One Year in Wichita: Trials, Joys, Celebration

 

It is July SEVENTH two thousand and twelve.  As I step out of intern resident shoes and into junior resident ones, I reflect on the year behind me. 

Thought # ONE: I am one year older
Two Thousand and twelve continues to press on and we are swept along with it.  Have you ever climbed a mountain?  Taking step after upward step towards the peak of a stony mass comparable in size to a city?  Sometimes I get caught up in searching for the upper most spire, the goal of the day's march.  Sometimes I loose track of milage, geography and time pondering questions from back home.  Sometimes I plod along like a mule, too stubborn to be hindered by the next step.  And sometimes I pause, lay down my daypack, swig a gulp of cool, filtered stream water, and wonder at the beautiful wilderness.  Don't forget to live in the scenery sometimes. 



A curious marmot on top Mt Wheeler



Thought # TWO: Finished twelve rotations in family medicine

One year of residency has done tons to build the confidence, experience, and demeanor I need as a physician, but there is so much still to learn.  Very thankful for another two years of familiy medicine residency to build and fine tune knowledge and skills under the supervision of my faculty doctors. 

Thought # THREE: Deeper friendships

 I am thankful for my fellow residents and faculty who have been supportive this past year, whether in constructive criticism or just hanging out watching fireworks ( I have been to four shows this year!  Two professional shows at the start and end of River Fest, one quite admirable show put on by an army captain and neighbor of my residency faculty member, and the last was a-top the hospital on July fourth - the whole city was ablaze in red-blue-gold-green - kind of like that movie Independence Day with Will Smith ).  Also thankful for my room mates, the church in Wichita, family and friends outside of Kansas; I am confident God is using these to inspire and instill love and peace in me. 



Building a porch with church friends



Star Wars Exhibit in Wichita



Thought # FOUR: Developing Heart - Sahel Africa

Central/South America were the global regions most on my mind before residency, but this might be changing.  I'm running into many people here who are re-classifying my vision for service.  Many of my colleages here are picking rotations in north central Africa and central Asia, to help staff rural hospitals in desperate areas for a time and possibly return for longer.  The assets of these regions are minimal compared to the western world, the level of need is too grand for any person to "fix", both physical and spiritual, but I think it still worth while that someone in this world commit to serve those nations too.  I am currently looking into options for an international elective rotation in one of the Sahel countries and praying about what serving in the Sahel might look like. 

Thought # FIVE: Conflict and Resolution - Life is learning
Life and work in Wichita has not been a complete "piece of cake".  What I'm about to share has been a source of greif and shame which has been one of the few dark spots on my overall delightful year in Kansas.  I have received feedback from a few hospital staff, other residents and some faculty doctors that I come off as arrogant, not teachable and unconventional.  While many of my colleages and friends assure me that I'm simply "miss-perceived", I know there is more truth to this than I feel comfortable admitting.  Perception can be reality and I feel this is a grave issue to my ability to communicate with the medical team and patients.  What has hurt most?  The idea that I am a representation of Jesus in my work environment = Jesus is arrogant, unteachable and a poor communicator.  Uggh

A list of efforts in this area:
My program gives residents a free Life Coach to help improve public image, work out the crinkles/stains; she is a great lady.  My little church just finished working through a sermon series on the book Crucial Conversations which is geared towards handling coorporate relationship conflict.  I am in one-on-one mentorship by a residency faculty member. Prayer and a solo study in the Bible on these topics.

The cool thing about this experience?  The realization of my need for Jesus.  Whether perception, truth or both,  I can point to where I was... and where I am... and then point to how I want to be and how Jesus is changing my heart about it.  It is not by my "goodness" but by His power through me. The end result has grown me into a better person, a better physician and a better follower of Jesus.

Thought # SIX: New saddle to ride
Last Spring I finally returned my friend's bicycle and fixed up a few new hot rods.  One was a old Raleigh mountain bike from a local Wichitan whose son had been riding it to work and beat the junk out of it.  The second was a white commuter road bike from a chemical engineer moving to Houston... where he will likely never ride to work again.  In the end, the replacement bike is an old eighties model Centurion.  After adding flat resistant street tires and corke handlebar tape, I get to work faster than ever!  price tag? $200 US


Thought # SEVEN: Exploits in the Soil
In the last few posts I have been sharing pictures of my front yard garden which is a patchwork of bulb flowers, ground cover and weeds.... This front garden was a nice stress releiver, but a real garden has now taken its place!  A friend from class said I could have his extra seeds this Spring and that began one of the coolest projects I've ever followed.  The garden, begun in early May, is more mature than I ever possibly imagined.  It's not my green thumb either, it is God at work in nature.  Cool stuff.  I love picking produce and living off the Kansas crust! 
Three different types of tomatoes, yellow squash, zuchini, green beans, sweet corn, cucumber, Four types of peppers.  Whoop! 



