I have held a lot of hands during diaper changes this week.

I mean that figuratively…though I have actually physically restrained children by holding their hands with some regularity while I coach my Iraqi counterparts on whatever it is that they are doing. 

I was there on my solo night shifts primarily with male nurses.  There are six nurses here for 24 hours so through the night they take turns sleeping in shifts.  So at any given time I only have two of them in the ICU with me.  Which is fine, but every four hours I have a new nurse who needs to be convinced that he is fully capable of changing a diaper.  I have to be firm: “No, you do not need to get the mother.  Yes, YOU need to do this, Yes this is part of your JOB.  Yes, I will help YOU.”

This whole thing must be such a shocking role reversal for these guys.  This feisty little American woman is making them change diapers and bottle feed babies. 

Weird.

It must be even more shocking to see this same little, bare headed, curly haired American woman, as well as her equally little, and even more ferocious British counterpart, advising their physicians and at times even vocally disagreeing with them (P.S. I think doctors may be regarded with even more esteem here than they are back home).

I am embarrassed to admit it, but I have actually yelled at people since I have been here. (“I don’t care if the monitor says the oxygen saturation is 93%!  The baby is not 93.  The baby is purple!!! The baby is not breathing….the baby looks dead! Monitor does not matter!  Baby LOOKS dead! Go get me some help!”).  I think this behavior on my part no doubt resulted in paralyzing shock for this poor man…hence his initial inaction.

We were given little certificates of appreciation for the work we have done here.  Mine reads “This certificate is hereby awarded to Ms. Kristen Anne Dill for having performed his duties faithfully, satisfactorily, and enthustiaticcally during the volunteer medical mission trip…”  It seems like an understandable error though…these surly British and American woman who speak their opinions to men (including doctors) and travel the world without their fathers or husbands are a much different breed than the variety of women predominantly found in this country.

I wonder what they really think of us.  Somehow think it is somewhere in between male and female. 

These children hate my guts….

….but their mother’s all love me. So I guess that’s okay.

[Totally unrelated: I’m sorry (and a little embarrassed to admit) that I have never fully grasped when it is exactly that you are supposed to use an apostrophe at the end of a word in front of the “s.” Is it ownership? Plurality? And what about conjunctions…is that what “that is” is?]

Okay, back to the original topic.

So yeah, I have rarely in my life received such looks of seething hatred. I thought I had had children hate me back home, but for some reason the children here possess nothing less than utter contempt for me. I am seriously afraid that one of them is going to succeed in making me burst into flames at any minute.

It is understandable. I make them sit up, I pound on their backs for chest physiotherapy (I teach their mothers how to do this as well), I only give them water as a reward for coughing, etc….all those generally mean nursing duties. I also smile at them and speak to them in a language they don’t understand…they seem to find both pretty galling. There they were, going about their lives, granted weak and easily winded in most cases, but minding their own business as otherwise normal Iraqi children no doubt do. And then I come along with this foreign medical team, and we crack open their chests, muck around with their anatomy, sew them back up, stick a bunch of tubes in their body, then wake them up, pull everything out and tell them to deep breath and walk.

I would hate my guts too.

But their mothers…they hug me, they kiss my cheeks. They grab my hand and thank me profusely for being part of this team that helped fix their child. Their adoration is in equal and opposite proportion to the amount that their children detest me.

So, like I said, I guess that’s okay.

Brian’s Christmas

Early in the trip we learned that our perfussionist was going to have a birthday during our stay here in Nasiriah.  Brian bonded quickly with our head security guard, a very imposing but quite jovial gentlemen named Anwar.  When Anwar and some of the other staff discovered that they would be sharing Brian’s special day with him they got quite excited. 

I was sitting in the common area one afternoon before work and one of the security guys started going on and on about “Brian something” (nope, still have no handle on the Arabic thing).  I thought maybe he was asking when Brian would be home?  “He is with the OR team all day today, will be back tonight,” I annunciated clearly…. but no, this response was meant with animated head shaking and hand waving.

Finally I made some progress: “Is he saying Brian’s Christmas?” I asked the other nurse sitting next to me.  And that was indeed what he was saying…quickly I realized that he had transposed the word for “birthday” with the American holiday of Christmas, which actually, sort of makes sense. 

At any rate, I still couldn’t make out what exactly he was on about other than the fact the Brian was going to have a birthday…Thursday.  Which is in all fairness, very similar to Tuesday, which is the day it was at the time of this conversation. 

