Change is Good. Change is Good. Change is Good.

"The old order changeth, yielding place to new

And God fulfills himself in many ways 

Lest one good custom should corrupt the world."

-- Lord Alfred Tennyson, The Passing of Arthur

Here I am, just before another corner. Friday was my last day in lab. On Thursday, my lab took me out to lunch at Pacific Catch at the corner of Lincoln and 9th, which was amazing. They gave me parting gifts -- a pediatric rheumatology textbook from my boss, a cute cardigan from our senior technician, and yummy hand lotion and tea infuser from my junior mentor. I brought them thank-you gifts, but was touched to receive things from them. I think the art of gift-giving is dying. It's sad. But that's another blog post. Anyway, with the lab folks, I really felt as though we had managed the true spirit of giving something you think the other person will like because you appreciate them and were thinking about them. One way to achieve this is to limit spending. Small consumables are more likely to make it into the "how thoughtful, I'll definitely use this," category.

Lab bench, all cleaned up before I leave for good.

The last few months of the research year are over. It's been fun. One highlight was a student conference at the Mayo Clinic -- technically it was free, but I have yet to be reimbursed :(. I roomed with a Pharmacy student, and we even went running by the river in Rochester.  We saw goslings! Rochester is a really cute little town. They are trying to encourage diversity, which means our waitress didn't know how to pronounce the eight very non-Christian names at our table, but actually cared about how to say them. The conference was interesting, but the food was unfortunately better than the content. You know there's something wrong when a poster you stumble across on your way to lunch is better than any of the day's speakers, keynote included. That said, there was some *amazing* student work presented. Out of three keynotes, the last was actually mind-blowing (pun intended) -- a neurosurgeon who has been part of a team that is inventing an implantable chip to measure neurotransmitter levels (like dopamine) in the brain, and then transmit the information to a computer. Amazing!! There will be so many applications for the technology.

Another random, cool event was my old high school best friend, Div, coming in from Dubai! She was visiting her brother on the peninsula and they all came up to the city for dinner, so B & I joined them. We ate at Udupi Palace, a South Indian restaurant. Delicious but precarious -- the dinner plates were literally too big for the tables, so the edges were hanging off the sides over our laps! Div is doing well, and unofficially planning a wedding! She's in banking, not a bio teacher as she originally planned, and I'm going to be a pediatrician, not a lawyer like I was thinking about in high school.

High school friends, 10 years later!

I'm trying to write a personal statement for residency. Meaning that I'm thinking about trying to write a personal statement about residency. It's much, much harder than I anticipated because I'm switching fields. All my research and volunteer work has been in aging/rheumatology up until now, and now I'm shifting gears entirely and working with kids and embryology. Somehow, I have to articulate my trajectory, the 'ah-ha' moments, and why I want to work with kids. I feel like there is an entire category of things -- exams, personal statements, impressing my supervisors -- that I'm no longer rocking. Nia needs her groove back. Ah, well. If you can't beat 'em, just keep plodding forward.

B is home from DC. People keep asking how married life is. It's awesome, because I'm rooming with my life partner. It's so worth it. It's something I'm grateful for every day. We celebrated our one year anniversary by running Bay to Breakers, which is a 12K (7.5 mile) race that starts down by the San Francisco Embarcadero and winds its way through the city and Golden Gate Park to end at Ocean Beach. It was on my bucket list, and B kindly agreed to run it with me. I was the 6202nd runner to cross the finish out of 23, 072, and the 1853/11,793 woman, at a pace of 10:22 minutes/mile (1 hour 17 minutes overall). Not too shabby. B was my coach and ran with me, instead of jetting on ahead. Nice B! Che and Rica did B2B as well, walking in costume (thousands of people dress up), and we all met up at the end for tacos!! Yum. Che was a naked lady and Rica was a superhero. My favorite costume was the guy who dressed up like he was riding an ostrich, with feet dangling on either side of the bird, so it looked like the ostrich was running the race. My least favorite costume was The Silver Surfer -- running behind his reflective outfit was like having a glaring mirror in my face for three sunny miles. I also enjoyed seeing the Salmon, who always run the race as a 'school,' backward from Ocean Beach to the Embarcadero (going upriver to spawn). I almost got a salmon high-five. The most popular costume was a pair, running as the Lorax and The Tree -- the tree was nearly 8 feet high!

I am going on vacation.

The next two weeks will be packed: Open House party this weekend with our friends & my parents' friends, etc, and then a week of very intense review/getting things done before my pulmonary rotation. The Open House will be a nice break from reality. We are sending the cat on vacation to my parents' for the party, because my mom wants to attend and she's allergic to the cat. My dad saw our place last week, took one look around at the mess, and said, "Well, since our friends (meaning real adults) are coming, you can host the party at our house if you want." Thanks, Dad. Thanks a lot. But then, he has many strengths beyond tact. I hope the weather is nice so we can go outside. I don't remember much clinical medicine, so I need to study like crazy. I bought and borrowed the books for my rotations, and they all weigh a ton. I really hope 4th year works. I am excited to study more focused areas of medicine than I did with my longitudinal clerkship. Also, wouldn't it be nice to have an MD?

Here's the To-Do:

Open House!
Study pulmonary medicine
Study neonatology
Study child neurology
Write personal statement for residency
Research rheumatoid arthritis paper
Write rheumatoid arthritis paper
Meet with pediatrics department chair/advisor
Come up with list of residencies to apply to
Get photo taken for residency
Ask research mentor for a recommendation letter

Busy = Happy.

Love,
Nia

Change is in the Air Again!

Okay, although I am totally overwhelmed, I need to write. So much has happened this month. Much of it has been very, very good and exciting. A lot of it is scary. And no, I'm not pregnant.