Mom and Dad 610 feet underground.  The Kansas Salt Mine Museum



Winter in Wichita and the Joy of Bicycles

(an old stone church in College Hill - Wichita, KS - Presbyterian..)

Winter Prologue

I am a Texan by birth and have rarely lived in other places more than a month, especially in colder climes (except for a month in the Bronx, NY and East TN last year respectively). However, now my home is Wichita, Kansas where common winter temps range from the teens Fahrenheit to 40s. This sounds pretty chilly if you are coming from the South/Southwest and it actually feels quite chilly on my early morning bike rides to work, but a nice aspect of Kansas is our frequent clear skies and noonday sun. The warm rays often overpower any chill the winter season has to offer, at least during mid day. But watch out for cutting windy breaths from the north. It has really been a mild and dry winter season and I do have hopes for change. Everyone report of snow from last season has left me with unfilled expectations. Only an occasional bicycle ride through flurries and white dusted streets has been enjoyed so far, but they are among my sweetest experiences! Let me explain seeming absurdity: Residency in Wichita keeps one at least 5-9 hours from mountains and too busy for weekend get-a-ways. Therefore my outdoor adventures are in the form of bicycle commutes which simultaneously work the body and expose it to the natural elements, whether they be face numbing chill or soul glowing sun. And winter cycling is actually reasonable, just winter-guard yourself with wind/wet-proof proof gloves, hat, leggings, jacket and utilize driver safety devices with reflective vest/pants, tail and front light and winter riding can be quite comfortable.

(Old Town)

Cycle Climax
My ride to St. Francis for Pediatrics this January month has been approx 20ish minutes and my ride to St. Joe for other rotations is about 10 minutes (about 2x the amount of driving time). The longer route is my favorite: it begins in my “Hilltop” neighborhood of lower socioeconomic homes, then moves above highway 440 into one of my favorite Wichita neighborhoods, College Hill, full of Victorian and brick-artsy homes, an old stone church and a 1-way road/bike lane lined with some of the biggest trees in the city flowing up and down gentle hills. The route then flies under I-135 and past a commercial/industrial portion east of downtown. As the route crosses Washington st the pavement morphs to brick inlaid street and enter “Old Town” where old-time red brick buildings have been converted into mostly entertainment venues/pubs/etc. Next cross under an elevated railroad and past an upscale loft neighboring a rehab dorm for the homeless, then a quick side glance by some low income apartments next to one of our clinics and the route ends at St. Francis hospital. Pretty cool eh!?! Literally, just long enough to numb my hands during winter (even with gloves), but oh so satisfying.

Cycle Anticlimax

Retracing the bike route brings to mind one of the less fun experiences of this year and city. During the first week of Obstetrics in December, and night float at that!, I was happily adventuring to work daily, then tragedy befell my dear bike whilst I was in my own home. As I slapped helmet on head and hopped out the side door I noticed that Topanga was not in her normal resting position in the carport. Me thought, “Hmm, I had locked only the front tire to frame, perhaps someone had attempted to ride off with her and then given up, laying the bike down in the front yard”, but no. As I walked about in aimless circles, searching for my favorite two wheels on earth, a neighbor lady across the way yelled out that she had spied a young hooligan wheel the bike down the road on rear wheel. Oh, the despair that filled my heart! It was a black night at work that shift. Topanga and I had been together since sophomore year in college. My friend Jordan had sold it to me for $5, felt bad about it and later gave me $5 back. I had lovingly maintained her in good working order, even upgrading a few parts: smooth puncture resistant street tires, a torn seat from an REI dent and scratch sale, a new front rim. She was closer to me than any woman had ever been. For a short time I changed my jog pattern to criss-cross the neighborhoods nearby, hoping that kid had left it for some bike he could actually fit on. I made a theft report, hoping the cops would not ask for a Kansas driver’s license. All dead-ended. I was angry at myself for not bringing the bike inside every day. 6 months of parking in the carport had seen no trouble, but it only took the first event for my world to come crashing down. Thoughts passed through mind; “maybe inner-city living is not for me, not when they take my dearest Topanga”. But God traded my despair and anger with the sobering realization that our world, including the Hilltop neighborhood, is filled with broken people who have far less opportunity than I (a well educated physician with a loving social support) and who are not blessed with faith and a conscience that gives them hope in life enough to not steal other people’s belongings. I was left bicycle-less but with a bigger heart for people. I still have not replaced Topanga, but will be searching Craigslist for a junker to clean up soon. Until then a fellow resident is lending me his fixed-gear bike; it is parked inside every night J.