We went to the hospital and had the terrible night I wrote about yesterday.  We were all pretty raw and devastated by the time we arrived home. 

When we walked into the common living area for breakfast we saw what our bodyguard had been on about: the room was decorated with brightly colored balloons and streamers, all part of the preparations for “Brian’s Christmas.” 

I needed that smile so desperately in that moment. 

The following night (I was back at work) they threw a proper birthday/Christmas party for Brian complete with party hats, music, dancing and a cake with sparkler candles.

I am very sorry that I missed it. 

We had a rough couple of days to say the least…

…and actually, do to the public nature of this whole, blog, thing, I am going to spare everyone the hairy details.  This really isn’t an appropriate forum for that kind of thing anyway. 

There is always a risk in cardiac surgery.  Things do not always go according to plan.  Challenges happen, the unforeseen happens, and sadly, the unfortunate as well. 

But, I am truly proud and grateful to have had this opportunity to work with such a remarkable team full of very capable and dedicated people.  I have learned so much this trip…especially during a particularly pivotal 72 hours.  And now I have this new threshold for what I know I can handle.  And that at least brings a certain degree of satisfaction. 

Learning.  Challenging myself.  Gaining intimate knowledge about the edge of my own abilities. 

These are reoccurring themes that I often write about and ponder…publicly as well as privately.  

And despite all the heartache, I am glad to say that they continue to be important themes central to...me.

The majority of the team leaves tonight.  Most are going home, and three will continue on to Sulaymaniah.  I will remain here in Nasiriyah with my friend and colleague, Dr. Pasha where we will attend to the children who remain in the ICU until we are able to join the rest of the team up north. 

Wish me luck!

I just opened the refrigerator in my room…

…to get some juice that I stuck in there the other day and I discovered a plate of fruit as well as a plate of little sweets and candy that had been left for me and my roommate. 

Hospitality they have here!

And there is such an abundance of food at every single meal.  I am offered more food at any given meal than I typically eat on an average day.  And since much of the food is the same at every meal, I have needed to select my food out of what is offered based on what meal it is.  I will eat my flat bread, cream cheese, and hardboiled egg for breakfast, save the yogurt and orange for snacks, the flat bread and hummus/cucumbers/tomatoes for lunch and try to sample the rotating dinner entre…all these items are available at every single meal. 

And check this out: we are not to leave the compound except to go to the hospital.  SO, if we need something, we can ask the guards and they will go get it for us.  And they refuse to accept payment!  Like adamantly refuse to accept payment.  Which makes me sort of reluctant to ask for anything…

But we do have this sort of nifty “third party buy now, pay some body else later” policy I have discovered.  I asked our head of security to buy me some shoes for the ICU since the do not allow us to wear street shoes in the ICU and I have been wearing my running shoes.  I wound up with the middle eastern take on Crocs…blue plastic clogs with holes and little plastic flowers on them…and me paying for them directly was made clear to be out of the question.  However, due to the aforementioned payment option, I was able to give some cash to Cody, one of the Preemptive Love Coalition guys, and HE can then give it to our security guy. 

One of the girls had given her laundry to one of our guards (who are also bizarrely charged with the duty of washing our dirty clothing) and a pair of jeans didn’t make it back.  At first there was denial that there had ever been jeans…then acceptance of their disappearance and assurance that they would be relocated.  After much discussion amongst themselves, the guards determined that new jeans would need to be provided… “We buy you new jeans!” despite the fact that the missing pair of pants has really never left the building….they just need to be located at some point seeing how it is doubtful that they simply evaporated. 

This morning they did show up. 

We don’t have much time left.

A few days ago, while rounding on the ward…checking in on the children who have safely left the ICU following their surgeries…a woman brought in her 5 month old and very beautiful blue blue baby.  Cyanotic blue.  He is okay, but if the anatomy of his heart is not rearranged very soon, he will grow weaker and die. 

He is on our “to do list.”  His surgery was scheduled for yesterday. 

But the unforeseen always occurs in medicine.  Things take longer than anticipated.  Kids need to return to the OR for emergent revisions of work already completed.  Kids are sicker in the ICU than expected.

And this lovely mother came to us in tears telling us with this cruel desperation how afraid she was that we would leave before we could do her baby’s surgery. 

“Please…. this is my only son.”

Communicating….or more to the point, NOT communicating.