Basically, next month is the culmination of the research year. Some of you have already heard that my molecular biology project was going really slowly. However, the fellowship I'm on expects us to have a finished, completed project that we did ourselves at the end of the year. So around December/January, I panicked a little bit and tried to think of something I could do that piqued my interests, aligned with my abilities, and was feasible in a condensed time frame if I worked hard. The project I came up with looked at predictors of refractory disease in rheumatoid arthritis patients, which I was totally psyched about because it was clinical, had statistics, and dealt with both medicine and health disparities/epidemiology.

I've basically been working every day for a long time on this project, and I finally have results! I love my data. But they are alarming, showing differences in outcomes based on level of education when adjusted for medication use and other factors. I am beyond excited that it looks like we have some interesting data. I just sent the dataset to my mentor, so I'm just crossing my fingers that she doesn't run my numbers and get something totally different. That would be a minor tragedy. My big boss I think was a little skeptical at first, but she seemed pleased at my lab meeting today and had some great ideas for what to do next.

So next week I have to somehow do the following: Finish and practice my talk, actually do the 10-minute talk for a symposium, present my poster, finish my resume and personal summary form for the Dean's office to kickstart the residency application process, go to a 2-hour evening journal club (which curtails my ability to speak with my husband on the East Coast, sadness), finish additional data analysis for my presentation, work on a different poster for a different project I've been doing on the side, and pack for a 3-day conference the week after that. Oh, and remember to give my little boss a birthday present. Actually, when I write it all down it doesn't feel so bad anymore. Thank you, therapeutic blogging. I was sad to miss meeting up with my Auntie from India, who was only in town tonight, due to a confluence of work-related and traffic-related factors. But she got to hang out with my dad (she's dad's brother's wife).

In the next month, I have to finish all my research because then I'm back on the wards! Here's my 4th year clinical schedule:

2 weeks of adult pulmonary medicine
4 weeks of neonatal intensive care nursery
4 weeks of child neurology
4 weeks of pediatric genetics
4 weeks of child rheumatology
4 weeks of adult internal medicine
4 weeks for residency interviews + some vacation time (or time to mourn lack of interviews!)
4 weeks of To Be Determined + some vacation time
4 weeks pediatric infectious disease
4 weeks of end of year required curriculum

I am so excited about this. If I do apply in child neurology, I'd like to fit in some adult neurology somewhere. So little time, so much to learn. Many of my old classmates are graduating soon. I'm a little sad when I think of it, but I'm very, very glad that I took a research year. Although I've been in medical school so long (6 years next year!) that when I graduate, it will be quite a shock to my system. If I had gone straight through, which is a big if, I could have been a 2nd-year resident by now. Then again, hopefully the added maturity will be a good thing when I have an MD behind my hybrid name. I should blog about changing my name. Anyhow, I am also nervous/excited because I finally was able to arrange a meeting with the child neurology department chair, whom everyone literally raves about (Pediatric department chair: "I'd trust her with my life...in fact, I have").

In fun news, I'm also doing Bay to Breakers! So are three people from my lab, one of my old friends who is coming in from out of town, and B. I'm so pleased B agreed to be my running buddy. He usually tries to do shorter distances because he needs to be able to sprint for Ultimate, but he was really nice about the 12K. I'm told the entire first half of the race is uphill. Ick. But then, I was also told that it's so crowded that you are forced to walk at points.

For those who asked, B is doing well. He and the other employees got to take a big group photo with The Boss of the House that Shall Not Be Named. Pretty snazzy.

And, just in case you were wondering about my political views, you heard it here first:
Keep your MITTens off my kittens. No more drama. Vote Obama.

April Showers, a 12K, & The Match!

It has been raining a lot. My research facility is located on a hill, which means that you get pretty wet from rivulets and waterfalls as you climb up to work. I think we're getting all the downpour we missed out on this winter. I am lucky enough to own two beautiful umbrellas and good shoes, so I can actually enjoy the torrents. Usually with a hot cup of tea. I'm drinking way more tea than will be sustainable on the wards. Yes, it's almost that time -- the moment I go back to the clinical life! Yikes (Which end of the patient is up, again?). It seemed so far away all year, but now I'm only two months away.

Warming up before the race

On the Sunday after St. Patrick's Day, we ran a 12K (~7.5 miles) to benefit the Edgewood Children's Foundation called Emerald 12K Across the Bay. It was a beautiful run, staring at Fort Baker and climbing up the (steep!) hill to the Golden Gate Bridge, crossing the bridge, and then winding down past Chrissy Field and ending near Ghirardelli square. My dad walked the whole 7.5 miles!

Beautiful views of the bay the whole 7.5 miles

Post-race party with live band at Ghirardelli square

Free chocolate milk from the Nesquik rabbit

The weather was breezy, sunshiny, and cold in the morning but perfect for running. As I crossed the bridge, I saw huge, graceful pelicans fishing at the mouth of the bay. I could see Alcatraz like a jewel in the water. It was amazing. I've never run that far before. My time was 1:20:38, for a pace of 10:49/mile. Just for perspective, the winning female runner did it at 5:32/mile. She's a year older than I am!

Speaking of clinical life, the Match happened two weeks ago. The Match is a huge, nationwide event that occurs the third week of March. Medical school seniors crowd into a room, open tiny white envelopes, and find out which residency program they'll be working at for the next three (or four, or ten) years. My friends all matched! Most of them seemed very happy. E is doing internal medicine. CL is doing pediatrics, and had some great advice for me. Dee is doing internal medicine. T is going to LA to do psychiatry, which is great because his wife, K, was offered a teaching position down there (congrats you guys)! Maybe they'll go all Hollywood on me and start doctoring/teaching the stars? Mimi won her coveted dermatology spot, for those of you who were biting their fingernails. Many, many people are staying in or around the SF Bay Area, which means I might see them once every six months during their training...

