I needed a bike for Burning Man….

So I did what any other person in my situation would do during this modern age: get on Craigslist and see what people are offering this week. 

Found it.  Found a few actually…stylish cruiser bikes in various colors and states of disrepair.  I figured $100-200 for a used bike would be reasonable and sure enough, I found the perfect fit.  Mint green with white trim…the add even described it as a “perfect bike to take to Burning Man” and the price was right.  Sold!

I contacted the guy who posted the add spoke with him via telephone a couple of times and eventually coordinated a time for me to go by his place to check it out. 

Scott.  That is what he said his name was I think…pleasant guy, but notable primarily for being VERY enthusiastic in his manner and speech.  Felt like I was talking to a kindergarten teacher who had just gotten a new puppy.  Huh.  Whatever, I’ll give him $150 in exchange for a snappy new bike to cruise around on the playa with, even if he is a little…odd.  And actually, given the Burning Man context, it actually seems pretty fitting. 

As I drove to the address I was given, it occurred to me that going and meeting some likely weird stranger at his house to look at a bike seemed to hold some serious kidnapping potential…as in, thinking to myself “Nah, I’m sure it will be fine…he seemed, um…nice…and this IS a nice neighborhood…” seemed like the beginning of some graphic horror flick where the girls gets kidnapped by the guy with the bike on craigslist and gets locked in the basement for sixteen years or something….

Obviously, lucky for me, that isn’t how it went down. 

I parked down the street and walked up the drive.  He came stumbling out of the house, bare foot and shushing my hello…

“Someone is sleeping inside…”  Tall.  Like lanky tall…and big eyes he opened wide to punctuate his speech.  Very, very animated whispering….honestly, I think he was shushing himself more than he actually needed to shush me.

“Wait right here, I will go around back and get it!” He tiptoed around what looked like shards of  glass from a broken neon light bulb in his bare feet. 

I stood there, politely waiting, feeling less likely to be kidnapped now.  The house was tucked back, off the street.  And there was a lot of stuff laying around the driveway and side of the garage.  Boxes with miscellaneous refuse., old office chairs, cowboy hats, lamp shades, plastic crates full of dusty old books…and boxes of dry food….crackers, pasta noodles.  There was a large van parked in front of the house that looked full…of stuff.  Was this guy one of those enthusiastic garage sale types or just a militant packrat?  Not that it actually matters…

He came back with my bike.  So cute!  A little rusty, but not too bad…nothing a little love wouldn’t take care of.  I took it for a spin around the block.  It felt great.  I felt like a little kid riding around without a helmet, completely the antithesis of the “cyclist” or “bike commuter” I have at times toyed with becoming. 

I went back to the pack rat’s house. 

“Why are you selling it?”

“Oh.  It’s not mine.  A friend of mine lost his house and I am storing a bunch of his stuff here…it is his and he is just trying to get rid of some things…so….”

“Oh. Okay, $150 right?  Here is $160.”  I handed him a little, pre counted stack of twenty-dollar bills.  I really didn’t expect to get change, figured that I could manage with parting with that extra ten bucks even before I knew that it was going to a homeless guy.   He offered to sell me a heavy-duty lock for my new bike but I told him that I actually already had one…

“Oh, great!  Okay…um…you want some food!?!  I have a lot!”  He sort of scampered off  (yes, I said scampered and that is actually what he did) around to the back of the van and opened it up for me.  It looked like he had just robbed a bakery….the whole back half of the van was full of loaves of artisan breads.  “Here, take some bread!  What kind do you like?  Here take a few!”

“Um…do you have any…um, how about one with rosemary?”

“Yeah, okay, here you go!  You don’t just want one!  Take more!  I have lots!”  He is wildly gesticulating while he enthusiastically encourages me to help myself to the pile of bread.  “Oh, you want some crackers!?! Or Pasta!?!  Oh, I have cookies too!  And salt!  You need salt don’t you?  Everyone needs salt! Do you want Kosher or Iodized!?!  What else you need!?!  Oh, do you see anything else you want!?!” By now he had opened the garage to reveal floor to ceiling of shelves packed with boxes of…stuff.  Like he had not only robbed a bakery but also the local thrift store.  On the floor were several boxes and bags of food…he literally had two boxes full of salt…three different brands…and yes, Kosher and iodized where indeed options. 

Not wanting to be completely rude, I graciously accepted a loaf of rosemary bread, two boxes of Wheat Thins, two boxes of spaghetti noodles, and a thing of Kosher salt along with my new bike. 

“You sure you don’t want any cookies!?!” 

There is nothing like a massage to ruin your day.