I think, more than anything else, this is the major hurtle for this project.  Those of you that have talked to me about ICHF and what our organizational mission is know that a major tenant of the whole thing is teaching.  We want these sites to do these surgeries without us someday.  That is the whole point…surgeries on children in the interim is somewhat of a bonus. 

And at this point I am about willing to give my right arm for a freaking interpreter. 

There is only so much I can get across with simple words and gesturing.  Yes, I can teach how to calculate medications with paper and an actual calculator, demonstrating math and physically drawing medications up.  I can demonstrate how to perform chest physiotherapy or how to draw an arterial blood gas from a line. 

But I cannot convey just how serious an oxygen saturation of 35% is.  Or a pH of 7.1.

Trying to explain why oxygen saturations of 75% are okay for a child who has had a Glenn but very, very not okay for the VSD repair in the next bed is out of the question.  Can you imagine how confusing that must be? 

But the worse part about not being able to communicate is the parents.  Regardless of the condition of their child.  They don’t know.  They have so many questions; so much fear.  They have entrusted us with the lives of their beloved children and we can do so little to reassure them or accurately inform them of the condition their child is in. 

I can’t even begin to imagine what that must be like.

The Burning Man Nasiriyah connection.

Yes, I know, it is a bizarre comparison.   

I took some photographs the other day while being driven around by my security detail (they took me and another woman for an “outing”…we drove around, visited the river, snapped a bunch of photos, etc).  I was sort of startled by the similarity these photos bare to my photos from Burning Man…big, flat monochromatic expanse crowned with an even bigger veil of blue sky…bright, vivid Blueness. 

In addition to that vibrant blue, the alien landscape encompasses a variety of makeshift buildings that possess a varying degree of permanence…strange structures litter the horizon. 

And today, the wind kicked up.  I saw people riding around on bicycles with their faces wrapped in scarves to prevent inhaling the pale dust that filled the sky and knocked out the light…leaving us all in this fuzzy haze. 

From this line of thought, being strictly comparisons of the visceral similarities of the two sites I have drawn additional connections…perhaps far fetched.  I found this passage just now on the Burning Man website:

“The touchstone of value in our culture will always be immediacy: experience before theory, moral relationships before politics, survival before services, roles before jobs, embodied ritual before symbolism, work before vested interest, participant support before sponsorship.”

Do I need to elaborate further? 

I think that sums it up pretty well.

Surgical Day #5

I got to sleep in and do a late shift today.  Went in at 2PM to assist with new post operative admissions, get them settled, and leave after the last case with the OR team. 

It was nice to sleep… I think that I have finally run, face first, right into that wall of exhaustion.  I’m still sort of wasted in fact (not that way though, it’s a dry country remember).  So it was also nice to come back to our guesthouse after only eight hours. 

So not a TON to report. 

However…I DID assist a mother in breastfeeding her infant five hours postoperatively, two hours post extubation, with one mediastinal chest tube, one pleural chest tube, one triple lumen IJ line, pacer wires, and an art line….I think we had weaned off pressors at this point, but not 100% sure on that detail.  Definitely still on milrinone…

So, there we were…in a Muslim country I would just like to add for anyone who might have forgotten…and we pulled the curtains, scooted the baby to the edge of the bed, I leaned over one side to support lines, drains, baby, etc and the mother leaned over the other side in the most awkward breastfeeding position I think humanly possible…

…and together, we fed her crying baby. 

What I did today…and what I did today that is actually in my scope of practice

1.)  Chest physiotherapy.  Lots of chest physiotherapy.  Percussion, deep breathing (assisted by enthusiastic crying…which was also assisted by nasal and oral suction).

2.)  Made two post op open-heart surgery children walk around the ICU despite their frenetic protest. 

3.)  Attempted to put a Foley catheter in one of the screaming children mentioned above who refused to, or more likely was unable to urinate…I failed but she peed, so whatev.  

4.)  Changed a central line dressing.

5.)  Changed several sternal incision dressings.

6.)  Obtained peripheral IV access in as screaming three year old.

7.)  Mixed up my very own Lasix drip (Oh, and YESTERDAY, I got to mix an epinephrine drip!)

8.)  Terrorized my lovely Intensivist Nadia by making her assist me in executing all the aforementioned “nursing” tasks.

9.)  Pulled two central lines and one art line

10.)    Pulled mediastinal chest tubes for the first time.

11.)     Pulled pacer wires for the first time (mostly because Nadia refused to do it because she said it was “mean”….probably because we didn’t use propofol).

