family medicine Archives

A hui hou and Mahalo Moloka’i

February 21, 2024 No Comments

Aloha and greetings from gray-skied Germany!

The fact that my last post was in August of 2023 is a good indication of how busy I was over the last 6 months.

Our time in Hawai’i has bittersweetly come to an end. We departed Moloka’i on January 19th, 2024, just 9 days shy of being there a full year. I am so happy I decided to go and grateful for the experience.

As previously mentioned, we moved into a new house for the remainder of my contract. The view from that house is perhaps one of my favorite views I’ve had anywhere. The house was spacious but certainly also gave me plenty of work keeping it clean. There seemed to be seasons for critters who tried to join our living situation. Cockroaches, scorpions, centipedes, ants, and mice all seemed to take turns keeping me on alert all the time. I always with house shoes on. I would scan the floor each morning before my toddler awoke to make sure nothing was lying around.

My fear was either of us getting a centipede stab most of all. Many on the island had told me these hurt the worst. I had also seen some infected wounds in the office. I didn’t mind the centipedes’ appearance, just their potential. The scorpions were my least favorite encounters, however. I’m happy to report we both made it off the island unharmed by critters.

We stayed mostly on the island of Moloka’i the second half of the year. Aside from a weeklong trip to visit my mother and sister in Ohio and New York, respectively, and an extended weekend trip to Miami for a friends wedding. Hawai’i is just so far away! Travel times were longer than my average travel times to Europe from the mainland. Luckily, my toddler is seasoned when it comes to long flights and we managed them relatively well.

Mokulele Monopoly

One of the main reasons we didn’t venture to the other islands for short trips was related to the singular and awful local airline. Notoriously unreliable, Mokulele, also called Moku-delay-lay, has made life difficult for the community on the island. Aside from frequently moved flights, delays, or cancellations, they are also quite expensive. A short 20-minute flight to Maui costs about $120. Whereas you can island hop between the other islands with Hawaiian Airlines for a fraction of the price. Although I realize flying small propeller planes is likely more expensive per capita than a full jet plane, it hasn’t always been this expensive. Pre-pandemic airlines used to offer reliable $50 one-way tickets. That company was sadly bought up by Mokulele and well, they certainly didn’t continue their business model in any regard.

The flight issues have lead medical specialists to stop coming to the island. Home physical therapists stopped their services as well. Patients have a hard time making it to their doctor’s appointments on time in Honolulu. Some offices have resorted to just saying “Get here and we will see you when we can”. I’m positive it is impacting more areas of business than just healthcare. I truly wish and hope that this improves for the people of Moloka’i quickly.

Waiting once again on our flight after several delays

The People

Besides the beautiful ocean views and ability to visit the beach on the weekends, I will certainly miss the people and community of Moloka’i. There is beauty in small towns and the communities that inhabit them. Certainly, there are also drawbacks. It’s not for nothing that a popular sticker reads “What happens on Moloka’i, everyone already knows!”

The vast majority of people I interacted with were grateful for my presence as a doctor. I always replied, “It’s my pleasure, a beautiful island is not a bad place to be!”.

The island doesn’t feel like your typical Hawai’i. It feels like real people, living real lives, with culture and community. I don’t blame them at all for wanting to keep it that way and hold off any major tourist development. This would undoubtably change the vibe of Moloka’i. So, if you are looking to visit Hawai’i, please, go to any of the other islands that are set up for tourism. Not only do those islands need the tourism to sustain so many people’s livelihoods but you’ll also find enough beautiful nature on the other islands with much better infrastructure to accommodate you. Don’t be shocked if you aren’t exactly made to feel welcome on Moloka’i as a tourist. It’s not what she is there for.

The Office

The office staff is another area I will miss dearly. The whole staff was female except one male MA (bless his heart for managing to work with all of us). They are fun, fierce, loving, caring, and work hard. My toddler enjoyed visiting all the aunties and especially loved being spoiled with chocolates.

Being a small town, patient and staff interactions were much more intimate and intertwined than in bigger cities. Many patients were someones relative or they had gone to school together. It often led to the hallways being filled with staff stopping at exam rooms to chit chat with patients or patients chatting across the hallway between rooms with other patients waiting. It was just a really lovely environment to work in. Props to those women and man for supporting their community so well.

The Beach

Months before our departure, it dawned on me that we only had a limited amount of weekends left on Moloka’i. To not regret not having used the opportunity wisely, I made an effort to go to the beach every weekend, usually on Sundays. It worked most weekends unless it was pouring rain. The few hours on the beach grounded me. My toddler enjoyed our beach days too. Nothing like rolling around in the sand and running into the ocean. We often started our time on the beach by ourselves and as it drew closer to noon, a few others would appear.

There was a group of paddlers that met most Sundays at one of the beaches we frequently visited. My toddler loved looking at the canoe and climbing all over it while on shore. I knew some of the paddlers through our friend who rented us the house we were living in. They all embraced my toddler’s curiosity and enthusiasm with the canoe and often would allow them to climb in and even handed them paddle to paddle the air. So often, my toddler requested to go out on the water with them. I sadly had to deny the request and said we would have to wait until they were older and bigger for it to be safe. So, while the crew of paddlers took off on their trip, my toddler and I would run, splash and swim in the ocean instead.

Looking back on those beach moments, I think being on those beaches was when I was most at ease.

On duty, all the time

Many people asked me if I would be coming back to Moloka’i in the future. I could see myself going back, for a few months at most. Alternatively, when my kid is in their tween years. As much as I enjoyed our year on Moloka’i, it wasn’t always easy. That’s not to say it was hard, but it was very busy. I initially thought it would be a more relaxed year overall given the limited distractions. While this was true in one sense and I certainly felt calm with living the slower-paced, less distracted life and daily views of the ocean,…normal day-to-day things kept me constantly busy.

On the mainland, I had several factors that helped simplify my life as a single working mother. I would occasionally have a cleaning person clean the house we stayed in. There were many opportunities to entertain a toddler including museums, parks, libraries, playgrounds, etc. I had an au pair last year which allowed for me to have a few hours a week to do something for myself such as work out or sit in a cafe and read. Purple Carrot (a vegan meal kit subscription) was not only extremely convenient but I didn’t have to plan what was for dinner. I’d also have a healthy, delicious lunch left over for the next day. I was closer to family which allowed not only for more visits but also gave me a sense of back up if I needed my mother to fly in to watch my child in case of illness.

In contrast, on Moloka’i, I had none of this. No one to clean the house (which took up several hours every weekend). No restaurants that catered to vegan or vegetarian diets and Purple Carrot didn’t ship to Hawaii. This meant I was fully responsible for all meals and if I didn’t have the energy to cook, we’d have pasta with tomato sauce. Besides the beach, there was one playground we could go visit. This had to be done in the early morning or late evening otherwise it stood in the hot sun throughout the day. There were no other toddler activities to partake in. My family and friends were so far away, that I hardly had anyone visit (despite SO MANY people saying they would when I announced I’d be going to Hawaii).

