happiest holidaze to all!

wow! where did the time go? i was just starting out on the journey of a lifetime (the beginning of my clinical year) and now, it's the holiday season and almost time to welcome in the next year. clearly, there has been a bit of a gap between my last posting and today (arrgghh, a over a month has passed by). i actually have several drafts written up, but have been unsure of how much of my personal experience to share. 

the past three months of clinicals have been exciting and i have learned so much that i barely even know where to begin to describe it all. that said, i will give a shot of at least giving a glimpse of me learning about the medical system, humanity and my tiny space in it all. i really expected the exams, diagnosing and treating part of my experience to be the most difficult - and it has definitely been challenging, but what has challenged me more though is the trust building aspect of the patient-provider relationship. i had thought that with my background working with different populations, often underserved, in education, counseling, and agriculture that i would find building relationships easier than what i've come to experience. 

there are power dynamics in these patient/provider relationships that are difficult to navigate. trusting the patient, having the patient trust me, finding compassion for everyone equally - these are difficult in the confines of a 20-40 minute visit when a patient is in pain or sharing some of his/her innermost concerns. am i providing a space where the patient can really confide what is the issue? i, at times, feeling like i am sizing up a patient - i am being told the truth or manipulated? why is the patient REALLY here in this office? when do i share information? what information do i share, what information do i withhold? how do i inform/educate the patient? do i address big underlying issues, such as poor nutrition, obesity, smoking, alcohol abuse, need for exercise... or do i just treat the cough (or whatever acute issue is being addressed) and sometimes offer a pill? and the big fear of mine... what if i miss something???? what if i say something wrong, give wrong advice, interpret something wrong, say something insensitive when i miss clues provided by the patient?

thank heavens i've had folks to debrief the days with. i am inherently a very reflective person and tend to spend too much time wondering/worrying about possible mistakes made or why someone pushed my buttons or i pushed theirs. add to all this, negotiating cross-cultural waters. i should probably give a HUGE shout out (thanks) to all the providers, social workers, nurses, techs, and everyone else at the clinic who offer guidance and who assist me in navigating these waters and hopefully, are watching carefully so that i don't fail my patients. 

and now, here i am in port angeles, wa sipping coffee, writing  a disjointed post to my blog, looking forward to digging out the inside of a quinzee later today (photos to come)... basically, re-energizing for the new year and the rest of my life to come.

in closing, all that come's to mind is... it's all good. somehow, no matter what happens - if we're conscious and compassionate, we grow and we find love, then truly, it becomes apparent over again and again that it's all good. 

peas to all my homeskillets out there. may you all have the merriest of holidaze. 

**what a crazy freakin' post. they don't call me the "shiny objects girl" for nothing, i guess.

3870

so, i climbed the mountain 3870 last weekend. it's a half day hike about an hour outside of nome. like the dingbat that i can be - i inquired at the top how it came to get its name. now in my defense, i couldn't remember the number to save my life - which i believe is the reason, i couldn't make the logical connection to it's altitude. well, that's my excuse and i'm sticking to it. just enjoy the photo. (i have a delightful 360 video from the summit, but once again being techno illit, i'm unable to post the darn thing.) 

a dear friend....

i found out recently that my close friend from childhood, kelly armstrong, was diagnosed with cancer this fall. i just want to put out a public request that anyone who happens across this website - please send a prayer, good juju, any cosmic/karmic credit you've built up, yada, yada, yada her way. she's a dynamo and though i haven't seen her in a long while, just occasional stories from my dad - i think fondly of her and know that if there were a soul in the world who will pull through all this, it's gonna be her.

caring bridge is a site where you may write a note to kelly. it's located under peep blogs on the left.

kelly - all my love goes out to you and your family.

just because...

if times weren't a bit tight right now, i can pretty much guarantee that i would be wearing this on a t-shirt, rather than posting it on a site. 

elections 2008

i voted today and was kind of excited... not just to be a part of the whole electoral process, but because ak has the coolest stickers ANYWHERE! below are two examples - i've got 'em both on my jacket.

