Ready for a Harbaugh-handshake, Clint?

It's College GameDay! It has been an awesome season at Stanford Stadium so far - tailgating in Eucalyptus Grove... playing corn toss thanks to my dad's superhuman carpentry skills... and most importantly of course, watching the Cardinal go 7-0!

And while we have been LUCKy (get it? ahh I'm so clever...) to have won by at least 27 points and as many as 54 points in every game so far, I have to admit that I'm a teensy nervous for today. Because TODAY is... DAH DAH DAH....

Ohhhh lordy. Let's look at the last five, shall we?
2010: Stanford 37 - USC 35 (Not exactly decisive but... I'll take it!)
2009: Stanford 55 - USC 21 (ahhh that's more like it :))
2008: Stanford 23 - USC 45 (oh NOOOOO... I blame this on USC revenge for 2007)
2007: Stanford 24 - USC 23 (Unranked Stanford upsets #1 USC!!)
2006: Well. This is my blog. So I get to say who cares about 2006 anyway? To hell with 2006!

Now, I love Stanford Football. I want to go to sleep tonight at 8-0. It's alllllll about the game. And the win over a team I have hated since the 1996 Rose Bowl against Northwestern. But the Stanford vs USC match up goes deeper than all of that. Every year, this day is not just about beating USC. It's about a whole year's worth of bragging rights over USC's biggest fan (and one of my oldest and best friends) Clint Bradford. For Clint and I, the razzing, the glory, and the passion behind the rivalry is ongoing no matter what day of the year it is. Let me be clear (ha, clever me again!), the clashing of horns between us about USC can be funny and friendly... but it is most certainly *serious*. So today I am practicing my BEST Jim Harbaughesque handshake in preparation for my victory celebration over Clint (err... I mean Stanford's victory over USC) when the buzzer sounds tonight. Are you ready for me, Mr. Bradford?

It's the wheel of the world turning around

This quarter I have a Childbearing Families rotation on 15 Long at UCSF every Friday. I'm assigned to a different part of the unit each week; postpartum, high-risk antepartum, lactation, well-baby nursery, and the BEST... labor and delivery. Last Friday during the 7am nursing hand-off, my nurse and I got pulled away because the patient we were assigned to was having continued decelerations (where the baby's heart rate drops significantly and takes a few minutes to go back up to baseline). Some decels are normal (with contractions, for example) and decels with variability (where the baby basically bounces itself back to normal) are typically ok. But this little stinker was having sustained lowered heart rates and was making everyone nervous for most of the night before and into that morning. We tried a number of nursing interventions on mama, but ultimately she had to sign the consent forms for a C-Section and by 10:30am we were suiting up for the OR.

Five layers of tissue (skin, fat, fascia, muscle, uterus) and an hour or so later, baby boy got pulled out of mama and we heard him use his little lungs after the peds team went to work a bit. My thoughts on the whole C-Section process? Other than fetal demise or injury, I can't think of a worse pregnancy outcome than a C-Section. Are they necessary? Yes. As much as we do them here in the States? Come on. It is incredibly invasive and traumatic and sterile. It is SO far from what our bodies intend for the childbirth experience. But I digress. Either way, it was pretty CRAZY to see a huge melon-sized uterus resting on top of mama's stomach while they sewed it back up. Fallopian tubes, ovaries, and all.

A few hours postpartum, I was standing next to mama while baby was trying to breastfeed for the first time. My nurse (who had been a nurse midwife for 36 years!!) showed me how she wanted me to hold baby's head against mama's breast in order to facilitate his latching on since mama couldn't hold him quite right because of her surgery. So I basically planted myself there for the next two hours with one hand on the back of baby's head and one hand coaxing her nipple to protrude or pushing against her breast so his little nostrils were clear to breathe. During orientation for this site, my professors said we should allow ourselves to fall in love with the mamas we are working with. And from small talk with her in the morning to giving her reassuring smiles with my eyes in the OR since my mask was on to helping her breastfeed her son for the very first time in either of their lives, I did indeed fall in love with her.

About 24 hours after that, I was sitting at a funeral for a 24 year-old who I have known since he was born too. And today marks one year since Praise died. I'm just finding myself taking it all in, you know? I'm far from uncomfortable with death. I feel like there has been enough of it now - indiscriminate of age or reasons why - it just happens. People die. People are born. Keira was born. Geoff died. Brendon died. Baby boy was born. Still, it's a strange juxtaposition when it happens so concurrently. Just trying to take it all in. "It can open your heart, it can break you apart, and it never even slows down..."

What do tinctures, Tupac, and a barge have in common?

In a word? ... Marin.

My community clinical placement this quarter has me in a county office with Public Health Nurses (PHNs) who work with resident clients on issues ranging from medication management to Adult Protective Service cases to finding housing for homeless citizens. It's a mixed bag out here across the bridge... that's for sure.