The above essentially meant I was always doing something. Rarely did I just sit and take a deep breath. If I wasn’t working my 40-hour weeks, I was fully engaged in being a mom and taking care of the home. I am aware that this is the reality for many women. Furthermore, I chose to go to a remote island. I’m merely reporting that it was a lot to juggle constantly and now, being around more resources, I more profoundly realize just how busy I was managing it all by myself this past year. Moving forward, I have to ensure certain support systems to prevent burnout on my end and to continue to allow me to enjoy the lifestyle.

What’s up next?

To be determined. For right now, I am enjoying some much needed time with family and friends in Germany. I’ve eaten my weight in bread because it’s just so darn delicious. The plentiful cafes and restaurants have also made me happy. I have some exciting developments in the works that I will share more on once finalized. So stay tuned for that! Shouldn’t be more than a few weeks.

mfg

Happiness, Locum, Travel

Cows, Water, Flights & Family

November 30, 2022 No Comments

Dairyland

I’m into my last three weeks of work at my assignment in Wisconsin. It certainly hasn’t felt like 5 months altogether. This may be due to the fact, and I’m sure this won’t surprise regular readers, that we were quite busy. If we weren’t off to a different state or country, we were spending weekends visiting friends in Madison, Milwaukee, and Chicago.

I work in a rural family practice with another physician and a nurse practitioner. As a locum, my schedule tends to fill up on the day of or a few days out. These visits are often same-day complaints, pre-op evaluations, ED follow-ups, and such. Things people would ideally see their primary care provider for but they are both essentially booked out for months! It is a different mind game seeing these sorts of visits on a regular basis vs typical primary care follow-up visits. I have a few patients I’ve seen on a regular basis, but the majority of patients are new to me every visit. It is all part of the gig as a locum, however, and I don’t mind it. Keeps things interesting!

I work with two medical assistants I’ve gotten to know quite well over the past few months. The rest of the staff consists of really lovely nurses, medical assistants, radiology techs, lab techs, and front desk workers. The feeling of familiarity amongst the staff was evident from the first day there. We have many laughs throughout the day.

The substitute teacher of doctors

Many patients have asked if I would consider staying. The administration did that same early on. I make a conscious effort to be clear that I live a nomadic lifestyle and that keeps me sane. The physician I took over for, left primary care to work in urgent care for more of a work-life balance. There is another locum coming in after me to cover the first half of the year before their new hire starts permanently. I feel the era of having the same family physician for 20+ is over but you can still find the occasional doc that has stayed in the same practice over decades. There are a lot of factors that contribute to this trend. Burnout is a big problem among them. The locum lifestyle definitely helps me avoid burnout because I always have a new adventure to look forward to!

Time: A man-made construct

Mausi has done astoundingly well for all the time zones I took them through over the past few months. There have been no “up all night” or “sleeping all day” despite time differences of 12 hours. The kid is made for traveling and I am pumped about it. We’ve also visited the cock pit of two of our flights and run up and down airplane aisles countless times.

September

We started the month off in Waupaca, spending labor day with family and friends. Mausi even went down the water slide a few times…with my help, obviously. The following weekend, Mausi and I hopped over to Cleveland to see my mom and partake in my citizenship interview and civics exam (aced it). By the end of the month, my mother came to Wisconsin to hang out for 9 days.

Took a lake cruise to see some of the estates

Wisconsin kiddo with cows and Oshkosh B’gosh overalls

October

The first weekend of October, Mausi and I flew down to New Orleans to visit our dear friend and former Eugene nanny and her two boys. At that time, she was far along in her pregnancy and I helped get stuff done around the apartment to prepare for baby number 3’s arrival a few weeks later. Mausi was ecstatic to see her two friends again. It was a quick trip but filled with fun.

The following weekend, I was lucky enough to witness my best friend from middle school/high school get married. I missed a lot of my high school friends’ weddings because I was in medical school in Germany. Then I missed a lot of my med school friends’ weddings because I was in residency in Ohio. I’m so happy I was able to partake in his!

I officially became an American citizen! The judge presiding over the ceremony held a very beautiful speech about the importance of immigrants in a country like the USA. Lovely to hear, especially after the rhetoric of the previous president and his administration.

Personal record

Toward the end of the month, Mausi and I went on our longest airplane ride together. It was a direct flight from Chicago to Delhi, India. The outbound flight lasted about 13.5 hours, and the return flight about 15 hours. On the way there, I was given a new seat assignment during check-in with the hope that I would have a whole row for us. Unfortunately, when it came time to board, we ended up having someone seated in the aisle seat.

Mausi, being their usual curious self, was all over the place; pulling anything that moved, pushing all the buttons, and climbing on the tray table. The travel busy board and busy cube I had purchased the week prior provided a few solid minutes of entertainment. Mausi did end up sleeping for a good 6 hours. I laid them across the two seats we had and tried to position myself around them. That was minimally effective and quite uncomfortable. After trying that for 4 hours, I eventually just laid down on the ground and slept for 2 hours. That was enough for me not to feel like a zombie when we landed.

India – Delhi & Diwali

We were met at the airport by my boyfriend and his son. At their place, we were lovingly greeted and welcomed to their home by his parents and the house staff. We ate delicious home-cooked food and I got a proper nap while Mausi explored the house and had many willing eyes watch her. That evening, we all went to a neighbor’s place for a Diwali celebration.

Diwali is the Indian festival of lights. It’s celebrated by many religions and is one of the most important holidays in Hinduism. We got all dressed up in traditional Indian outfits and ate way too much food. Mausi met a few children at the party and played with them essentially the entire night, just coming to check if I was still around from time to time.

India – Goa

The next day, following our Puja (prayer) for Diwali, my boyfriend, his son, Mausi and I were off to the airport. We caught our flight to Goa. Goa is a coastal town about halfway down the west coast of India. Portuguese architecture is prominent due to the Portuguese history of colonizing the place. My boyfriend’s sister, brother-in-law, and nephew joined us in Goa. Our routine for the next several days was simple; wake up, get ready, go eat a delicious breakfast, and then spend the rest of the day on one of the various beaches.

I even drove us home at night three times. For those who don’t know, they drive on the left in India. They also drive like crazy people! Very different driving culture than in America or Germany. We survived, no cows were hit (they like to just stand in the middle of the street sometimes), and no traffic tickets were issued.

After five days, it was back to Delhi. We only had the last day to run a few last-minute errands because our flight left at 2:15 AM.

Paging Dr. Hasselhof

While at the airport, it took forever to get checked in. I made it to the border control officer at the time boarding had started. And I arrived at the airport three hours before our flight time. Three stalls down, a man started having a seizure. Luckily, two others caught him and lowered him to the ground. I saw this all unfold and told the border control officer that I am a physician and should go check on that man. The officer was not impressed and told me to wait. Again, I pressed that time is of the essence and that I need to help keep that man safe. The officer continued to be unimpressed.