this is inupiak,

and this was yupik. very cool. but truly i should have just gotten the one below, because that was more in line with my absentee vote. (i couldn't find my favorite '04 alaskan election stickers, which looked like the alaskan ones above but just stated "i farted!" 

and finally for all you fans of governor...   awww, steph, are you really going to make us listen to you rant about the mcpain campaign and your bleeding heart, can barely shift any further to left, you're nearly a socialist political views? no. not today. for one moment, i'm going to let you have just this one pass to enjoy what you truly will be voting for....

that was your moment. from here on out it's all about kucinich '08!  

you know you're really in alaska when...

... this is your mode of public transportation to get back and forth from the clinic to airport.

... this is downtown savoonga, which is not to say that downtown looks any different from any other view.

... the big excitement of the day is catching a 25' minke whale.  

... enough said.
... you get your sushi (fresh whale meat) right on the beach. fortunately, this community didn't eat the muktuk (whale fat) - so, i didn't have to try that. 

i've been twice now to savoonga and have to say it is quite a unique experience.  really nice folks, but definitely as cross-cultural an experience as you'll find anywhere - u.s. or other. want to learn more about savoonga, kiddos? check out the wiki/savoonga link on the right side of the page.

welcome to nome, ak!

nome. where the iditarod ends. (i'll miss it by a month. darn it!)

 this is a hundred year old historic church. my apartment is the brown building in the back.

downtown nome. bars, bars, liquor stores, a couple of restaurants and gift shops. it kind of feels like a step back in time.

this is looking at nome from down the road. i can't wait to post the same photo once the ice comes in...

finally, an entry....

the town of nome is generally a quiet village, sled dogs howling from time to time, located right on the water. no foreign policy experts here, unless they've been out to the islands where you can see russia on a clear day. there are lots of bars, less churches and just a couple of restaurants. mostly dirt roads around modest houses. outside of town is tundra and some good size hills. i haven't had much of a chance to explore yet, though i'm still hoping to check out some of the other communities on the road system and go for a hike or two. i hear there is plenty to do, but mostly i've worked, studied or slept.

which leads me to claim, after one month, that i do believe this has been one of the most challenging and emotionally exhausting months of my entire life. on day 2, i was told to start pulling charts and seeing patients. well, heck this is a clinical rotation - of course it makes sense to start pulling charts right away. what they failed to mention is that i don't really have a preceptor to train, educate, supervise me or otherwise. i do get people to sign charts and answer questions, but education only comes to me if i am very assertive and prod people for advice. fortunately, everyone is very friendly and a couple of folks go out of their way to teach a bit. 

how it works... the students who rotate through here see all the walk-ins that come in the clinic - which is a bit like an urgent care center. (sore throats, fractures, abdominal pain, prenatal visits, pretty much a smattering of everything - which i kind of feel like i know slim to nothing about... and often, slim left town.) every fourth night, i pull an overnight shift working in the emergency room. again, the students are the front line. sadly, the vast majority of what i see at the late hours entails dealing with drunk people in various nefarious states of being. it is easy to see losing compassion when so much energy is spent on this issue at the expense of truly sick and injured people. arrggghh. 

after 3 weeks of this, poor sleep, and lots of anxiety, i took advantage last week of the opportunity to go out to savoonga two times to perform sports and employment physicals. i am also helping with community health aide training this week as another means to catch my breath. when i pulled an overnight shift sunday, i actually felt a bit less anxious. i start back at the clinic on thursday hoping that i'll be ready to go again.

well, so as to not bore folks, i'll cut this posting short. enjoy the photos. next entry... trips to savoonga. (for your continued education, feel free to peruse the nome, ak link listed under "tour locations links".

thought for the day...

thought for the day...

ALL MEN ARE BROTHERS

Mahatma Ghandi

Things That Will Destroy Us

Politics without Principles

Pleasure without Conscience

Wealth without Work

Knowledge without Character

Business without Morality

Science without Humanity

Worship without Sacrifice