I wore gloves for some of these tasks…(well, one actually) but I think I will edit the details of my general non-compliance with universal precautions.  There are two boxes of gloves that I have seen so far in the ICU…and I am not sure if more will materialize should we use them all.  Plus, after the event last night…I think I would prefer to save the limited number of sterile gloves for direct cardiac massage…i.e. putting your hand in a kids open chest to pump their heart (yep, that really happened…in the ICU…last night). 

Most of this stuff I am actually completely qualified to do…well, I think I am at least.  At my home center our cardiac surgical PA definitely pulls all the mediastinal tubes and pacer wires, so those are nifty new skills I have acquired on this trip.  However, the Australian nurse I have been working with does that sort of thing all the time back home.  Same story with the mixing of drips…I have never in my nursing career had to mix anything other than sterile water with ampicillin.  I have required a lot of hand holding for these tasks in particular…epinephrine and heparin drips are two that I would prefer not to screw up. 

The pulmonary toilet stuff…well, totally within my scope of practice but almost never expected of me clinically due to the prevelance of respiratory therapist is back in the States.  Not hard though.  Good skills to refine.

But my favorite part of all this: NOT CHARTING

In Stateside medicine we end up spending as much, if not more, time documenting everything we do then we actually spend doing it.  Much of this is an unfortunate byproduct of the litigious nature of our country.  If anyone can “blame” you for anything that goes wrong, you need to be constantly proving that you did everything right…hence to meticulous and voluminous documentation that anyone working in healthcare in the States is familiar with. 

This is not to suggest that there is any change in the level of accountability; the difference becomes personally inflicted in a sense.  I care about doing things right because I care about doing things right….not because I am worried about getting sued. 

For me here in Iraq, it is all nursing.  It is all patient care and teaching and collaborating with my team.  I love working side by side with an intensivist who knows everything about the ventilator, can help me calculate doses and drip rates, and will help me place the Foley catheter that they just asked for.  I love working with other nurses who have skills that I may not but who are happy to share those skills with me so that I can teach the local staff.  I love trying to figure out how to do something without the resources I am accustomed to…only having six syringe pumps for the whole unit, or not having the syringes or variety of various specific tubes at my disposal. 

The bottom line is that we all do our best with what we have.

And I like that…if feels like real medicine. 

The nursing staff here is sort of hilarious.

They are predominantly male, very friendly, and very eager to learn.  They have many questions and I often feel frustrated by the language barrier…their questions are excellent and completely pertinent to what they are doing but it is so difficult to adequately explain concepts and really just ANSWER the freakin’ question because of the language thing.

(And I keep trying to talk to people in Spanish, which is clearly my default second language….oh, except when I want to say thank you…the Russian word for that always tries to come out).

There are also so many of them, the Iraqi nurses, five or six a shift it seems…and their professional relationships are quite jovial to say the least.  Very social bunch for sure.  And it typically takes two of them to ask a question…which works out pretty well since between three people, one who know zero Arabic (aside from how to say “thank you”) and two who speak a small amount of English, we can usually get the point across with a great deal of gesturing and calculating things together on paper. 

Another interesting feature of how they “roll” here is that everything becomes a discussion...sometimes a very lengthy discussion.  “Will you please give [fill in med here]” will often result in two to four people discussing the med, the dose, and who knows what else before finally getting it into the patient…a process that can take between five minutes and two hours.  General questions are much the same way.  Two people ask a question, get the answer, then go off presumably to discuss the answer at length among themselves and either come back for clarification or find a new person to ask the same question.  The other day I tried to answer, in the most simple English possible, the difference between epinephrine and norepinephrine…and I am pretty sure I was the third person answering the question. 

Last night, I had a pretty sick little one who needed a ton of intervention.  Blood and plasma transfusions, multiple doses of calcium and sodium bicarbonate, a new arterial line (go Pasha!), titration of epi and norepi, various other scheduled medications, etc, etc, etc.  It was a busy night with a fragile baby for sure.  And while I understand fully on an intellectual level that the goal of this mission is teaching, it was quite the challenge to delegate all these tasks to my Iraqi counterpart.  When I get stressed I tend to just want to do everything myself…but my nurse tonight was quite on top of things and followed every direction perfectly.  He also asked me some great questions…I just wish I could do a better job answering those great questions. 

Day…3?