Finally, someone in the security line shouted out “is there a doctor here!?”. I raised my hand and exclaimed that the officer wasn’t letting me pass. Finally, a supervisor came and waved me through. I lifted Mausi out of the carrier and handed them to the supervisor.

How to help someone having a seizure

The main goal in taking care of a seizing person is to keep them safe. That means ensuring the area around them is clear, cushioning their head so they don’t hit it on a hard surface, and protecting their airway by positioning them on their side. Do NOT wedge something in their mouth. We quickly laid coats under the man’s head and positioned him correctly. I tried obtaining some medical history from his travel companion. He mentioned issues with low blood sugar but couldn’t tell me if the man was diabetic. Eventually, a paramedic came with a suitcase filled with medical supplies. At this point, the man had stopped seizing and was slowly coming to. He was still very confused, as was expected. He was surely even more confused when the seemingly only caucasian person at the airport was now hovering over him asking him questions.

Gotta go!

I stayed long enough for the paramedic to check that his vitals and blood sugar were stable (I had sent someone to fetch apple juice after the comment about low blood sugar in case we needed it). Vitals and blood sugar were good. Then it was time for me to go catch my flight. Luckily, the supervisor had me expedited to the front of the line at security but I still had to run, with a toddler strapped to my chest, to make it on our flight.

November

We were home for a mere 12 days before hopping on a flight to Germany. My cousin turned 40 and the whole family was coming together to celebrate. The week flew by because there were so many people to see. Anytime I am in Germany, there are a number of people I must see every visit. In the town I went to medical school in, there is a group of 6 people I do my all to see while there. Once again, I saw them all! The second half of the week was especially busy because everyone was arriving for the festivities. It was a good time.

Breakfast is my favorite meal of the day in Germany

My older sister came with her husband and kids. None of the extended family had met her kids before. Her youngest and Mausi are only ten days apart in age and are like two peas in a pod when they get together. Pushing them around in my sister’s double stroller made it look like I had twins!

The week involved family complexities I won’t go into detail on this platform. But, I will say, I think it was a very successful week for my family overall.

Now, we are back in Wisconsin and I have been busy over the weekend packing and organizing. The following two weekends are already planned out before we have the last weekend to do the final packing. Then it’ll be off to Ohio and Rochester, NY for Christmas before we head back to India for a three-week vacation with my mother and her fiance.

So, where to next?

It’s official! I will be headed to Molokai, Hawaii for 6 months starting in February! I’m beyond excited about this next assignment. If you have any tips for the island of Molokai or any of the other Hawaiian islands, please send them my way. I plan on spending the majority of the time on Molokai and just enjoying island life. However, one weekend out of the month, I’d like to hop to one of the other islands. My younger sister will be joining me for three months to be Mausi’s nanny. I’ll have to find someone local to take over once she leaves, or open it up here for applications for a three-month nanny stint 😉

I hope everyone in the States had a lovely Thanksgiving with family and friends.

Stay healthy!

mfg

Locum, Motherhood, Travel

A Tale of Three Months, Four Time Zones, and Five Countries

September 25, 2022 No Comments

Oh gee…I certainly was not planning on waiting 3.5 months before posting again. I know I sound like a broken record since I start off almost every post these days with an apology that it’s been so long. I was posting every two weeks almost consistently when I first started out and was pregnant. It should come as no surprise, especially to the parent readers, that a toddler requires a lot of attention, however. And honestly, I will always pick spending time with my child over engaging in social media. This time is so limited and so precious.

Also, instead of using “my child”, I think I’ll henceforth refer to them as “Mausi”. I continue to want to keep their identity off the internet, but for the sake of more fluid writing and for the sake of not sounding like I’m from a previous century, I’ll go with my nickname for them. But let’s dive in and let me get you caught up on what’s been going on!

June

For the last two months of my assignment in Eugene, we had to relocate to an apartment from the house we had previously lived in. This was known from the beginning as the house was already rented starting in June. The agency found us a 2-bedroom apartment close to the Willamette River. We, unfortunately, didn’t have a playground right down the street from us, but we did have a lovely trail along the river that we visited often.

Abortion is Healthcare.

On June 24th, the day people with a uterus’s constitutional right to bodily autonomy was stripped away, Ally, Mausi, and I attended a protest in Downtown Eugene. It was a peaceful protest and I was happy to see many men in attendance. Frankly, there should have been many more considering how the Supreme Court’s decision to overturn Roe vs Wade affects men too. In this sense, I feel like a broken record here too. The constant injustice we see happening in this country is truly disheartening. The fact that a handful of people get to decide the consequences for the majority of people is scary. They have real power. It is so important that everyone vote and that we elect leaders that will protect the rights of all citizens.

Blushing Blonde moments

Mausi and I spent an afternoon near the Heceta Lighthouse having our pictures taken by a local photographer. I really enjoy finding local photographers everywhere I go to capture moments of Mausi and me. Being a solo mom, there are plenty of pictures on my phone of Mausi, but rarely one where we are together. Having a photoshoot every couple of months makes for a fun way to capture our lives together. It is also a reminder of the places we’ve been.

Silver Falls Park

We finished off the month with a hike in Silver Falls Park. Only a 1.5-hour drive from Eugene, this park has a 7-mile loop that passes 10 waterfalls. We hiked it with another friend of mine with a baby. We’d like to say we made it the whole 7 miles, but then we’d be lying. We did, however, make it about 4.5 miles and passed 7 of the 10 waterfalls. The trail leads behind a few of the falls which were pretty cool. Definitely worth the trip if you find yourself in the area!

July

July and the half of August were several weeks of traveling. After the first week of work, Mausi and I flew to Europe for a two-week trip! The first week of that was the first legit vacation I’ve taken since October of 2019. Sure, there were trips all throughout the years, but they were mainly to Germany, which is like going home, it’s not a vacation in the sense of relaxing and exploring.

Μύκονος

Mausi and I spent a lovely week on the Greek island of Mykonos with my boyfriend. It had been almost 5 years since we were in the same physical space. He and I went on a date during my travels in India in 2017. Sounds crazy, I am aware, but it didn’t feel like we hadn’t seen each other in that long.

We stayed in a nice little boutique hotel just a few minutes’ walk from the beach. We rented a mini cooper convertible for a few days to zip around the very narrow streets of the island. My main touristy objective was to see the windmills that Mykonos is famous for. Mykonos is also known for its glitz, glamour, and party lifestyle. There was no partying for use with Mausi along but I was ok with that. There was an alarming amount of designer handbags to be seen by just about everyone walking around the island. I include myself in this, but in my case, it’s also the only small handbag I own.

