out there, you pick your meals and all the pre-portioned ingredients are delivered to you. No food waste! Dinner was my favorite part of the day during residency. My then-roommate and I would cook together every night and enjoy a freaking delicious meal together. Now that I am alone in SD, the meals are both dinner and the next day’s lunch! I still enjoy the process of cooking. Last week I made this eggplant Florentine with tofu ricotta and chickpea pasta…delicious!

My intention is not to try to convert anyone to veganism. I’m aware vegans have a bad rep for that. But maybe, take some time to analyze what nutrients (or lack thereof) you are putting into your body. Food is medicine. Your body can only be as healthy as the food you give it to run on. Also, if you don’t know how many resources a pound of beef or a gallon of milk uses and how that impacts the environment, do a quick internet search. Even just reducing the amount of meat you eat or dairy you consume by a little will do your body, the animals, and the environment real good.

I’ll continue to share little aspects of how I try to live a healthier, more eco-friendly life. It’s never meant as a sermon or me wanting you to feel bad about choices you make. I just truly believe many people don’t contemplate the impact their food choices have on themselves and the world. I come from a place of genuine concern for peoples health and the health of our planet. Please don’t hesitate to ask questions if you have them or share the ways you are making your diet better! I’d love to hear what you’re doing!

mfg

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