It is so easy to get confused about where and when you are on these trips…I think it is Thursday?  Our third operative day in Nasiriyah and I get to sleep today and switch to nightshift after my first two days here working during daylight hours.  Not that I really ever see daylight while at the hospital anyway. 

We drove from Baghdad Monday in a large convoy…five identical Toyota Land Cruisers, limited to three passengers each.  Our lead car announced our importance with flashing blue and red lights the entirety of the four hour trip and close on his heels was an imposing 4x4 pickup with a very large and imposing piece of artillery mounted on the roof of the cab, complete with it’s very own gunner for the ride.  I think we even traveled with a fuel truck and of course a tail car following us the entire way.  Four hours weaving in and out of traffic and approaching uncomfortable speeds.  All the drivers were armed and carried assault rifles in their vehicles. 

Still rolling with that surreal theme…but I honestly felt very safe the entire time. 

The security guys are pretty funny. It is abundantly clear that everyone is VERY invested in our safety.  There are guards in the hospital, sitting outside the ICU and every time someone walks out of the room they jump to their feet so that they can escort us, literally around the corner (!) into the break room where there are always between one and three additional guards/security personnel.  The guards at the guesthouse are slightly more relaxed but not much.  This morning I had two escorts for my sunrise walk around the closed and guarded compound…because the one that I had yesterday evidently was not adequate. 

Okay, so I think that should be enough about security to put everyone’s mind at ease.  Yes, I feel very safe and well looked after.  In fact, aside from the prominently visable automatic handguns on the hips of our security guys and all the rifles being carried around in hospital, everything seems pretty normal.

The ICU has eight bed spaces and currently six beds.  We have done four cases so far and I believe that three are slated for today.

ICU equipment and supplies in these developing programs seems to be the biggest issue.  Part of that challenge comes from not knowing what we have available and not knowing where to find what we do have.  This inconvenience does not lend itself to smooth execution of care inside the ICU and winds up being the biggest source of frustration.   (Well, actually no, the biggest source of frustration and possibly the most important challenge is the communication piece…but more on that later.)  But this is by no means an insurmountable problem. 

There are also odd issues that are really just functions of how medicine works in places outside of developed countries.  When we obtain a CBC here for example (which is an acronym for lab work meaning complete blood count), we send the sample to another hospital and then the family has to go to that other hospital, pay for the test, and return with the results.  And hopefully, while they are there they remember to pick up the Tylenol and ibuprofen that we will need to provide their child with pain control.  I had to wait for four hours the other night to give our first patient Tylenol because I didn’t have another patient to “steel” it from.  Had I known this was going to be an issue I would have brought a gallon of liquid Tylenol from home. 

So that is hard. 

It’s funny…we have all this technology…cardiac bypass and open heart surgery going on in the surgical theaters, a handful of ventilators, a few syringe pumps, the essentials for ICU care (syringes, saline, IV catheters and such) but then getting my hands on Tylenol or clean diapers can become such a challenge.  Weird, right?

It just makes me appreciate how much I take for granted being back home. 

Welcome to Baghdad…

…holy cow.  What a weird place. 

As I was sitting with the team in the airport, waiting for our visas and praying that our luggage made it, it occurred to me that I could be in any one of the countries I have traveled to over the last few years (back to that whole airport no-man’s-land idea).  Pretty basic passport control.  Straightforward.  Small.  Not glamorous…except for the marble floors….

But it’s not like any of the other countries I have traveled to. 

It was sort of hard to wrap my head around that fact…and still is in fact.

Even while traveling in our eight-car convoy, going through check points (never seen so many Kalashnikovs off the big screen…but then again…why would I?) it seemed surreal.   

Oh, wait…it IS surreal.

Empty roads.  Giant concrete barriers along the edge of the highway lined up top with what I am assuming to be loops and loops of razor wire.  Tanks…lots of them actually.  Black smoke in the distance. 

And the light was funny…funny odd.  A weird bluish haze hangs over everything.  But all the light and from the clear sky seems to wash out the color.

But then again, I am not sure that there really is much color.  Concrete and anemic looking palm trees don’t offer much of a brilliant palate. 

Then we arrived at our little welcome brunch in this strangely opulent building that I believe was once Saddam Hussein’s palace.  Could have that detail wrong though.  Marble floors.  Crystal chandeliers.  Ornate plasterwork on ceilings.  Gilded Victorian couches and chairs.  And a decadent breakfast waiting for us.  Such an odd contrast to the world outside the doors.   