There was an Italian restaurant within walking distance of our hotel that served delicious food and was staffed by really friendly people. Honestly, every restaurant we went to was extremely child friendly, and didn’t mind Mausi crawling absolutely everywhere. Often, the waiting staff would even hold on to and play with them while I ate. If you want to do something kind for a mother of a small child, watch their child while they eat their meal. It’s so rare to have an uninterrupted (warm) meal when you’re a mom.

It was a really fun and enjoyable week for our little trio.

Bachelorette Fun and Fancy Pizza

After our island adventure, it was off to Germany to partake in my best friend’s bachelorette festivities. Thankfully, she isn’t one for crazy outfits and silly games. We had a delicious dinner and spent the next day doing a photoshoot and going to a spa. I was really excited to meet some of her good friends that I had only heard of. Our friendship has been strong and thriving since I left Germany in 2015 but I’ve also missed a lot of the day-to-day stuff. I feel much more in the loop now that I know all her other close friends.

Between the bachelorette weekend and the wedding weekend, I crammed in as many get-togethers with my friends as possible. I also jumped on a night train with Mausi and traveled to Vienna to visit my sister Karoline for two days. I enjoy traveling by night train. The rattling of the train on the tracks is a great way to sleep and I am in a position where I can afford my own cabin now. On previous trips as a medical student, I’d book a spot in the 6-person cabin. At the time, I didn’t mind sharing the space with strangers. I didn’t want to do that with a toddler though.

Karoline works in a fun, hip pizzeria as the pizza decorator extrordinaire. We walked all over the city and ate many scrumptious meals together. I adore her and am always so happy to spend time with her. After our short 36-hour visit, we hopped back on the night train and traveled back up north.

Wedding Bells

My best friend’s wedding was a day filled with love, happiness, great conversations, and delicious food. Having missed so many of my friend’s weddings in the past, I would’ve moved mountains to attend hers. Lucky for me, she got married after I finished residency so no mountain moving was necessary.

Hello again and goodbye!

We flew back to Eugene for my last four days of work before heading to Wisconsin. I had a really great time in Eugene. I definitely did not see and do all that I planned to. My coworkers were such a joy to work with. It felt like hanging out with a group of friends every day. The work was not always easy. For the most part, it was actually complex. The patients I cared for were complex both medically and socially. There were a lot of social factors that came into consideration compared to previous jobs. Even “just” seeing 8 patients a day was a lot due to their individual complexities.

I had some great patient relationships build up in the 7 months I was there. For several, I felt like I made a real positive impact on their lives. I was even gifted a thoughtful gift by one of my patients. He had used the box that his medications come in to craft a keepsake box. I’ll have to take a picture of it and share some time (it’s currently in my new office space). I found certainly consider returning to the Lane County Clinics in the future for another few months.

August

As if traveling from Eugene to Europe back to Eugene and then to Wisconsin wasn’t enough of a timezone whirlwind, we traveled the first week of August as well. This trip was originally planned in March when none of my other travels had been planned yet and I felt like I needed a break and some adventure between jobs. But before we jumped on our international flight, we made a pit stop in Waupaca, WI so that I could attend my high school best friend’s wedding shower.

Back in High School, I was friends with the “Fab Five”. Not to be confused with the Fab Five of Queer Eye for the Straight Guy. (My fashion and hair would’ve been much better had that been the case.) Although I was with them a lot, the Sensational Six didn’t have the same ring to it…and I was the only girl in the group. Bryant, Ryan, Kyle, Chase, and Caleb were all back together for the wedding shower and I was thrilled. Zach, an underclassman during High School, an admirer of the Fab Five, and a good friend of ours, was also there.

After that short visit, we were off to Panama!

Panama City

We were only in Panama for 4 full days plus the two travel days on each end. It wasn’t a lot of time but we managed to see a variety of things. We stayed in Casco Viejo while in Panama City. It was built in 1673 after pirates almost completely destroyed the former historical center of Panama Viejo. It was a mix of old and new. Some buildings were filled with fancy restaurants or boutique hotels. Others were just the facade and completely gutted on the inside. We ate some yummy food and did a bit of shopping.

I bought myself, my mother, and my boyfriend each a Panama hat. Panama hat is a bit of a misnomer as they actually come from Ecuador. During the Gold Rush, people would travel from South America through the Panama Canal onwards to California and often bought a hat in Panama to shield themselves from the sun. When asked where they had gotten their hats from, they’d answer Panama. And voila, the Panama hat was named. The really nice thing about the toquilla straw hat is that it can be rolled up and packed for travel. No more filling half a suitcase with a hat or trying to awkwardly wear it on the plane.

Jungle Living

After two days of wandering around Casco Viejo, we headed north towards the coast. Because it seemed silly not to, we stopped by the Panama Canal Locks at Miraflores along the way. If I hadn’t been aware of the monumental engineering feet the locks are, this would’ve been a rather boring stop. However, knowing a bit of the history and the impact that place has on the world economy, put it into perspective and made me appreciate what I was looking at.

We spent two nights in an AirBnB hosted by a very lovely French couple. They spoke French and Spanish and a little bit of English. I speak English and German with a little bit of Spanish and French. Nonetheless, we had pleasant conversations and a great time. Getting to their place was an adventure. We used google maps until Portobelo and then followed several directions sent to us by the host. We counted miles and kept an eye out for the structures that signaled to us that it was time to take a turn. Eventually, we found the entrance to their property. We continued from the gate to about 50 m from the house in their 4-wheel drive car before trekking the remaining distance up a steep muddy hill. Totally worth the trip. Our room overlooked their luscious garden and the ocean.

Island Time

Our hosts took us out on their Waverunner to show us the islands in the area. We zipped past the island Shakira apparently likes to vacation at. We slowly rode through the mangrove trees and what is known as the tunnel of love. One turn was taken a bit too sharply and we were all in the water. Luckily, we could easily stand where we had fallen off.

Ultimately, we decided to spend our day on Isla Mamey. Supposedly, the island used to belong to Pablo Escobar. I’m not really sure what constitutes “used to belong to” or how long it’s been since it was his, but there was a huge skull face etched into the ground. I wasn’t able to find any connection between Escobar and Isla Mamey online though, so maybe it’s just a good story they tell visitors.

Regardless, Isla Mamey will hold a special place in my heart since it’s the place Mausi took their first steps! Way to pick a memorable spot, kiddo!

The beauty of travel

On our last day in Panama, we went to a restaurant that had a great online menu for brunch. I am a sucker for a good brunch. We were the first to arrive. When we reviewed the menu, I was a bit disappointed that it didn’t include all the fun stuff I had seen online. Nonetheless, we stayed and ordered some waffles and eggs. We were the only ones there until about halfway through when a couple came and sat near us.

They received their menus and were trying to decide what they wanted. While verbalizing their options, I realized that we had not received the same menu. Their menu did have the fun stuff I read about online. At this point, it was too late for us though since we had ordered. Mausi, as they do, quickly made friends with our table neighbors and this led to a conversation amongst us all. And what a wonderful conversation it was! I think we spent another hour there just chatting!