The evening of Match Day, there was a class party at a cafe near the beach. I went even though I am no longer in their class, just to say congratulations. Unluckily, it was pouring rain (again). Luckily, it was indoors and we had seats by the fire. Butters brewed an awesome, hoppy beer and brought it! Dee baked a pie (her first! With homemade crust! It was delicious). There was wine and excitement and congratulations. I couldn't believe how grown-up everyone looked. I am so very proud of them and all the hard work they've invested. The matched folks graduate this May with MDs. Dear Lord, they are going to be doctors. Our 2013 graduation will be so lonely without them. Can you believe how time flies? And the handful of us that added a year are left to plunge into the breach.

A beautiful gel for Western blot, loaded and ready

Research is going...strangely. After working on a basic science project all year, I'm not sure if it's going to manifest itself or fall through. However, I've also just started a clinical project that might save my behind when the NIH people come after me for Results with a capital R. Crossed fingers. It's interesting work, looking at what types of people don't respond to treatment for rheumatoid arthritis and how their bones erode. It's actually great stuff. We'll see how it goes; the deadline is a conference coming up in May (and prior to that, an abstract due next week).  I can't believe how much molecular biology and statistics I've learned this year. I hope all the clinical info regarding patients is still in my head somewhere. Unfortunately, I've had no time at all to work on my master's thesis, and I'd love to edit it and submit it. My brain is going to explode one day, wait and see. It'll be interesting. Anyhow, this week I get to teach a high schooler volunteering at the lab. She's a bubbly senior, five foot nothing, long dark hair, wants to major in chemistry. Rock on, my little friend.

B continues to work at the pale house in a certain capital city that shall not be named on a public blog. He's coming home weekend after next, though. Yay! Maybe it'll stop raining enough for us to go hiking. It has occurred to me that it's very late and I should go to bed (this is laughable: by hospital standards it's not even the end of the day). But I am so very happy to get a chance to sleep that I should carpe noctem. Bonne nuit.

Emerging from the Library

The Step 2 CK exam was yesterday. It was a long, grueling nine hours, and by the time it was over, I was so brain-dead that I have no idea whether I made it or not.  It felt terrible to leave the testing center thinking that I might have done badly after studying so hard. I did feel like I was catching up during my studying, but still. Not a great feeling. And there is quite a lot riding on this exam. It is sickening not to know if my career goals will come to pass. After imagining out every possible scenario and moping around for a bit, I decided that regardless of the outcome, it's going to be weeks until I find out. And regardless of the outcome, I did what I could in the time that I had. It is now in greater hands than mine. So in the meantime, I'll write a bit about what's going on now that the board exams are (for the moment) over.

The grass is greener on the other side.

Catfish the Siamese is home, after spending a little vacation at my parents' so that I could actually get some sleep (she enjoys parading across the bed and meowing for food at 5 am every morning). I went over to my parents' place to collect her right after the exam, and was able to spend a good long time with the family. B came with me, and my brother even stopped by. It was so nice to have an impromptu family gathering.  The weather has been trending towards chilly rain with a generous helping of clear, bright days.

This morning we went to the farmer's market -- there will be just one more next Sunday and then the harvest season will be over. Guess what has come into season whilst I was studying? Fuyu persimmons! We also found fresh cauliflower, tomatoes, onions, and apples. They were selling apple cider but we decided to pass this time around. It doesn't last as long in our house as the apples do! We sliced up our bell peppers onto whole wheat toast (B's home-baked bread) with mozzarella and tomato puree -- our marinara open-face sandwiches were delicious.

B making bread dough.

A golden loaf, fresh out of the oven.

The end product!

We also took a short journey to Golden Gate Park this afternoon to enjoy the November sunshine. There were so many families out walking or boating, and any number of ducks, seagulls, and flowers still in bloom.

A bright yellow blossom seems to say, "Cheer up, cheer up! Life is worth living!"

The moss, trees, bridges -- everything felt fresh and interesting. It was lovely to be outdoors instead of studying. The animals at the lake are used to people and will let you get pretty close, hoping to be fed.

Contented ducks.

The Canada geese were quite docile.

Sleek geese getting nervous before Thanksgiving.

We made friends with an elderly gentleman who was feeding the seagulls -- I was able to catch their excitement as they flew up to catch the breadcrumbs!

Free meals draw crowds.

Whee!

As we drove home, we were treated to a beautiful early sunset against the autumn clouds.

It didn't seem real to us, either.

Speaking of Thanksgiving, I saw an article in the September Education issue of the NY Times Magazine discussing the differencing between raising overachievers and raising children with "true grit" -- the strength of character to succeed in the face of adversity. It really spoke to what I've been thinking about lately and what my boss and I have discussed -- that life is not an IQ test, and that your drive, optimism, gratitude, social skills, curiosity, and sheer gumption will get you a lot farther in life than just intelligence ever could. It's called "What if the Secret to Success is Failure?" I think the title is misleading, though; it's more about whether character can be taught than whether failure is needed for success.

For someone in my particular position (that is, trying to learn a set of skills, earn a degree, and begin a profession), it was a very hopeful read. It's been a more difficult road than I anticipated, for a whole host of reasons, so it was nice to hear that continuing to strive for the goal is worth something in itself.

A red-eared slider at the lake. Slow and steady wins the race.