I know what you are thinking: “Great Kristen, you have so little to say at this point that you are going to actually bitch about having a massage.”

Relax (ha!).  I’m not really going to bitch about it, just making the kind of tongue and cheek observation that one can only make when they have the luxury of being on vacation.  And since I seem to be suffering from a lack of material in my novel new life, I am just going to run with it. 

So, for those of you who do not keep close tabs on me and my whereabouts, this weekend I am occupying a fancy schmancy time share condo up in South Lake Tahoe (THANKS MOM!).  Sweet digs to be sure (and man o man, they almost got me to sign up for one of my very own…but I think they may have still gotten my number since it appears that I have purchased a ten day vacation on Maui for sometime in the next eighteen months).  And Lake Tahoe, just as I remembered it from a brief drive-by I did back in my Mammoth days, is stunning.  But while Tahoe is the kind of place ripe with pristine natural beauty that I often frequent, the novelty of the aforementioned fancy schmancy condo is a bit disorienting.  Those of you who know me well can attest to me being more the camping, sleep-in-your-car-at-the-beach or live-in-a-van-with-your-stinky-boyfriend kind of gal rather than your grandma’s luxury time-share type. 

(Cue the Talking Heads right here…)

In the spirit of occupying someone else’s life, I decided to book myself an overpriced, ski vacation town massage this morning, as my back has been tweaking out (I think I am out of shape for working those 36 hour weeks…I know, you feel REAL sorry for me for that one too).  

It was great.  Maybe not worth the exorbitant price tag but I am, after all, pretty spoiled with the $6 medical massages I was getting on my old insurance plan. 

Then I had lunch with an old friend, which is probably another story onto itself (seriously…here is a little trailer for you: I had lunch with my best friend from first grade whom I have not heard from for a solid thirteen years).

My plan for my day had be as follows: get up, make coffee/breakfast, enjoy the jet tub in my unit with a hot bath, attend overpriced massage, meet childhood chum for lunch, rent kayak and paddle around this big blue bucket of crystal clear water, spring the dogger from the kennel for a few hours (no dogs allowed in fancy schmancy land) and go for a walk and maybe sit on the beach with her for a while, then dinner and chill. 

Things didn’t go awry until after lunch.  Somehow lost my motivation to finish the day strong (sorry dogger, but maybe I will catch a second wind here and we can go for a little sunset stroll). 

Like I said, I blame the massage.  Just too relaxed.  Clearly.  Plus it got cloudy and a little windy and kayaking sounded cold.  Going back to my big leather couch and gourmet coffee maker to write for a while and maybe read sounded better to me. 

So here I am…. 

“Letting the days go by…”

Hillsborough, California

From Wikipedia, the free encyclopedia:

Hillsborough is an incorporated town in San Mateo County, California, in the San Francisco Bay Area. Hillsborough is one of the wealthiest communities in America and has the highest income of places in the United States with populations of at least 10,000.

           

Area code 94010.  Yep, that’s me.  Living with my dog in one of the wealthiest communities in America.  Go figure. 

I feel compelled to actually wash my car for the first time in years…not that I haven’t washed my car in the last few years, it’s more like I have never felt like I needed to…I’m a little concerned that someone is going to call the cops about the vagrant with the red Subaru from Washington…since I obviously must be a squatter. 

But it gets better!  Wait, actually, a little back-story first: I am renting a few rooms in a big fancy house (in one of the wealthiest communities in America).  It is sort of an apartment that is connected to the rest of the house…private entrance, private bathroom, bedroom, and this weird “kitchenette” that consists of a microwave, mini refrigerator and some of my own Rubbermaid bins draped with sarongs hippy style, to provide me room for food preparation and coffee production.  And my “apartment” is separated from the rest of the house, via the actual kitchen, with a mirrored closet door that has been propped over the entrance to the real kitchen and then held in place between my fridge and the larger one on the other side. 

So it is a slightly funky set up. 

And, true to the same form that has provided me with such a high tech partition separating me from the rest of the house, the shared washer and drier on premises have been out of order since I moved in.  Of course….

I finally gave up on doing my laundry here a few days ago.  One of my house mates, another unsuspecting medical professional (an oncologist researcher from Maryland actually) suggested over a glass of wine the other night while we were comparing notes on our land lady, that the two of us do a trip to the local Laundromat together. 

So, Tuesday night, my new doctor friend and I packed all of our laundry into his car, and wound down the hill to the nearest Laundromat, located in the next town over, Burlingame.  You see, it turns out that one of the wealthiest communities in America for some reason does not have it’s own Laundromat within it’s city limits. 

Go figure.   

I can’t believe I have been to Siberian twice now in less than six months.