Kate (an award-winning author) and her husband Dave have been traveling the world since 2013, house-sitting in various locations. They were both so interesting to talk to. We definitely connected on our desire and need to continue traveling, mixing up our surroundings, and not being in one place for too long. I could see myself doing something similar in the far future if house sitting is still a thing. What a great way to work/retire/live. She blogs about it on her blog Living the Journey.

This is what I love about traveling. What I’ve missed about traveling. Meeting new people with interesting life stories. People’s stories fascinate me and I have met so many cool people on my travels. I look forward to hopefully many more similar events as traveling becomes more frequent again.

Dairyland

After our short Panama excursion, we were back in Wisconsin. I’ll save the rest for the next post, which will hopefully happen before my contract here is done (hehe), but we’ve covered so much already. Props to you if you’ve made it this far. Thanks for hanging in there, I know it was a lot.

Hope everyone is well and healthy.

mfg

Mother Nature, Motherhood, Travel

Emotional Rollercoaster

June 3, 2022 No Comments

Well, after being a bit smug the last few weeks about how I hadn’t had Covid yet despite being exposed to it from essentially day 1 of the pandemic (and thinking I might be one of the lucky “immune” people), Mother Nature humbled me last week when I tested positive last Thursday. I’m fully vaccinated so my symptoms were luckily really mild. I tested myself due to a scratchy throat. With the current requirements, I haven’t been allowed to return back to work yet. I won’t be back to my normal schedule until next week. This unexpected forced vacation has allowed me to get some work done that I haven’t had the time to do otherwise. Finally getting an update here is one of those things.

April showers bring May flowers and somehow we are already in June?

It has been almost two months since I last posted. The weather has continuously gotten nicer in the Eugene area. We moved out of our house and into an apartment for the last two months of the assignment here. It is a bummer to have left that neighborhood due to it being so walkable and a park just down the street. The new location is located near the Willamette river though and we are able to take beautiful strolls along the river. Still on the lookout for our nearest playground.

We flew to Ohio to celebrate my baby’s first birthday and for me to attend my co-residents wedding. As my facebook friends may have also noticed, I’m now in a relationship. My facebook relationship status hasn’t changed since the day I created my account many, many years ago. So, it’s a big deal for me. There have been a lot of great moments for me over the past two months.

Unfathomable events

But there have also been absolutely heartbreaking moments. The shootings in Buffalo and Uvalde tear my heart to shreds. As do the many other shootings that have happened since but don’t get as much media coverage. These occurrences make it harder and harder for me to justify being the United States. I have become so aware and alert of my surroundings. I look for my nearest exit when I enter a building. But even if I were to leave, that doesn’t help keep the people still here safe. I believe the US could do so much better, be so much better. If only money didn’t corrupt humans so much. It’s unfathomable to me that we as humans can witness 19 children and their teachers slaughtered in a classroom and not change anything about the laws that helped facilitate it from happening.

Before I was even able to get around to uploading this post another horrible shooting has taken place. This one also hits me hard personally. A fellow physician was gunned down at a medical facility in Oklahoma by a patient that blamed him for his ongoing pain. The elementary school shooting shattered my heart and made me fearful for children everywhere in this country. As I intend on having my children go to school abroad, its one less fear I have for my own children. But I have a niece and nephew here in the states and friends with children. So it still is a fear that effects me personally.

The murder of a physician and staff members over dissatisfaction on the patients part solidifies a deep fear in me for my own safety. I try really hard to help my patients. I will try to find ways to help them and feel less pain. Sometimes the safest and recommended option is not what the patient wants and they get angry. Weaning a patient off of addictive and harmful medications is the right thing to do (while obviously working on the underlying issue and finding other, healthier alternatives). But when patients get angry, there is a part of me that is terrified they might try to retaliate. I am hyper-aware of my surroundings when I’m entering and exiting my places of work.

I shouldn’t have to feel this way when all I am trying to do is help people. Children shouldn’t have to fear for their lives going to school to obtain an education. Black people shouldn’t fear for their lives going grocery shopping. No one should have to fear for their life just living their life not hurting anyone else.

The ongoing war in the Ukraine. I know the news cycle has swabbed out coverage for other issues, but horrific and utterly unnecessary damage continues to be done to the people and their country.

None of these situations are natural disasters or forces of nature we can’t control. They are deliberate decisions by human beings and that makes it that much more heart retching to me. People choose to not love and help one another. It must be such a sad position to be in to willingly hurt another human being or help facilitate that hurt. Were these people not loved as children? It’s the only explanation I can think of. Humans aren’t born evil.

Adventures

I don’t really have a clever way to transition from such dark topics, so I won’t try. I’ll just continue on to share some of the beautiful places we visited over the past few weeks.

Eugene Saturday Market

I’ve written about this market before. We’ve been back a few times. The opening weekend was definitely the busiest. The subsequent times were less visited but nonetheless fun to attend. We also made it a few streets further north to the Farmer’s Market. I have a hard time visiting a farmer’s market and not buying fresh flowers. There is just something magical about a fresh bouquet of flowers. 😉 We also met the “bubble guy” and had a blast taking some fun pictures.

Sahalie Falls

My local nanny, her two sons, Ally, my baby and I all took a road trip to see the Sahalie falls in April. The plan was to hike a few miles and see a couple waterfalls. As we ascended into the mountains, however, the snow started accumulating height. The parking lot wasn’t plowed so everyone parked along the road. The walk to the viewing area of the first waterfall was an adventure in and of itself. Ally, who is still getting used to how snow works, took a few tumbles navigating the snow and ice. Many years of Wisconsin winters in my life allowed me to navigate the trail well enough not to fall with a baby strapped on my back. Although we only made it to the first fall, it was worth it.

Redwoods

I drove to Medford with my baby for a weekend to visit a friend and explore the Californian Redwood forest with her. These trees are massive. I felt like I was in a Jurassic Park movie just waiting for a velociraptor to appear. The grandiosity of it all doesn’t even really hit until you leave the area and start seeing “normal” sized trees again. The weather was amazing and the lighting in the forrest was magical. We did a quick pitstop on the coast before returning to Medford. What a great area to live with the Redwood forrest and a beach so close to one another.

Crater Lake

This location has been on the top of my Oregon list since we got here. I’ve been waiting for warmer weather so that more of the roads would open up. Despite going in late May, there were still winter weather condition and closures happening. A friend of mine from Ohio, also a SMBC (single mother by choice) and my baby nurse during my labor and delivery experience, was in town visiting with her child. She really wanted to see Crater Lake as well so we figured this would be a great time to check it off both of our lists. Despite there still being snow, and I mean A LOT of snow, the limited views we did have were well worth the 3 hour one-way trip. When there aren’t winter weather conditions at that altitude, more access roads are available as well as the many trails in the area.