To NIH and Back Again

The NIH Clinical Hospital: Every patient is on a research protocol

I recently made a brief journey to the National Institutes of Health for what I believe qualifies as my first-ever business trip! That is, if you consider a 'business trip' to be one that is both mandated and paid for by your employer. It was an incredible trip. I met nearly 100 other medical students also taking a year "off" from school to do research. They represented an incredible range of schools and interests. I took a chance by going to a neurology networking lunch one afternoon, and was invited to do an elective at NIH next year by one of the physicians there! Wow. We also attended presentations about residency selection, balancing a clinical practice with a research career, finding funding, and dealing with student loans.

The keynote speakers were very famous people -- Francis Collins (NIH director, working on aging), Anthony Fauci (he and his PI essentially discovered the treatment for Wegner's granulomatosis and his lab went on to develop AZT, the first antiretroviral, discovered much of the natural history of HIV/AIDS, and convinced three presidents to fund AIDS interventions in Africa), and Marston Linehan, whose lab is responsible for discovering the basic pathways of kidney cancer AND creating new techniques to vastly extend life in patients with kidney cancer. I was in awe that such brilliant people were also such good speakers and seemed very personable. They encouraged us to take over from them in the next generation. What shoes to fill!

Building 50: My Old Lab!

We were housed at the Hyatt in Bethesda -- my roommate was a wonderful person who studies colon cancer risk decisions and wants to be a rural family medicine doctor. I was very glad to have met her. I also reunited with medical students I had met on the interview trail years ago, but had gone somewhere else. There was not too much time to socialize except for the meals --  which were delicious and plentiful. I was very grateful that NIH had organized the weekend for those of us funded through NIH student grants (of which there are many). Bethesda was beautiful in October -- crisp air, deep blue skies, fluffy clouds, and trees just beginning to change. I very much enjoyed being back there after four years away. It was over so soon.

Trees Changing Color at NIH

I flew home and found, to my surprise, that I was sitting next to two medical students from Yale, a year my junior, going to a surgical conference in the Bay Area! We spoke at great length about the Bay Area and medicine versus surgery. We called our little area of the plane 'Medical Student Row,' and were continually being visited by other students on board who were also attending the same conference.

Cat in a Bag

NIH or no NIH, however, there is no place like home. My sweet cat had been moping around, according to B, but she was perky when I arrived, and we found her contently chewing on a receipt in a brown paper bag that evening.

Cactus and Aloe in Window Silhouette

Exam Rose!

Our plants were looking wonderful, the rose B had given me to cheer me up was still in bloom -- and this reminds me that now, and for the next month or so, you will please forgive me if you hear very little from me. I must somehow gear up for all the examinating that lies ahead. There are now only 18 days between myself and Step 2 CK.

Mountains Ahead

Dolores Park on a warm fall day (Ingrid Taylar)

The Bay Area's hallmark late summer seems to have come at last, three days before the official beginning of autumn. After fog and wind all summer, it's been 80 degrees with warm nights and bright sunshine. It is a cruel trick for visitors to this region that our summer starts as soon as tourist season ends, indulges us for a month, and then gives way to a chilly fall. This morning, I took a minute to look out over the channel where the bay meets the ocean on my way home from work. Stunning. It does make up for missing the brilliant red and gold leaves of the East Coast. I sense that our sunshiny autumn will bring exciting change and mountains to climb!

Clean, white paint instead of baby blue/taupe/coffee.

At home, B has been hard at work to brighten up our ground floor apartment -- he loaded up the storage shelves that we built, which freed up some much-needed room, and then he painted two rooms by himself! We had chosen the colors many weeks ago, but he finally decided that he would paint before he starts work again. The bedroom was a pinkish-beige color; we opted instead for a more neutral golden-cream. It looks beautiful! The bathroom was a tiny, multicolored space with a bright yellow bathtub, so for that we chose a clean, white gloss. It looks like an entirely new place. Apparently, latex paint can take up to a month to cure, so we are camping in our living room for the time being. It's fun to have a makeshift studio.

I have managed to put our little Siamese on a successful diet (she was gaining weight due to her asthma medication), and she looks pleased with our place thus far. She likes to sit in the window seat in the sunshine, or else to guard our front door. I have also found a few minutes here and there to finally hang our pictures and put away odds and ends. Our living room is wood-paneled (including the ceiling), so after the exams I'm going to look a way to bring more light in.

B's delicious home-made whole-wheat flatbread zucchini pizza!

On the work front, B has been approved for his internship! I'm so glad he painted the house already. We were both surprised that he would start on a weekday, but apparently there was a motion to be filed this Friday, so they needed all hands on deck. My own lab project has been challenging, but I finally managed to sub-clone the gene I am working on, so my boss left for her conference on Friday a slightly happier woman. And of course, the boards are coming ever closer. I manage not to be nervous while actively studying, but when I'm speaking with coworkers or attending research meetings, there is a tiny undercurrent of dread always ready to claim my soul :) We (especially B) have been cooking and freezing up a storm in anticipation of my boards studying in the evenings and his working from 6 am -7 pm every day. The feline friend will have to find something to occupy her time with both of us at work all day! Right now, her strategy is to yell loudly anytime anyone approaches the front door.

I guard: No-one in + no-one out = happy cat.

Maui in August

Oheo gulch waterfall pools

My parents gave us a honeymoon for a wedding present! We had a lovely time in Maui. Of course, the only camera I brought was my cell phone. We flew out last Friday and landed in Maui for dinner, which we ordered to our room (Ocean view! Chocolates! Patio! Stove!) at the Hotel Wailea (we were given a honeymoon upgrade). A yummy Italian meal.

The next day, we explored. We went for a run on the beach, bodysurfed, and then made an architecturally robust sand castle that withstood the tide coming in and impressed a discerning 10-year-old. We had lunch at a cafe by the beach and then swam in our pool before eating dinner, which was ravioli that we found locally and cooked on the stove in our suite. On Saturday, we hiked through the beautiful national park, including a tall, dark, ancient bamboo forest, swam in an enormous waterfall pool at Oheo Gulch (at left), and drove the Hana Highway, a winding highway along one of the most beautiful coasts I've ever seen.