How ridiculous is it that I’m in London for the first time…

…Hell, Europe even. 

And I wont’ be leaving the airport.

Just a few hours in London-Heathrow, then to Turkey (is that Europe? It’s in the European Union, right?).  And then Baghdad.  Ha!  Weird!

But then again, I guess I’m not really in these countries am I.  Nope.  Not really.  I am in that neutral territory that known as is international travel.  Airports.  They really aren’t anywhere after all.   Sure, they have geographic locations in actual sovereign nations and all, but if you never go through passport control, does it really even count?  Are you really in? 

Debatable. 

I think it’s funny to think about though…me and all these travel refugees, floating around in airport no man’s land. 

Kurdistan is not a country.

Okay, time to come clean. 

Kurdistan is not a country. 

Kurdistan ("Land of the Kurds"^[3].; old Curdistan^[4][5]; ancient Corduene^{[6][7][8][9][10][11][12]}) is a roughly defined geo-cultural region wherein the Kurds form a prominent majority population, and Kurdish culture, language, and national identity have historically been based.

… Contemporary use of Kurdistan refers to parts of eastern Turkey (Turkish Kurdistan), northern Iraq (Iraqi Kurdistan), northwestern Iran (Iranian Kurdistan) and northern Syria .

Thanks Wikipedia (http://en.wikipedia.org/wiki/Kurdistan).

Okay, okay, in all fairness, I wouldn’t have known either. 

The part of this region I am traveling to is Northern Iraq…and that is the really only the second part of my trip.  The first part is full blown Iraq.  Nasiriya to be specific. 

I shared this detail with a handful of people but for the most part when asked where I was going, I stuck to “the Middle East.”  Upon further questioning, Kurdistan became my answer. 

I really hate lying.  I am really uncomfortable doing it in fact.  But I didn’t want’ to freak people out.  And I didn’t want to hear peoples opinions that would likely be formed in a few moments after I had given a great deal of serious consideration to the proposition of traveling to these locations. 

So how did I arrive at the ultimate decision?  To go.  There. 

Carefully. 

           

First off.  I feel safe.  I know the people who made the decicion to travel and work in this location.  And I can honestly say, with conviction, that I do not believe that this organization would willingly risk the lives of their volunteers.  I talked to people who had been there.  I asked the questions about safety and security.  And I was satisfied with the answers. 

Iraq is a big place.  Yes, shit happens.  People get killed there.  People also get killed on I-5.  People drown in the ocean.  People asphyxiate in the concrete coffins created by snowy avalanches.  Climbing gear fails.  Planes crash.  People sometimes even just drop dead.  Turns out, life is pretty freaking hazardous.

But you can’t live in fear.  Or at least I can’t.

This is an important part of the world.  Iraq is often considered the “Cradle of Civilation.”  Writen language, agriculture, a model for modern societies…these were all born there.  And today, it is a region marked by political turmoil.  But it is turmoil that is remote in the extreame to most of us. 

And I want to understand.  I want to see it for myself.  I want to meet the people who build lives there.

My intensivist friend form Belaruse told me that Iraq is “the most exotic place” he has ever been.  He described Iraqis as possessing “generosity without borders.”  I want to meet these people.

I also want to offer them what I can.  I want to help them mend little hearts but more importantly, I want them to someday do it independently. 

Reconstruction. 

In a different sense. 

Yes, I am a heart nerd.

And I am not embarrassed about it either. 

I have admittedly sort of a ridiculous track record of getting REALLY into whatever I am into at any given time.  But then again, I guess I find an interest and cultivate it intensely for long enough to integrate it into my life. 

Surfing was like that…as in it was the most important thing I did for a few years.  And I have zero talent for it…so it was a good challenge.  It still is.  But then again, maybe it is the challenge that is so satisfying. 

I had this professor in college…total wing nut.  Sort of an old stoner turned community college history professor.  Brilliant.  A tad eccentric.  The guy literally would stand outside his building, smoke tobacco out of a pipe (seriously, like one of those Sherlock Holmes kind of deals) and try to corner unsuspecting students and engage them in intellectual conversation.  I think he told us once that he had spent a year in some back woods cabin…no electricity, no plumbing and he drug his poor wife out there with him.  Like I said: wing nut!

Anyway. 

I can’t remember how it came up in class…which was U.S. history up until the Civil War by the way.  So he was explaining to us for some reason how he wound up teaching history.  The story went that he had been a bit of a math genius…granted, it is hard to say how good of a historian of his own brilliance he was…it seemed genuine though…it seemed authentic and honest at the time…granted I was only seventeen...