I would definitely like to return in the future to check out some of the trails and see the lake from different view points. My aunt was the one who first told me about Crater Lake. She had seen it mentioned on a show in Germany that was discussing different shades of blue. Apparently, Crater Lake’s blue color is quite unique. The water in the crater is from precipitation. It doesn’t have streams feeding into it. That combined with the depth of the lake and the way the sunlight refracts in it, creates a very beautiful blue color.

South Jetty Beach

I can never get enough of the coast and ocean. My friend from Ohio and I took the babies to the beach one day and it was wonderful. It was a bit chillier than I expected it would be (I should have opted for something longer than shorts). We had the beach all to ourselves for most of the time. It was really low tide so the beach extended far out. This provided plenty of crawling/walking around opportunities for the kiddies. Nature’s sandbox is a good place to be.

Emotional Rollercoaster

These last few weeks have really been a ride for my emotions. I don’t believe you are living if you aren’t feeling. Life has its ups and downs. You can’t appreciate the highs if you don’t experience the lows. Having that emotional complexity makes us human. It’s not always easy. Especially experiencing the lows. Whenever the lows occur, I first allow myself to experience them. Then, I fairly quickly try to figure out what the low can teach me. Often, I adjust my priorities. Especially if the low is inflicted upon me by another human. I don’t hold grudges. I’m not mean. I don’t retaliate. I adjust my priorities. And sometimes, that means that person may have fallen lower on my ranking of priorities. I can’t control how people act but I can change my reaction to it.

No one has personally hurt me recently. Those comments are meant in a more general, life-view sort of way. On the contrary, I’ve received a lot of loving energy personally in recent weeks. But I’m also a very empathetic person and the recent events around the world weigh on me. The senseless gun violence, the loss of life, the attack on people’s right to bodily autonomy and abortion laws… it all affects me. As a woman, as a mother, as a physician…and above all, as a human.

I’m not naive enough to believe all these issues will be solved quickly. If anything, they will have less media coverage to make room for the next big story. The sadness, anger and hurt will seemingly fade and it won’t resurface until the next big tragedy. I hope I’m wrong. I hope that this time, something good will actually happen. As the German saying goes “Die Hoffnung stirbt zuletzt”… Hope dies last. So I will continue to hope and find ways to make a positive impact in this world and help protect and heal my fellow human beings and our planet.

mfg

Happiness, Locum, Mother Nature

From Land to Shining Sea

March 14, 2022 4 Comments

Oh my! The last month was busy! Before I dive into what I’ve been exploring lately, I want to first address the horrifying things happening in Ukraine right now.

War has always been horrible. There are constantly wars and conflict happening around the world and often times, we are ignorant to them. To a certain extent, we have to be. If we knew about every human suffering occurring in the world, we’d all constantly be depressed and distraught. So we focus on news and events in our more immediate surroundings. When horrible things then happen to people that easily could also be us, it hits harder and deeper.

Since I’ve become a mother, my emotions are on steroids. I love harder, I grieve deeper, and I empathize more intensely. Where I used to see mothers and children of the world suffering and would feel terribly saddened by it, now I see myself and my baby in the women and children being bombed in the Ukraine and fleeing for their lives and its heart wrenching. I walk a fine line between staying informed and protecting my mental health. Since I’m on a contract right now, I can’t be in Germany helping the refugees. So instead, I am supporting various humanitarian aid charities that are helping the people of Ukraine. Hopefully, you’ve been able to do the same.

The clever ways people have been helping the Ukrainian people has been proof of human ingenuity. I’ve seen people booking AirBnB’s in Ukraine with obviously no intention of staying there but rather getting financial aide directly to those Ukrainians. I’ve read about information being shared as reviews on various sites because the Russian government is censoring social media.

It is absolutely despicable that one man can cause so much trauma, heartache, death and destruction. I don’t know how, but this war needs to stop.

Coming to America

A few days after my last post, my AuPair Ally arrived from South Africa. The first few days were spent giving her some orientation and letting her adjust with the jet leg. 10 days after her arrival, my aunt and uncle visited from Germany for 10 days. Thus, the last few weekends were rather busy and I enjoyed them fully. We initially wanted to take a trip to Crater Lake. My aunt had seen a TV show discussing blue colors around the world and Crater Lake was mentioned as being particularly beautiful. It’s still winter season here in Oregon however and the road circumventing the lake is closed at this time. We had a great alternative weekend adventure instead!

Let me share some of the fun things we’ve been up to!

Spencer Butte

The second day Ally was here, our local nanny (and now good friend of ours) took us on a hike up Spencer Butte. It’s located a short drive outside of Eugene. There is a steep ascent and a gradual one. We took the steep way up. My nanny and I each packed a baby and Ally packed our two backpacks. The ascent was not a walk in the park. It had rained a bit before we started our hike, so the paths were a slightly muddy at times. There was also a bit of boulder climbing involved but it was a lot of fun and provided some amazing views. We even saw a full rainbow once at the top!

McCredie Hot Springs

On her second weekend here, Ally, my baby and I drove an hour southeast of Eugene to take a dip in the McCredie hot springs. This was Ally’s first time seeing snow! There were a few pools available. We shared one with just 4 other people. Baby loved it! They love bath time so this was a special treat.

Sweet Creek Falls

The first stop on our weekend tour with my aunt and uncle was at Sweet Creek Falls. Located about 1h15 west of Eugene and on the way to Florence, is where you’ll find the beautiful forest and water falls. The hike was easy and took us through lush greenery up along the river to the waterfalls. The water was cold but I can see myself coming back on a hot summer day and splashing around a bit.

Heceta Lighthouse & Cape Perpetua

After a short stop in Florence to visit the marina and grab lunch and coffee, we headed north up the coast. Our first stop was the look out area overlooking the coast with the Heceta Lighthouse in the background. When I was here with my mother, we discovered hundreds of sea lions hanging out directly below us. Unfortunately, none were to be found this time around. So we snapped a few pictures and headed to the Heceta Lighthouse.

The parking lot for the lighthouse is located at sea level across from a beach. To get to the lighthouse, you have to take an uphill walk past the Bed & Breakfast to the lighthouse. From the top, I was able to take some nice pictures of the coast line. The blue, green, gray and white color palette of the nature is right up my alley.

Upon our decent, we spent some time hanging out on the beach and letting baby play in the sand. Afterwards, we drove 20 minutes north and up to the Cape Perpetua Lookout. From here, we could look down on the coast line and watch as the sun started to set. We didn’t stay for the actual sunset because we still had to find a hotel for the night and cellular reception was nonexistent for us where we were. We had intended to visit Yachats as well but decided to continue north to Newport for the night.

Newport

A few miles north of Yachats, I finally had cellular service and was able to look up a motel for us. We headed to the port of Newport to grab dinner. It was already pretty late and restaurants were close to closing. Luckily, the Clearwater restaurant was open longer than the others. It is situated right on the port. The best part was truly what was happening in front of the restaurant on the marina side. The floating docks were filled with sea lions! They were the first thing we heard when we got out of the car. It was dark, so we were only able to see the ones illuminated by the dock lights. It sounded like there were hundreds more hanging out in the dark bay.