We also saw some of the small towns of upcountry Maui during that trip. Lots of horses, some cows, and abundant sugar cane. You know the brand C&H sugar? California & Hawaii! As we drove, we saw an interesting mix of prosperous and working neighborhoods -- I think most of the inland neighborhoods are houses owned by everyday folk, not retirees or the wealthy. The huge differences between the resorts and the towns really illustrated how much the economy of Maui depends on tourism (and therefore the national economy). Many of the little houses reminded me of towns in India; I was expecting something much more like California. Land is relatively cheap in Maui.

Beach properties everywhere

On Monday, we spent more time at the beach, this time protected by new Quicksilver/Roxy rashguards (such a useful souvenir) that had the Hawaiian flag on them. This was to prevent more of the inevitable tan/sunburn under the powerful Maui sun. While we were out there, I spotted a boy of about 7 or 8 who was unable to get to shore against large waves and the tide, which was going out. We asked if he was okay and he said no, so B swam out to him and brought him closer to the beach, then I swam out to them, and between us all we were able to get to shore. It could easily have gone wrong. Scary. Very scary. That evening, we calmed our nerves over a delicious sunset dinner at Capische.

Iron ore in the hills but no metal in ancient Maui

Tuesday was a treat -- we took horses down into a volcanic crater. The red rock (left), the eerie moon-like landscape, and the stunning views made the strong sun worth it (we were above the cloud level at about 9,000 feet). My palomino quarter horse was named Linus because he likes to suck his tongue. Rocky, B's horse, was an absolutely beautiful bay thoroughbred-quarter horse mix. It was tricky footing, but the equines had sure feet and we had riding helmets. These horses climb up and down mountains at elevation all day -- they are ripped! Look at their muscled behinds!

Well-muscled horses ready to descend into the crater and back

General store high tea

We drove through the upcountry and had a heavy tea at the Haliimale General Store, which is an old store that has been converted into a fancy restaurant and tavern (photo at right). We didn't know that! Luckily it was casual, so they didn't blink an eye when we showed up dusty and smelling faintly of horse.

Later, when we arrived in Kapalua, we checked into the Ritz (the very posh RC). Very, um, ritzy. No celebrity sightings, however. We were greeted by leis and given an upgrade to a club room, which apparently is Ritz for "we'll give you free food and alcohol in an exclusive lounge during your stay." Neither B nor I drink much, but the food! What an amazing treat. And they had gourmet tea, coffee, and cookies all the time. We entered our room to extreme luxury -- marble counters, hardwood furniture, shell trim -- and a big bottle of champagne and chocolate-covered strawberries with "congratulations" written on the plate! I have never felt so spoiled.

Welcome to the Ritz, indeed! With champagne.

At the RC club, we ate a delicious breakfast each day facing the golf course, which gave B the opportunity to tell me about his days on the high school team. It was much more fun to watch golf in person with a personal guide to the game than it is on TV. We saw couples, families, and a few near-pros golfing during our stay. Apparently, someone once had a hole-in-one during lunchtime and the entire club balcony was watching, and started cheering. We saw a man climbing the palm tree here (level with the eighth floor!) to trim it -- which I think is even more impressive.

Our cosy breakfast nook overlooking the golf course

We rented snorkeling gear on Wednesday and played with a sea turtle, only a few meters away from the shore! They are beautiful, endangered, and curious ($2000 fine if you touch one). This guy was about three feet long from tip to tail. He was not at all afraid of us; he would have stuck around all day. The turtle was so graceful in the water, and well-camouflaged because all the green patterns on this legs and shell looked similar to sunlight refracting through water. What a peaceful, amazing sight. The Hawaiian word for sea turtle is Honu. We had a sushi dinner at Kai, a new restaurant. They had the freshest sashimi I've ever tasted.

On Thursday, we braved the waves in Lahaina and took a surfing lesson. It was awesome! We both stood up and I think we each began catching our own waves. I thought the standing up part would be the hardest, but it's not. The hard part is paddling into the wave fast enough to catch it and then steering your board once you're up. There were a few collisions out there, but no major damage done. I loved turning around to find B and seeing him on a big wave! Afterwards, we ate lunch under a huge banyan tree that takes up 3/4 of an acre and fills the town square in front of the marina and old courthouse. It was amazing. It looks like five trees have merged; and then you realize it's all the same tree!

Art fair under the huge, multi-trunked banyan tree in Lahaina town square

The next day, we had a rest from all of our outdoor activities. We drove the winding, tiny north shore highway, which is a coastal road that goes from a two-lane state highway with a guard-rail to a one-lane dirt road hugging the cliff, and no rail. Luckily our Ford Escape did great. Along the way were little turnoffs with fruit stands and even a big food cart -- how they managed to tow the cart up there I have no idea. We ended up in Kahului, at the Maui Megaplex (a tiny outdoor mall with a theater). We ate delicious Thai food in a welcoming restaurant and then heard a Taiko drum troupe in the outdoor courtyard. We drove home full and well-rested and watched a movie in our hotel room (Thor -- lots of fun).

One of the many blue lagoons with coral visible through the water

On Saturday, we decided to go snorkeling again, so we made our way to Honolua Bay. We swam out from shore about 50 yards along some beautiful cliffs that had rocky tide pools and other neat little inlets near their feet. We saw lots of beautiful fish and another turtle! He was grazing on seaweed near some rocks, getting washed around in the water as the waves pushed against the rocks. From time to time, he would come up for air and I would go with him, watching his sleek head break the water.