I am somewhere around 26 or so hours in transit…I think this trip is going to wind up being somewhere around 30 hours total, airports and actual planes.  I am actually getting pretty skilled in sleeping upright on airplanes…a year ago I was incapable of such a feat…kind of amazing what a body can become accustomed to. 

Even more astounding to me is how far I have come from a professional standpoint in this same time frame.  When I went to Siberia on my first trip, I really had only a rudimentary knowledge of congenital heart repairs…I knew how to care for a post operative open heart child in the ICU but it was a more task oriented knowledge.  I didn’t posses a really solid grasp on the physiology; sure I understood it all when procedures and complications were explained to me on a case by case basis, but I didn’t own any of that knowledge; I would have to look up every repair and almost every anomaly that came through the door…partially in an attempt to not look like a complete idiot. 

The first time I was in Siberia, I knew that I had very little to offer the local nurses and I sure as hell didn’t have a thing to offer the local physicians.  I also realized just how much more I could know; how nice it would be to actually understand this stuff rather than trying to wrap my brain around new info every time I got a new patient. 

I made a joke to my nurse counterpart from Melbourne the other day, about one of our patients who had had a post operative complication involving a blood clot in his superior vena cava which caused his upper body to become edematous and cyanotic.  She said something about how she keeps forgetting what the child’s anomaly/repair was and thinking that he was a Glenn (which is a surgery that is  part of a staged repair that routs venous blood from the upper extremities directly into the pulmonary artery).  I said
“You keep thinking he is a Glenn because he looks like a Glenn!”  We both had a good laugh because yes, the purplish tint to his lips did indeed look very much like those of a child several days following their Glenn surgery. 

I didn’t know this last November.  Yes, I had taken care of children with this surgery but I often had to refer to bedside drawings of their anatomy or definitions in textbooks when trying to remember what the repair looked like.  Looking back, I am blown away by this and everything else I have learned over the last few months. 

I got back from Siberia with a renewed motivation to learn; I read books, I studied each of my own patients in depth.  I looked at the long strings of incoherent words listed as diagnoses in cardiology notes and tried to piece all the parts together. 

And then Iraq happened. 

I was entirely not prepared to face the degree of complexity and stress that I had to cope with there.  But I did.  And I learned volumes. 

So upon returning to Siberia, I have come a long way.  I have a different point of view.  Yes, of course there is still so much to learn.  But I saw things from a different vantage point this time….my rose colored glasses seem to have gotten lost somewhere over the Atlantic.  That is probably fodder for another entry…for some reason rehashing the petty frustrations presented on this mission does not sound appealing to me at the moment.  In short, the ICU team clearly did not want us there.  Yes, the nurses are excellent at fulfilling their bedside care roles as Russian nurses; they have little interest or incentive in learning beyond what they already need to know to complete their day to day tasks (though, I did have the opportunity to give an impromptu lecture inside the ICU one morning about the aforementioned Glenn procedure…totally at their behest).  And the ICU doctors really had little interest in input from our nurses…to the point that it was an aggravating issue.  At one point, one of the doctors went so far in excluding me from managing a patient that he instructed the interpreter to not translate for me (she was appropriately horrified).     

Like I said, it was frustrating. 

But at the same time, I feel so lucky to realize that.  I feel like I have packed so much into the last several months…the last two years in fact.  The amount I have learned and the experiences I have had, both clinically and through repeated international travel, seem to expand beyond that time frame…it feels like I have crammed five years into two. 

I ran into my ex-husband briefly while in the Valley a few weeks ago.  He was friendly, if lacking sincere warmth.  Can’t really blame the guy for that honestly…but it was suddenly so shocking to realize how long it had been…but then not really at all. 

Two years. 

The common question “What have you been up to?” makes me laugh every time. 

“Ha!  Where should I start?”

“No running with tonsillitis!”

These were Pavel’s words to me when I left him at the hospital last evening, seeing now that he is my “personal doctor” and all, he apparently feels entitled to give me such advice…and he also knows that I will be off for the next twenty-four hours and naturally inclined to do something silly like that. 

Damn.  He knows me so well.

The funny thing is that despite my resurgence of feeling fatigued and miserable for the last couple days, I felt well enough all day today that while looking at yet another sunny day outside I said to myself “Maybe if it is still nice tomorrow I will take myself for a run.” 

Seriously.

I’m stuck by this strange power play between my brain chemistry and immune system…for once brain chemistry is loosing to my other physical needs…but she is not going down without a fight damn it. 