(my friend's fixed gear bike, which I am borrowing)

(my amazing red team nurses! we work as a team in the clinic)

(All Hallow's Eve - my attending is dressing the part )

( awesome Toyota Previa in the background - any man's sports car dream)

(I am getting ready to assist in the operating room on my surgery rotation. This surgery was probably for salvaging an infected wound)

(In this picture I am assisting Evan in the delicate art of dumpster diving. I believe we salvaged a few nice pieces of timber on this occasion)

Well, this Saturday morning after PEDS night call is almost complete and it is time for something else. Thanks for keeping up.

With Love from cold hands but a warm heart,

~drew

4 Months In - Family Medicine Residnecy

(Summit of Cameron Peak, forteener 9-19-2011)

Hey family and friends,

Thanks for joining me in a brief recount of my new adventures. By this time in October I am well into the intern year of residency training and really feel like a doctor, a feeling that I have been looking forward to for so long and, probably appropriately, never grasped during medical school. The responsibility of patient medical care, the investment in each unique life encountered, the decisions that must be made, the strong work put in every day that makes a man satisfied…. Ah yes, residency is great. Patrick, Jonathan and I are hanging out at Panera Bread near the house this morning, just chatting, talking about our troubles, whether work or personal, and our joys. These are my room mates my fellow interns and I love these guys. Patrick made the comment, “We got paid yesterday; it feels so good!” And it’s true, paychecks are amazing, and we all agree that we aren’t anxious at all about getting paid, we love what we do and getting a paycheck every other week is almost a surprise, icing on the cake. Of course, when loan repayment begins in December we won’t see much of it anyways.

( A few of the interns and I on top a 12,500')

Residency is structured somewhat like medical school, we have a schedule of 12 months and each is filled by a rotation in a different field of medicine that will prepare us for practice on our own. This first year my schedule includes:

3 hospital based medicine months

ER

2 hospital based pediatric

2 hospital based obstetric

Surgery

2 weeks of behavioral science and Ear Nose Throat

Geriatrics

Sports Medicine

Basically, this schedule means that I’ll be on 8 “service months”, otherwise known as months when we get to the hospital early and leave late, 6 days a week. 7 of those months require a “night float” or a week long period where each resident takes turns admitting sick people into the hospital during the night. I will be starting my second night float week today at 5pm and I’m excited about it. Although the physical changes are demanding, the more work and experience I can have in residency the better. The other months are a bit more relaxed, like geriatrics and sports medicine, which are clinic based.

(I have eaten 3 of these peppers to date and looking forward to more)

Gardens

In the last post I shared about an assortment of plants a grocery store allowed me to take free, as they were nearly dead. OK, update on the garden. The plants are actually doing very well. The most beautiful among them are the Green Bell Peppers which did not flower in the heat of summer but are growing myriads of little peppers into big ones. While visiting my Aunt in Denver, she let me dig up a bit of her garden to transplant in Wichita. Unfortunately the chicks and diks are not doing so well. I think they need more sun, but the others seem to be steadily growing. Also, one of my neighbors works at the botanic garden here in Wichita. He is bringing home extra plants all the time, so I dug under a patch of tulip bulbs a few weeks ago. They will be such a surprise by spring!

Neighbors

On my street the yards are too small to exercise any meaningful play, so one must utilize the street. I have played enough football for a lifetime these last 4 months. Incredible, I have historically enjoyed Frisbee or basketball type sports, but when the neighbor kids ring the doorbell every day to get us out and playing, it just happens. Last month we had a Labor Day cookout and yesterday was pumpkin carving. The strange thing is, although I always see the kids, their parents have more of a hibernating bear attitude, stay inside. I am hoping for more relational depth in my neighborhood.

( My residency program went on our annual bike trip in September which also included climbing a few forteeners :), we biked from Frisco to Vail and back. Amazingly fun yet tiring vacation under the guise of continuing medical eduction)

(One of my attending docs asked me to play at a coffee shop open mic. This was the first set of this kind I've played, lasted ~1hr, banjo/guitar. Fun times, might do it again. Might need a shirt with sweat pads in the armpits next time too.)

An End and a Beginning

Four years ago I went back to school, a thing that has been a momentum changer in my life. Through this experience professionalism, responsibility, humanity, medical science and other ways of the physician have instilled a niche in my person, in who I am now. On May 14th I graduated from medical school and on July 1st I started my new job as a resident physician.


(Dancing with Mimi at her 80th Birthday Party Dallas, TX)


(Getting hooded at graduation - Fort Worth, TX)
Photo Courtesy of Kate Leverenz
www.kateleverenzphotography.com

In between school and job, I went back to the area of Guatemala I worked in last year and spent a wonderful month continuing relationships with locals, practicing Spanish, and volunteering in a clinic that served a low access area in the gorgeous Guatemalan Highlands.