Sadly, a lot of the coral in this bay was dead, which has been attributed to nearby agricultural run-off from the plantations back in the 70s and 80s. Apparently one drop of round-up is a gallon of poison in the water and can kill an immense amount of coral. However, it was still beautiful and we could hear the crunching of thousands of happy fish feeding on the coral, so clearly it was still appetizing. We went home happy and exhausted.

After tea, we drove into Lahaina, where we selected small souvenirs for our families, and generally relaxed. In the evening, we ate at the Banyan Tree (a restaurant, not the actual tree). We shared a local ale and each had the prix fixe menu with goat cheese salad, hamachi starter, and then B had Ahi while I had Hapu fish. For dessert, B had dense, bittersweet chocolate cake with raspberry dressing, and I had a cheesecake with coffee ice cream. It was a little edgy and easily one of the best meals of my life. The chef there, Chef Jojo, who apparently trained with one of the Iron Chefs, came out to wish us a happy honeymoon. He was so kind! We ended the evening by counting constellations from the hotel pool under a light drizzle.

Our last glimpse of Haleakala, the volcano

On our last morning, we had time to eat our last RC breakfast before we had to check out and hit the road. On the drive, we said a last good-bye to the volcano (left). We managed to return the car and get to the airport early -- about two hours early! So B polled the info desk about what we should do. Of course, they said walk to the beach! The airport parking lot connects to a beach road, where we found kite sailing to watch. It was incredible. Some people were leaping 10 or 20 feet into the air. When it was time for our flight, we went through the security line while being entertained by hula dancers. What a nice send-off! I also thought it was neat that because there had been a canoe competition, so a lot of canoe teams were returning to other islands at the same time. And then we boarded our flight to start the journey home, arriving in SFO by the Monday morning redeye.

It was one of the best weeks ever and a dream come true.

The beautiful Hana coast

The Year Ahead

The dust from the wedding has mostly settled. We've moved into our new place, our photographers are slowly getting back to us, and we're still writing thank-you notes to all of the wonderful people who contributed to the start of our married life. We moved into a new place, B is taking the Bar as we speak (goodluckgoodluckgoodluck), and I started my research fellowship. On Friday, we are leaving for a 10-day belated honeymoon in Hawaii! I think all the red tape at work has been taken care of.

Today I started thinking about what happens when I return from the honeymoon. What are the most important things to focus on this year? I want to give a lot of thought to my future career and my professional identity. As a doctor, one can travel many paths: clinical care, education, research, administration. It's hard to do everything, and it's impossible to do everything well. My mentor and I had a conversation about this. Her take was that at some point, you just have to accept that with all the things you do, you will do none of them at your absolute full capacity. While that is true, I don't think it follows that you should overextend yourself to the point where you feel you are doing a mediocre job of everything. So this year is about career discernment. How do I want to make an impact in the world? How can I be of most use? What path will give me the most fulfillment?

The other concern is practice. Often, something just isn't going to be fun or interesting until you have devoted enough time to becoming good at it. I'm 26 now, and one important question comes to mind: how long am I going to spend being a beginner at many things, as opposed to advancing in a few chosen areas? So this year is also for taking stock of the skills and talents I have and capitalizing on them, rather than trying everything on for size. I'm getting impatient with not knowing anything about anything. Also, if you are a beginner you end up taking a lot of help and not giving very much back.

One of the lessons I think America can learn from the UK is that of encouraging vocations in young adults. I think many 16 or 17 year olds do know what kind of work suits them. The trouble in the States is that our indecision is encouraged, even applauded. We do four years of college. Then I did four years of masters/MD, with one research year and one additional clinical year still to go. But the choices that once felt so freeing are beginning to drag me down. I want to define myself further, not open even more doors and then stand before them all saying, "Look at all the things I might do!" Which is why this year is important.

All of this said, I have compiled a checklist of things I want to focus on this year. Hopefully, I will look back at this next May and have a tangible record of whether I met my goal.

2011-2012 Checklist:

1. Work on my work ethic.
2. Submit my thesis work to a journal for publication.
3. Finish a cohesive research project at the lab this year.
4. Decide my top two specialty choices and arrange electives accordingly.
5. Find a non-academic activity to channel my creative energies.
6. Develop good study habits and practice with my licensing exams!
7. Make time for friends and home life.

Even when plans don't work out, isn't it fun to plan? I almost feel like anticipation is half the fun! Hmmm. I don't know if that applies to a honeymoon. Anyhow, until next time!

Back to the Blogstead as a Married Lady

Hello again! As I have a wait step in one of my experiments, I have a moment to come and write. I have been away for a long time, but I do have an excuse for my absence: B and I got married at the end of May. It was one of the loveliest things that has ever happened to me. With the help of friends and family, we did a lot of the crafting of the wedding ourselves. I will post more about that in future updates, but just wanted to check back in with my new blog.

Since the wedding (pictured here, with my maid of honor and our officiant in the background), B and I have moved into our new apartment. We had dropped off his belongings from Los Angeles before the wedding, but it was only two weekends after the wedding that we were able to visit my storage unit in Berkeley and recover the possessions I had stored there while living at my parents' place for a year. Now we have a little bit of furniture (although still no chairs), a big computer, and the all-important wireless network! There are still unopened boxes, piles of important papers, and a narrow pathway through the house. However, we do have a functional kitchenette, the laundry has been effortless so far (it's free and four steps from our front door), and the cat has moved back in! Since B and I are both studying at the moment, it's hard to find time to work on unpacking and setting up. Hopefully 15 minutes here and there will eventually lead us to a completed apartment.