The next morning, we grabbed lunch at the Nye Beach Cafe before going on a walk along Nye Beach. The ocean seems to really ebb and flood on this beach. We found beautiful sea anemones (amenonemomne?) amongst the rocks. There are some pretty cool shops in Nye Beach. We stopped by the Blue Pig Bakery for some delicious treats. The bakery is worth visiting even if you don’t have a sweet tooth because every room, nook and cranny is filled with gifts and goodies.

After stuffing my face with a scrumptious cinnamon roll, we headed back to the port where we had been the night before. The port is lined with a lot of shops, many quite unique. We browsed, snacked, and shopped for a while before heading back to Eugene.

Svikki MD

Work has been good. The patients I see have medical issues all across the board. I’ve had a few no-shows (not uncommon for a FQHC- federally qualified health center) which allowed me to catch up on the copious amount of tasks that flood my in basket. The team I work with is really great and I enjoy my time at work.

We are already looking ahead for the remainder of the year. Usually, jobs don’t get confirmed until 2-3 months before the start date. The job I’m currently at was confirmed unusually early and I’ve don’t it again with my next assignment. I’ve also been able to negotiate a pay raise which feels really good. Anecdotally, I’ve experienced women be less direct about pay raises and negotiating. It’s definitely still a work in progress for myself as well but I definitely scored a win this round.

Starting in August, my baby, Ally and I will be headed to…. Wisconsin! Go Badgers! lol

I will be working in a town close to Milwaukee, Madison and Chicago. I’m excited to show Ally the state I grew up in and it’ll be nice to be close to so many lovely friends I have in that area. Eugene doesn’t really get any snow, so we will definitely have to prepare Ally for a Wisconsin winter. She saw her first bit of snow here in Oregon but I’m going to blow her mind with a legitimate snow storm in Wisconsin should we have one this year.

So, to all my Wisconsinites, I look forward to seeing you and introducing my baby to you later this year!

mfg

Locum, Motherhood, Travel

Welcome to Oregon

January 17, 2022 No Comments

Holy moly, time flies! I’d really like to be posting more than once a month (or a month and a half!) and I think it’ll be more likely in the future.

This past month has been exceptionally busy. First, there was enjoying the last few weeks of maternity leave with family and friends in Germany. We celebrated Christmas with some of my aunt’s family by having a nice raclette feast! Shortly thereafter, my aunt and uncle drove us to Frankfurt where we all spent the night before baby and I caught our flight to Ohio.

During our short three days stay in Ohio, we visited my residency program to see everyone. I also had an OBGYN appointment for my Pap smear (make sure you are up to date on your Pap smear, my cervix possessing friends!).

Our journey to Eugene Oregon the next day was a doozy.

Connecting Time – Indefinite

Our journey from Cleveland to Eugene started really early on December 30th. Our flight out of Cleveland was at 6:10 AM (!). The flight to San Fransisco was fine, Baby didn’t sleep much at all but did make friends with the passengers around us. Shortly before landing, I checked the airline app to see if our connecting flight was on time. It was not. Au contraire mon amie! It was CANCELED. Due to staff shortages.

Remember hearing in the news how United had to cancel a bunch of flights between Christmas and New Year. Yeah, mine was one of them.

Once on the ground, I contacted a United agent to see what my next option would be to get to Eugene. The best they could do was put me on standby for a flight at 4:30 PM. Not great, especially since it was only 8:30 AM at the time. All of the flights the next day were only on standby as well. I neither liked my chances nor did I like the idea of being stuck at the airport with a baby for 8 hours. So after some deliberation with my family, I decided to rent a car and drive. Also not ideal with an 8-month-old baby but at least I was getting closer to my destination.

Road Trippin

We were looking at a 540-mile trip ahead of us. It took forever to get out of San Fransisco. Driving over the Golden Gate Bridge somewhat made up for it though. I only made it to Redding, California before booking a motel and spending the night. I don’t typically experience jet lag but I kept us on sort of a wonky schedule in Ohio because we had such an early flight to catch. Now being 3 hours even further behind, we were in bed by 8 PM. However, we then left the motel by 3:30 AM.

The morning drive was adventurous. Once we crossed the Californian border, we were in the mountains. The fog was so thick and it was snowing. At one point, I was only driving 15 mph downhill and hoping my little economy car wouldn’t fail us. Eventually, I started to get hungry and really wondered if there would even be a place to eat since I hadn’t seen an exit in quite some time.

Heaven on Earth

I asked GoogleMaps where the nearest restaurant would be. It suggested a place called Heaven on Earth which was only 20 minutes away. Well, with a name like that, and my options very limited, I decided to give it a try! We left the highway and quickly pulled up to a wood cabin with a big sign that read “Home of the Famous Cinnamon Rolls”. The sun was just starting to rise. We walked in to find cinnamon rolls as big as a plate! A lovely lady seated us. The only other folks there was a table with 4 older gentlemen who all seemed to be cowboys.

The omelet I ordered was exactly what I needed. The open fire made the place very cozy. We chatted a bit with our server and the chef before heading out again for the last 2 hour stretch of our journey. Before dropping off the rental car at the airport, I stopped by the gas station to fill up. I was quickly informed by a nice man that I better not touch the pump or I could be looking at a $1500 fine. … Wait…what? Turns out, you are not allowed to pump your own gas in Oregon and New Jersey. Good to know!

Eugene

I spent New Year’s Eve going to bed around 9 PM. I was in a new city, knew no one, had a baby, and was perfectly content with it all. The following day, we walked around the city a bit and ran some essential errands before picking up my uncle late at night. He flew in from Germany to watch the baby while I went to my first week of work.

My first impressions of Eugene:

Weed is omnipresent. There are so many dispensories in and around the downtown area. Holy Grail, Spacebuds, Oregon Weed Oulet… so… many…shops.
Homelessness is omnipresent. There are large lots filled with tents. Tents are set up at seemingly random places along the neighborhood. As a co-worker would later let me know, the numbers of homeless people is so high in Eugene due to a combination of skyrocketing rent, strict city expansion laws and liberal policies which make it a more welcoming place. In contrast, in Springfield, a more conservative town, which is literally right next to Eugene, it is illegal to hand anything out of your car window. Apparently its a law to stop people from giving food or drinks to the homeless. Supposedly, other more conservative cities in Oregon give the homeless a one-way ticket to Eugene and tell them they’ll be taken care of here.
Kindness is omnipresent. Everyone I have met has been kind. There are countless Black Lives Matter signs in the businesses and “Choose Kindness” signs in the neighborhood.

