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.

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

Saturday Morning Flower Market!

Mimi, a school friend of mine, and I decided to spend one recent Saturday morning visiting the big downtown flower market. It's located in what couldn't be a more urban setting, since it consists of basically a parking lot surrounded by stores backing onto two huge airplane- hangar-sized warehouses. The warehouses, however, are filled with any number of beautiful stalls displaying hundreds of varieties, sizes, and colors of flowers and plants.

The early morning is reserved for professional florists with a wholesale badge, which are a hot commodity in the city and which we did not have. One of my other friends recently opened a flower shop in a small town south of the city; I wonder if she goes to the 5 am market! In any case, we wandered in after it was open to the public (trade business ends at 10 am). Since a picture can be worth a thousand words, I won't delay in sharing the rest of these with you. Needless to say, it was a beautiful and peaceful way to spend some lovely hours with my friend on a Saturday morning:

Orchids and ferns remind me of my high school years, spent in Singapore. Orchids are the Singaporean national flower, and they have one of the most beautiful orchid gardens in the world.

Our own SF Bay Area tends to be good for ferns because of the cool, foggy climate. I also enjoy growing indoor succulents and cactus, which are found naturally all over the west and southwest. Being at the flower market made me want my own garden. I'm so glad our new flat has a yard -- you can tell the family (I think mostly the Dad) gives it plenty of care and attention. I will post more pictures of home, but in the meantime, more of the astonishing beauty we found behind the cement walls of this downtown warehouse.

Each of us had a mission: I was buying flowers for our family to give my father for Father's Day, and Mimi was buying flowers for a mutual friend and colleague who is pregnant and whose waters broke early, forcing her to stay on hospital bedrest for nearly a month until her daughter is born (hopefully) safely. While finding the gift, my friend was unable to resist roses for herself before settling on a beautiful potted orchid for the hospital room!

Orchids used to be my absolute favorite flower, but B and I have a little cactus and succulent collection at home and they are quickly working their spiky little way into my heart. On a tangential note, I love my choice of vocation so far, but I have to admit that on beautiful days I do wish it took me outdoors more often. The flower market reminded me that all of this came from somewhere -- nurseries and farms up and down the state.

It is so grounding to smell and see all of these flowers and realize how close we are to growing things, even when we haven't seen any green leaves all day and are surrounded by buildings at work. I found some beautiful (but thorny! Ouch!) roses for Dad that I was commissioned to purchase on behalf of Mom via telephone, and some Dendrobium orchids on sale as well (couldn't resist). I also noticed a tiny little coffee shop anchoring the parking lot of the flower market, although we didn't try it so I can't recommend it one way or the other.


These cactuses are the citrus of the flower world: doesn't it cheer you up just to look at them? In all honesty, the prices were variable --some stalls were charging far more than I was willing to pay, and some seemed to be giving away flowers! Many of them are willing to negotiate, especially towards the end of the morning. I think the flower market is best suited to one of two things -- either you have a specific and unique type of flower in mind, because you are likely to find it (think black roses, miniature varieties of rare plants, organic purple cabbages masquerading as flowers), or you have a specific budget and are just looking for pretty flowers of any variety you can get. However, it's also a good place to cheer yourself up if you are ever feeling blue:

Or purple, or white, or really any color at all! Where do you go for beautiful flowers? How do you feel about cut flowers (do you love them, hate them, or buy them and feel guilty about them)? What about organically grown versus with pesticides? Do you grow your own? In any case, see you next week!