We went to the bank and opened a joint account two weekends ago, and the teller asked us, "Does it feel different now that you're married?" It's the standard question you get after a birthday, and in that case the answer is usually no (at least in my case). When he asked us about marriage, though, we looked at each other and paused. It did feel different. They say it's just a piece of paper, but the fact that we separated the legal and the community ceremony shows what we think of that. I think that successful marriages are based on a belief that a private and public declaration of lifelong commitment does absolutely mean something. I am very grateful for it. So it felt different. I am also glad that we both decided to change our names and have a joint account.

In terms of the name change, it became a little controversial among friends and family. Living on the West Coast in such a liberal city, it has gotten to the point where true-blue feminists get angry when they hear you are changing your name, and the traditionalists are miffed if you aren't. We came from two different families in this regard. B's mom changed her name because she did not want to keep her father's, so they all share the same last name. In my family, my brother and I got the same last name but it is an old family name from both sides, and is different from both my father's and mother's last names. So our last name is, in some ways, unique to us. I didn't want to give that up. Apparently, in Denmark at the turn of the last century, name change was so important that the king had to sign off on it (at right)!

When B and I talked about getting married, the name change was an important issue. Your name does represent your identity, after all. Together, we decided that we a) wanted the same family name for all of us and any children we had, and b) we would find a relatively fair way to do it so that I would not be giving up my whole last name while he kept all his names. At first, we thought we would just have two last names, so we would both be Firstname, Middlename, Hislast Mylast. However, California law makes this very difficult, because unlike other types of name change, you cannot do it directly on the marriage license. So we decided we would both change our middle names to my last name, and change our last names to his last name. Now we are Mr. & Mrs. Mylast Hislast, and our children will be, too. Since his last name became our last name, we agreed that we would try to give any kids that came along Indian first names so that they had a lasting sign of their bicultural heritage. I think this final decision shocked both of our parents equally, which is probably indicative of a good decision...just kidding.

Anyway, being married is an incredible gift, as is seeing B every single day. Even on nights when I get home from lab at 7 pm, I still see him more than I did when he was in LA. Imagine that! You know, it boggles my mind that people were so generous as to travel to our wedding and also send us gifts. Their presence at the wedding and the wedding itself was more than enough. What amazing friends and family. Really. I am still writing thank you notes to all these wonderful people.

Since the wedding, I also started my new job! You can see a picture of my very own lab bench, above. It's actually a research fellowship, but I call it my job because it pays me and it's not directly related to the medical school curriculum. I'm working in an immunology lab and it's a great working environment. It's fun to be surrounded by smart people, and there are many clinician-scientists. I've already had the chance to present a patient at conference, which was fun. Hopefully I can begin regularly seeing patients at the weekly clinic. My other goal (other than studying for the second medical licensing exam) is to learn STATA, a statistical software program that is widely used for epidemiology research.

So, in short, we are adjusting to a calmer and more 'normal' way of life as we try to sort out the apartment, the legal Bar studying, the research, and the being married before we go on our (slightly delayed) honeymoon in August (another very generous wedding gift).

An Apartment Worth Hunting For

We've been looking for a new place to live. Although it's pretty traditional for the girl to live at home before marriage and with his parents after, we aren't quite that traditional. B has been on his own for eight or nine years. It's actually funny to me that I do live at home right now, given that I was living alone for three years prior, and hadn't lived at home since 2002. My poor Dad is having a rough time of it because of the wedding, and I'm sure my at-homeness is contributing to some degree. Anyway, B is moving to the Bay Area after the wedding, so we needed a place to call home. He was here for a weekend and the Hunt began. Quite fortunately, it also ended the same weekend!

We started with that quintessential renter's tool, Craigslist. I am not exactly sure what people did before Craiglist. I have a vague recollection of old books advising readers to hunt through the newspaper classifieds and then call people. Of course, if you were moving out of your area code, you had to pay long-distance rates to call potential landlords. Shock!


Now, I use Craiglist, which is happily free, and email, which is also free, and my cell phone plan, which is pre-paid and does not penalize me for having an East Coast area code left over from college even though I no longer live on the east coast. I love living in the future! It really does feel that way to me, and I'm sure to others of my generation, who started grade school in a world of rotary phones and the Dewey decimal system and now take our self-scheduled, multimedia medical licensing exams in computer labs after studying for them on the internet. You can also book a storage unit, a rental car, and movers online without so much as checking what time of day it is to see if the 'office' (another old-fashioned term, when nobody knows which days our curriculum coordinator works from home as long as she has occasional office hours) is open. So my point is that I'm grateful not only to Craig, but all of the people who have conspired to make this apartment search so much easier for a poor student. (In a strange turn of events, my mother recently became acquainted with Craig of Craigslist, but that's another story.)

I got on Craigslist about a week before B arrived and started searching for likely places. I also contacted friends, colleagues, and professors/adults for possible leads. Between us, B and I had put together a relatively impossible list of requirements. Here it is, for your perusal:


You'll notice that I wrote it with a real pen on real paper, even though I am so excited about the Information Age and the Technology Revolution and live within driving distance of Silicon Valley. But our list was pretty extensive: near public transport and freeways, allows cats, safer neighborhood, close to somewhere we can run, has bike storage, easy access to laundry, and (for B, compared to my old place) has a shower head higher than 5' off the ground. All of that for less than what we decided was our price ceiling, which was not extravagant in the least. That's asking quite a bit of this very expensive area of our lovely nation!

So using my various sources, I excitedly made a number of appointments (more than we could ever go to) for the weekend B would be here. That in itself was interesting -- I guess the internet makes frivolous/fraudulent listings easier, so I basically dismissed anyone who didn't post photos, sounded the least bit strange on the phone, tried to rush a viewing, or got back to me with weird requests. B read through the postings I had picked out and decided which ones he was interested in, too. Then we both figured out how many we actually had the energy to see in person. The answer was three (ooh, insert Goldilocks foreshadowing!), although some of those were drive-by viewings.