Svikki MD

My first week at work was all orientation. I work at a community health center. There are several offices throughout Eugene and I was able to shadow at several of them throughout the week. Not only was it nice to shadow providers to get a feeling of how their electronic medical record program works (vastly different than the Epic program I am used to) but it was also nice to shadow them seeing patients. It’s been 9 months since I’ve seen patients. Although I wasn’t afraid of having forgotten how to use a stethoscope, it was nice to ease back into the clinical setting by being a fly on the wall.

Everyone, from the providers to the support staff, really seem to enjoy the work that they do. The patients we see in the clinic are mainly Medicare, Medicaid, uninsured and underserved. They tend to be fairly complex, both medically and socially. However, the people working in the clinics really seem to have a passion for helping these people get the healthcare they deserve.

I was happy to find out that I would be working in a clinic closer to home than the one I originally was told I would be at. Since I was all over the place for orientation week, I was able to stop by at home for lunch a few times. My first week was Monday through Friday. Going forward, I’ll only be working Tuesday through Friday.

My first week of orientation went well and my first week of being back at work went well for Baby too. My uncle did a great job and I really enjoyed having him here with me.

I receive very intense kisses when I get home from work.

Three Day Weekend

I’m so excited to spend our 3-day weekends exploring Oregon. My coworkers have given me some fun suggestions of things to check out. My uncle, the baby, and I spent our first weekend in Portland. I’ll write about that and my first week back seeing patients in the next post (which hopefully will be next weekend…truly, I hope). If you have any suggestions of what I need to see, eat, do, or experience in Oregon, PLEASE let me know! I’m here for 7 months and I want to explore!

mfg

Locum

From Sea to Shining Sea

September 2, 2021 6 Comments

Originally, I thought I would be starting a new job this week. I’m so happy I’m not. It was a bit of a rollercoaster ride getting here though!

{Bridge near where I was living in Germany}

The Search

Often, with locum work, a job is found and agreed upon a few months prior to the start date. I work with two locum agencies. Doing so provides me a broader range of job offers. I told my recruiters that I would like to have a job near my mother in Ohio for September through December and starting January 2022, start traveling again.

One of my recruiters reached out in April with a job offer in Oregon. We presented me with a start date in January. Simultaneously, we were looking for a job for Sept-Dec.

Ohio Option #1

One of the first offers was an outpatient position about 3.5 hours from my mother’s place. I offered 4 days a week instead of 5. They countered and asked if I would work 3 days. Heck yes! More time with my child? I’ll take it. They offered to pay for a hotel as our accommodations. I found an Airbnb in the area and suggested that instead. That way, I could get set up in one place for the duration of the contract. Now that a child is in the picture….so is their crib, diapers, toys, etc. I did not want to move all of that every week. I also didn’t really look forward to a 3.5-hour drive twice a week but I did like the possibility of a 3-day workweek.

Ohio Option #2

While option 1 was being discussed back and forth, my recruiter from the other company reached out with an urgent care option 3.5-hours in a different direction from my mother’s place. They were looking for a physician to work 8-10 twelve-hour shifts a month. I figured I’d at most want to do four shifts in a row. That would cut down the 3.5-hour drives from weekly to about every other week. More pros included fewer workdays, freedom to create my schedule, and a higher hourly wage.

This option moved quickly and within a few days, I had an interview. The interview went really well. They even actively helped me look for child care options. I started filling out paperwork for credentialing and handed in the days I wanted to work in September. However, a few days later, they decided that they only needed night shifts covered. … Well obviously that wasn’t going to work.

Ohio Option #3

While option #2 was falling apart, my recruiter was already working in the background to find a backup option. Usually, hospitals or clinics reach out to the locum company with a need for a doctor. However, my recruiter and her co-worker flipped the script and started reaching out to clients around Ohio. A clinic 50 mins away took the bait. At this point, I was already in Germany. So instead of telephone interviews, we did Zoom calls to avoid international charges.

The first interview was with the CEO and COO. It went well. The second interview was with the medical director. It went well also. A few hours after that interview, the medical director called me back and asked if I would seriously consider a permanent position. I told him that I am a traveler and I could commit to four months. They were looking for at least a 6-12 month commitment. With that, this option was over.

Many, many options

After option #3 fell through, I reconnected with my agent from the first agency. I had told her about option 2 when it seemed like that was going to happen so she didn’t need to continue looking for Sept-Dec. Since we weren’t finding an option in Ohio, I opened up our search to everywhere. Within a few hours, I had so many options emailed to me. There were offers including New Mexico, Colorado, New Hampshire, Kansas, and Washington. I really liked the Washington offer but getting a license in Washington can take several months.

Simultaneously, my other agent really wanted to get me placed somewhere (I’m pretty sure they get paid a commission for placing physicians). She called me with an option in Indianapolis. I got really excited because one of my best friends and former co-resident/roommate lives and works in Indianapolis. The office looking for a locum was located RIGHT NEXTDOOR to the office of my friend! I was so excited.

An interview was scheduled a few days later. I know I mentioned that the other interviews went well but this one didn’t only go well, it was also a lot of fun. I instantly connected with the ladies. The work environment they described sounded great: a very diverse patient population with many non-English speaking patients. I like caring for patients from different cultures and working with translators. My friend and I discussed all the fun we would have if/when this option worked out.

Of course, the Indianapolis job was just too good to be true. They wanted me but there was an issue with licensing which wouldn’t allow me to work there in time.

Running the numbers

After the Indianapolis job fell through, I decided to run some financial numbers to see if I could afford just not working for the remainder of the year. Having saved most of the money I earned in South Dakota, falling into a lower tax bracket if I didn’t make any more money this year and that freeing up the money I had put aside for taxes, I was fortunate enough to be able to afford to extend my maternity leave!

If the perfect job had presented itself (the Indianapolis job was indeed my favorite), I would’ve liked to be back in the office seeing patients. My mom guilt would likely be a bit reduced for a job I truly enjoyed rather than just working any job. I definitely could have found just any ole job if I wasn’t the one being so restrictive. However, I refuse to work more than 4 days a week while my child is so young. I didn’t want to go to such a remote area that child care options weren’t available. Additionally, I wanted to be somewhere new and not work somewhere I’ve worked before. I’m grateful that I am in a position to be that picky.

So, I have extended my maternity leave through the end of the year! I’m back in the US for a few weeks before heading back over to Germany until shortly after Christmas.

2022

The job I mentioned at the beginning of this post, the one in Oregon, worked out! I am scheduled to work in a Family Medicine Clinic four days a week starting in January through July 2022. I’m currently in the process of finding an Au Pair to come live with us.

I am beyond excited to spend a few more months full-time with my child and family/friends. It’s great that I have new adventures to look forward to in January.

The process of finding a locum contract might seem messy and stressful. However, I actually find the journey rather exciting and thrilling. It can definitely be an emotional roller coaster to imagine yourself in various places from coast to coast in a 24 hour period. The process is not for everyone. But as of right now, it’s exactly what I want and need.

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

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

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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