A few days ago, after a few days of antibiotics and a totally insufficient amount of sleep, I woke up and felt the urge to go for a run…despite the fact that I had slept for only four hours, had been given my tonsillitis/sinusitis verdict two days prior, and that it was raining.  I just was feeling energetic…so I hit the road for about an hour…maybe four miles?  And I totally got caught. 

“I saw you!  From the van, going to the hospital to check babies… and you were RUNNING…in the rain!?! Crazy girl with tonsillitis!”

What can I say?

And of course, I felt awful again for the following two, three days.  Seems that my compulsion to move may actually be bordering on pathological at this point. 

Sigh. 

I swear the nurses hate us here

I can’t say that I can blame them honestly though; they are all very good at their jobs and have extensive experience working with adult heart patients of all sorts (this hospital is devoted  entirely to heart patients).  The other guest nurses agree that we feel like we are invading their turf.  A few are friendly; most seem indifferent if slightly annoyed at times…and then there are a few who are outright cold. 

But it must be difficult and frustrating for them; they all work very hard and are arguably overburdened.  We come in and all of the sudden they have even more work to do because of the increased volume of cases plus they have the added annoyance of having us get in the way and ask them tedious questions like “what med is this?” or “when did you start this drip?”  Nothing is labeled in English, med-wise which at times is scary, especially considering that we have caught several medication errors already.  There also seems to be a general indifference about learning anything new; it feels like every time I make a suggestion I am met with an emphatic explanation of “this is how we do it.”  The physicians are just as bad; I don’t even want to bother making suggestions at this point so unless I feel like a decision is going to potentially harm the patient, I just let it go. 

This experience, though not really that much different from my first Siberian ICHF trip, stands in such stark contrast to my Iraqi trip.  The nurses needed so more much help but they were at least somewhat appreciative of our presence…and it felt like we were doing something.  Teaching, caring for patients, modeling good practice.  And everyone was so friendly. 

Not the really the case here…at least not clinically.  Which is a bummer.  And frustrating. 

Cutey Pie hanging in the ICU post BT shunt

SO, for the most part, I just try to stay out of the way: do data entry for our trip, catch up on emails and reading…and try to enjoy the fact that this isn’t a total clinical nightmare.  

This little guy has AV block and is stuck in the ICU on a pacemaker...I think he is over it.

Had my first “proper” banya experience.

It was rad. 

One of the local doctors who are hosting us has a little country home (Pavel called it a “bungalow” which prompted a discussion about the differences between simple tropical houses on the beach and rustic cabins in the woods).

This country home is about an hours drive from Kemerovo and situated in the Taiga forest; I was told that this is the larges forest in the world, though this is a fact that I have not been able to substantiate as of yet.  It was beautiful though…an expanse of birch trees and tall firs. 

Our hosts provided us with a generous spread of food, primarily of the type that appeals to hard-core carnivores…I counted nine different varieties of cured meets and three of cured fish (we are certainly not lacking for protein or sodium).  And of course, bottles and bottles of vodka.  And fresh beer (you can take your recycled two liter bottles to beer dispensaries that have a wall of taps and you can have your plastic bottle of beer filled over and over…and novelty aside, the beer itself is quite tasty). 

After our salty, meaty meal and libations, we headed out to the actual banya.  It was a little log building behind the house, with a toasty common area with a large sectional vinyl couch for lounging in between rounds in the sauna.  We lazed about in our swimsuits, drinking fresh beer and sparkling water and took turns in the absurdly hot dry sauna…by far the hottest sauna I have ever been in. 

Then they busted out the birch branches. 

So the practice, which I became acquainted with courtesy of one of the local ICU doctors (PS, this is a hilariously incredible departure from the customs of Iraq where men preferred not to touch women or even look them in the eye) goes something like this: You lay prone in the sauna and a beefy Siberian dude in a Speedo hits your repeatedly along your back and legs with steamy branches of birch leaves…after getting you “warmed up” a bit, he throws more water on the hot rocks, heating the tiny space up even more, wets the branches again, places them on the hot rocks and goes for the second round.  THEN they throw snow all over you…and in my case, being the first victim and subsequently having the privilege of experiencing the fresh enthusiasm of our hosts, I was so overheated that I could barely breath the scorching air and tried to escape…so they had to restrain me in the sauna while they rubbed snow all over my body. 

There was a great deal of squealing and screaming to say the least. 

The other first timers found the volume of my good natured protest to be a bit unnerving…though no one else seemed to have quite the same intensity of experience that I did…except our surgeon, but I think he asked for it. 

So once I finally escaped, I emerged form the sauna soaked with sweat, completely lobster read and covered with birch leaves…and I think I must have looked pretty shocked and disoriented by the experience…which made the other first timers just that much more nervous.      

Despite all my caterwaul, it was actually kind of great.