The first place we went to was lovely, tiny, in a great location in terms of access, not really in a safe neighborhood at all, and highly overpriced. The second one was a drive-by viewing of two places close together -- one was run-down, not a great (as in, ugly) neighborhood, but relatively safe and accessible. It had bad reviews on Yelp (another wonderful invention, though it can get ridiculous at times). The second seemed beautiful and well-maintained, but had no place to walk or run and was quite a drive to anywhere -- not really okay for people who don't want to live in their car. The third was different, because it wasn't an apartment complex. It was a basement apartment below a family who owned the house. It seemed bigger than the other places, so we decided to visit in person.

These photos are highly unflattering and low-resolution, so please bear with them. As you can see, it's quite dark because much of it is paneled in a medium brown wood. It has low ceilings, panels to nowhere, random steps up and down to different rooms, and three doors. Its layout is a square -- you enter into the kitchen from the garage. In front of you is a step down into a dark, square room with big windows. To your left in a little passage that leads to an L-shaped living area at right and another little windowless room at left. It has a kitchenette, a tiny bathroom, and a rubber-ducky- yellow bathtub.

It is separated from the family's upstairs home by a flight of stairs that locks at the top on their side (not ours, which I had trepidations about). It was such a quirky place and full of character that you either took to it right away, or didn't. I think both B and I were quite taken with it from the get-go, although of course the shower head could be higher (he's nearly six feet tall) and the bathroom was quite tiny and old-fashioned.

We both liked it and the price -- it came in under our sum, and this included all of our utilities except internet/phone, as well as laundry and permission to use the garage for our bikes. The only thing about a place like this is that you live with your landlord. So you had better get along well with your landlord! Apparently, he and his wife had two college girls living there before, so we figured it would probably be okay. There were no weird rules about parties or friends. He even said that if we felt like re-painting, he would pay for the paint. He was up-front about the financial side of things, prompt with the lease agreement, and brought his kids and wife to meet me when I went back for a second look. He promised to replace the carpet before we moved in. So we agreed that, although a relatively strange arrangement compared to what we were used to, we would take a chance on it. And we signed the lease this past weekend!

Our adventure begins. It doesn't look like much now, I know, but I can't wait to get in there with my good camera and take some before/after photos of the place before we settle in and decorate. And then, once certain huge exams beginning with B and ending with things that rhyme with TAR and SWORDS, respectively, are over, we shall hopefully have a housewarming!

Can you think of any good names for our new home? We could go with something traditional, like The Cellars. A nod to classic fantasy, like The Hobbit Hole? Or unfortunately true, like The Basement Mews? All suggestions welcome, no matter how inappropriate/punny.

A Moment of Serenity

Today I went seeking some peace, quiet, and serenity. In the form of a cup of tea, some roses, and a bowl of blueberries, yogurt, and cinnamon bread that my dad brought home (at left). I was playing around with roses trying to figure out what to do with our wedding tables. I'm drinking decaffeinated Earl Grey. Mmmm. And of course, I am gazing at a very contented, bread-loafed cat. Tea and cats are pretty nearly synonymous with home, aren't they? I am very excited to start living with B in our new place (which we haven't found yet), but it certainly is strange to realize that the year is over and I'm moving again. Also, I'm going to miss having both my parents under one roof for the first time in 20 years (their work has kept them apart). It's so fun to call out, "Mom!" or "Dad!" and have them actually answer, no phone necessary. Of course, my little feline has been with me throughout medical school (we got her when I was 14).

This year, both the cat and I moved back to my parents' house (for the 3rd year of school), as did my dad (from Japan) and brother (from Las Vegas). My mom went from living by herself to living with all of us again! I moved back into the room I've lived in since we came back from South-east Asia in 2002, which used to be our home office when I was five and we had just bought the house. This room is the first room I ever typed on a keyboard in! Although it took all of us some adjusting and my brother decided he wanted his own place and moved out, he comes back on weekends to hang out and do laundry, and we do have some moments of peace now and again. And of course, since my parents are cooking, the meals are pretty gourmet. Yum. This is inspiring me. Maybe I'll make some gingerbread tonight for my nice mother and father (and brother, if he drops by).

I think we are actually ordering in sushi this evening, which is pretty special. My dad cleaned out our entire garage today so he could manage the people from Home Depot as they covered our garage walls in shelving units. It's going to be so tidy and neat to have storage for all of our seasonal items and things that would otherwise be stored in an attic (there isn't one at our house). He worked very hard all day, and I think as a celebration of our new, organized garage he is treating us to sushi! When we start eating, I'm pretty sure the poor cat will rouse herself and perform her sad-cat-without-sushi dance back and forth across the kitchen floor. My dad always takes pity on her (I captured this sweet shot of my parents sharing the papers in our living room).

But as I write, both the cat and I are at peace. And outside, the garden is blooming (the pink tree buds have opened)! I love spring. We have a postage-stamp size garden, but it has a rose tree, a cherry tree, a pear tree, a tiny lawn, abundant daisies, fresh mint, several jays, hummingbirds, raccoons (!) at night, and sometimes, neighboring cats. You can probably guess how our resident feline feels about that.

We do have a redwood fence that allows us some privacy, so we can have cookouts sometimes. My brother uses the barbeque frequently, and he's a very good cook. Our next-door-neighbor's flowering tree overflows from their yard and lends a nice backdrop to the grill.

One of these days I'll have to write more about the garden. It is a potentially enchanted place. With tasty barbeque chicken.