Arriving in the USA 4 days before residency began, I made a quick journey from Houston to Wichita, Kansas and have since settled into life here. My two room mates (also interns in my program) and I are becoming decent friends. We have room mate dinners at home, play football with the neighborhood kids, play music and encouraging each other to become better doctors. The only improvement I could ask for is to have Guatemalan highland weather here in Kansas. The scorching sun is not being kind to the potted plants I received for free from Dillon's, the major local grocery chain. I'm not too busy to neglect planting them in God's good earth, eventually, maybe tomorrow after my Emergency Departement shift.

Below are a few pics of Guatemala last month.

(The mountains in the background are quite, quite high and steep - Santa Cruz la Laguna)


(Other med student friends and I on a hike - Santa Cruz LL)


(Group photo! Students, Doctors, and nurses/interpreters - Santa Cruz LL)


(The infamous tuk-tuk. A three wheeled vehicle for people transport quite common in all areas of Guatemala. This photo taken in Santiago LL)


(Catholic Church courtyard - San Pedro LL)


(Normal street scene - San Pedro LL)



(Los Tres Amigos riding horses to the base of Volcan San Pedro approximately 3,200m)


(At the dock. Boat is the primary mode of transportation around Lago de Atitlan - Santa Cruz LL)


(My hostel room at La Iguana Perdida. I lived here for one week - Santa Cruz LL)


(This morning was chilly, about 50F - Santa Cruz LL)


(Also at La Iguana Perdida - Santa Cruz LL)

A New Destination

(Wichita's Skyline)

On the day of sugary hearts, chocolate love and red roses I received a special note.... No, this was not a love note, nor I wasn't celebrating Valentine's Day with anyone. It was a notification from the osteopathic residency match service that I had matched with my #1 choice for Family Medicine, Via Christi Regional Medical Center in Wichita, Kansas!

Hmm, now that I ponder on it, I believe the residency match system has quite a few similarities to online dating services. Allow me to explain: all respective participants build their profile, buffing and fluffing it up as much as is decent, then they perform a database search looking for compatible partners, contact is made, they go on first dates (interviews) and if both respective parties "like" each other --> marriage is the next sensible step... Oh and all this transpires in a matter of months. Yeah!!!

So in my own weird and nerdy medical student way, last Valentine's Day was one full of romance. :)

But to continue with seriousness, I am so excited and thankful for the way this process has played out. God granted me peace to rank residency programs in a specific manner and and it's now easy to accept the results as a great outcome. Via Christi was my first choice for a reason and I believe my internship year will be one filled with adventure, challenge, maturity and new friendships. Questions and thoughts taking priority over my brain synapses now are:
1. Should I rent an apt or buy a house? I hope to find a few other kids from my intern class to room with too.
2. Planning out the coolest bicycle route from home to work to church to the nearest coffee hang-out in my future city of Wichita.
3. A friend in PA just offered me one of her Aussie Shepard pups. Cool! But can I be responsible enough to care for people and dogs?!!?
4. Can I make it down to santa cruz la laguna in Guatemala for another month of jungle highland medicine?
5. Ah!!! I can't believe I'm leaving Texas! I may have to transfer resident status :(. The home state and all its wonderfully friendly people seem so much sweeter than before.
6. Which river in the Ouachita Mountains of Arkansas should my friends and I float this April? Duh! The Ouachita River.
7. The list goes on...


(Verdi Square on Broadway and 72nd st, Upper Westside Manhattan)

And I can't finish this without a word or two for my month in New York City. The story leading up to this is cool: I met another osteopathic medical student in Guatemala who told me about a manipulation rotation located in the Bronx, NY at St. Barnabas Hospital. Upon returning from Guatemala last June I lost this guy's contact info but was able to set up a month at St. Barnabas; then 9 months later my acquaintance and I reunite during working hours on a med-surge floor... surprise!!! It was great. The month allowed me opportunity to hone my manipulation skills and also plenty of catch-up with friends who had been transplanted in the city. A month of snowy, cold days and nights. I would not trade it! One fun experience was at the Newyorican Poetry Cafe in lower east Manhattan, an actress, Sarah Jones, provided the audience an evening of discussion and laughter while she played her various impersonation roles of the major ethnic groups in NYC, about 20 or so. Cool stuff.

Bottom line: Yeah, I liked living in New York City... But no other extended visit or relocation there is anywhere in my future.


(Washington Square Park)


(Morningside Park with Cathedral Church of St. John the Divine atop the hill)


(Can you tell it snows a bit in NYC? W Central Park and 68th St)

Thanks for reading and keeping in touch,

~drew


(Below are a few pictures from the Bronx near my usual hangout locations like the washateria and an Italian pastry shop called Polombo Gelato. I actually lived in the "Little Italy of the Bronx".)