Regardless. 

So he had this ridiculous talent for math.  Like he could not bother to show up to a class all quarter, crack the text the night before the final, sort of study, then proceed to get wasted, wake up late, go to class and pass his exam with flying colors. 

I sort of hate freaks that can do that. 

But he wound up hating it too.  It was boring.  He was really, really good at math and ultimately he didn’t want to have anything to do it.  So he started to study history.  Because it was hard.  He sucked at it.  But it was interesting.  It was a challenge. 

This tale, regardless of how accurate it is, has ultimately…and weirdly…shaped my approach to life (I guess you can never predict who will have an impact).  Pretty profound for community college history I’ll admit.  But it has really affected my approach to learning. 

So that’s why I surf.

That’s why I climb. 

And that’s why I want to pursue a career focused on cardiology. 

It isn’t easy. 

Granted, it makes sense, I’ll admit.  Once you understand the physiology, you can anticipate how everything is going to work.  But understanding the physiology isn’t easy for me…which is what makes it ultimately so satisfying. 

Plus, there is the emotional piece.  I love my heart families.  I don’t know what it is about them…bad things happen to good people I guess.  Or maybe its the good people who can pull through…can hold it together through the roller coaster ride.  But it’s hard.  Everything is so tenuous.  Yes, we can theoretically fix your babies heart but we still can’t grantee that he or she will ultimately be okay.  Medicine is, well, a practice after all.  This is a challenge.

And it seems worthwhile. 

kdheart

It's a weird title I know. 


This was a little magical coincidence that I was going to keep to myself, but seeing how I just designated it as the title of my freaking blog, I guess it warrants some explanation. 




I recently ended a relationship with an amazing and delightfully creative man, whom I love very much but just can't be partnered with anymore...that is another long story and I don't think this is really the appropriate forum for that.  Regardless, he made the observation early on that my initials were "K.D." and made the obvious but previously unrecognized connection between that moniker and the common girls name "Katy."  So that's what he liked to call me....KD.  I kind of like it.  So that is where that comes from.


Heart: This is a funny story.

I walked into this funky, Oregon gas station to buy beer from this Indian guy...Habeeb's I think the place is called. He looked at my driver's license, looked at me, looked back...paused and said as he handed it back to me "In my language your last name means 'heart." And sure enough, it does.  Granted, it is spelled, in Hindi I believe "dil" but Hindi seems to be pretty loose about spelling and connecting words like that.  Weird, right?

Weird especially since it's baby hearts that are taking me on my current path.  Congenital heart defects took me to Siberia, are taking me to the Middle East, and now also appear to be taking me to Stanford for a remarkable nursing position.  

Now, my mother pointed out that "kdheart" is sort of redundant and she is admittedly correct.  It is after all like Saying "Kristen Dill Dil." But I still like the ring of it.  Maybe "Katy Heart" can be my pen name or alias some day.  Anyway...

People keep telling me that I need to start a blog...

...and seeing how I actually do very much enjoy writing, I have decided to do it.  I also had a touch of insomnia last night (it may have been worth it however, seeing how it was likely due to the espresso con panna I had with my tiramisu last night...yummmmm) which meant that I didn't fall asleep until around 0400 which meant that I couldn't get up at 0600 to drive to the coast and surf the groynes in Westport at low tide...which means that I am sitting at home like a lazy slacker and I might as well start a new project while I drink my second cup of coffee. 

 But I  digress...

The impetus for "The Blog:" Last year alone, I managed to surf in Mexico, travel to Indonesia for two weeks, alone, to surf their, spend days and days in the mountains learning to rock climb, went to my first Burning Man, ran my first marathon, and traveled to Siberia with International Children's Heart Foundation (ICHF) to work with a teaching oriented medical team to perform repairs of congenital heart defects in children and infants.

Each of these experiences, while sounding cool, where big steps for me and all very satisfying.  I expect the coming year to be just as full and exciting.  It is February 5th and I have already quit my job (and I did it without a new one, which was SUPER scary), got an amazing offer from an amazing institution in California (which means I will be relocating to the Bay Area), and I am about to leave for a four week adventure with ICHF in the Middle East.

I enjoy sharing my adventures with my friends and family and people seem to be genuinely interested in what I am up to.

 So this project should streamline that whole sharing process. 

Enjoy!