I try to err on the side of staying reasonably mum about my impressions and opinions relating to public institutions, places I'm working, and people I'm working with (with obvious exceptions I am WELL aware of thank you very much!!). Regardless, the internet is a very accessible place! So I'll just say this before I launch into what I have been specifically working on: Marin is an enormously wealthy, predominantly white community. Community Health placements are NOT the same as hospital med-surg floors. Thus, the pace... the energy required for a clinical day... the skills one has to draw from... the challenges one encounters... all very, VERY different than my summer on 14 Long. Dig? :)

Every Tuesday and Thursday morning, I wait for my friend Adam's holler from the street to let him into the garage with his bike. We hop in my car and cross the Golden Gate, watching for the glorious spot where the fog line recedes and the sun shines through. And then we do things like... well... meet up with our third half Kate, and show up at St. Vincent's soup kitchen during lunch service. With a bunch of flu vaccines. We set up right there in the cafeteria and two hours later, we walk out 53 flu vacs lighter.

A day later, we were out in the field at a community health fair. Our medication management booth was adjacent to a homeopath who was providing homeopathic flu vaccines. Intrigued as I was by her claims that she could also reverse autism with her elixirs, I did not bite on the homeopathic hook. Adam, on the other hand, abandoned all training, science, and reason he has ever been motivated by and foolishly accepted her tincture tea concoction. Two sips and a burning throat later, he came to his senses and hightailed it out of there. His EXACT words regarding the incident: "It tasted like tingly burning tree bark... It tasted like regret."

One of our favorite experiences was an orientation to Marin City by one of the PHNs who has worked with the community there for-ev-er. Marin City has about 3,000 residents and was initially a shipyard where African Americans from the South moved to work during World War II. The war ended and work dried up, but the community survived. Today it is situated in some of the most beautiful and highly valued pieces of land on the planet, since it overlooks the Bay and is literally 10 minutes from SF. It is filled with a lot of Section 8 housing, is a designated area of gang activity, and doesn't have a grocery store in its vicinity. It boasts the likes of Jack Kerouac, Annie Lamott, and Tupac Shakur as notable one-time citizens. We desperately want to work with the NP at the health clinic there - but it feels like it has been harder than it should to make that happen so I am not overly optimistic at this halfway point through the quarter.

As I said above, we have a number of PHNs that we can connect with to see if there is something we can go do with them. I knew I found a good fit for me with Sean when I saw a full BDU and weapon picture of him in an indistinguishable desert, a huge bald eagle/American flag picture on his computer desktop, and noted he looks like every middle aged detail guy I ever worked with in DC. LOVE IT! Long story short, he works with a community on Richardson Bay called "Anchor Outs" who live on dilapidated boats that they scrape together or buy for 125 bucks. They are totally at the whim of the elements, and have no direct way to get to shore other than inner tubes or dinghies they have. They have a full on community out there though - there are about 100 boats where some people have lived for years. Every winter there are a few deaths due to exposure. There are good guys and bad guys out there, I'm told, and the bad guys live in (drumroll please) THE BARGE. Lots of drugs happening on the barge. The barge is like... the big bully of the neighborhood. Anyway, Sean invited us to the meeting he had set up with the Police Dept's task force on homelessness. In the meantime, we concocted a plan (and YES, Adam, I'm giving YOU the credit!!) to ask the cops to take us out on their boat so we could offer flu vacs and basic health screenings to the Anchor Outs. We met with the PD this week and they seemed amendable to the plan but have some stuff to sort out first. So FINGERS CROSSED that we will actually get a date set for this endeavor and we can suit up in some scrubs and hop on a boat to give some shots! In the meantime, I am practicing the discipline of "letting Marin be Marin."

30 before 30: #14 Indulge in a day-spa package

Two weekends ago, I was spoiled ROTTEN when I got to check the "day-spa package" off the 30 before 30 list. In honor of my 27th birthday, my birthmom Veronica, her two sisters Gloria and Roz, and her mom Mary treated me to an unbelievably relaxing and special day at the Spa at Cache Creek with them.

I have had fun spa treatments over the years at various places, but I had never had the whole shebang at once before. Now I can say... YES, it really is as amazing as it sounds :). We all started with some nice hot tea in the waiting area after we changed into our robes, then got right down to business with massages. Honestly, it's hard not to sound overly indulgent in this post so I will go ahead and take off the band aid fast for you: The rest of the day we spent at the cabana they rented for us to relax at between treatments- so between my massage, pedicure, AND facial, we were sipping greyhounds (or whatever we decided Gloria's special recipe was) by the pool. Oh my lord, it was heaven.

I was feeling so pampered by the end of the day, I almost fell over from shock when we walked into the hotel room and they had snuck in during the day and set up - wait for it - 27 BIRTHDAY GIFTS for me to open. Amazingly perfect gifts - A really nice traveler coffee mug that is fast becoming my morning best friend, gift cards to all my favorite/most used places, a BEAUTIFUL bracelet that Gloria picked out and personalized for me, the most cozy blanket I've ever used, and so many more.

So needless to say, this 30 before 30 blew ALL expectations out of the water. From the spa treatments and the facility itself to the pool cabana to the showering of gifts to the time we spent together over meals (and losing money at the penny slots with Veronica!), it was a very special time. Thank you SO much to Veronica, Mary, Roz, and Gloria for your outpouring of love on my 27th birthday :)