9 weeks and 2 days

I'm still processing so this may not be pretty.  Trigger warnings this talks about loss and body issues.

I've been exhausted for weeks.  I had a weekend hospital shift (which are notoriously hard). I was coming down the the virus that everyone else in the household had.  Everyone knew these facts.  What everyone did not know was that I was about 9 weeks pregnant.

My husband and I had made a clear decision to tell as few as possible in the first trimester.  I took Reproductive Epidemiology in public health school.  I knew that about 1/3rd of all pregnancies end in miscarriage especially in the first trimester.  Also I just didn't want the questions and the looks.  I honestly intended on not telling anyone I was pregnant until they asked and then make them feel guilty for calling me fat.

I expected things to go terribly as my baseline anxiety kicked in.  I literally know everything that can go wrong.  However after a "normal 6 week US" and 8 week first prenatal.  I was cautiously getting comfortable with just making it through the first trimester.  Which is what people kept telling me that was all I had to do. 

Easier said than done with the bone deep fatigue, growing out of all reasonable bra sizes (34 G+ are hard to find), and my baseline duties as a new doc in a resource poor area.  I felt terrible canceling morning or evening clinics when I just could not do another thing other than fall into my bed.  I also have PCOS (Polycystic Ovarian Syndrome) and Insulin Resistance which makes eating more more than 1200-1700 calories against what I've practiced for the last decade.

But as the weeks racked up I was cautiously hopeful that I could make it one more month. 

So I did the right thing.  I called in back up for my hospital shift, which was amazing. I saw patients. I admitted patients.   I did a little clean up work from the previous hospitalist.  I got home about at about 12:30 intending on sleeping for 7-8 hrs before doing it all again.   Then right before I went to bed I went to the bathroom for the last time and saw bright red blood.

This led me to handing over my shift to my amazing medical director (one of 2 people at work who knew).  And heading to the ER at 1am. 8 hours some blood tests and the most uncomfortable ultrasound I've ever had later the verdict was in.  Where there were heart tones before, there were none now.  I got my meds for a missed/incomplete abortion (medical language for miscarriage) went home.  On the way I texted the 6 people who knew who responded with great outpourings of love and care.

It is impossible not to think about the what ifs and possible signs, even though I know the most likely cause is chromosomal abnormality.  At my dating ultrasound I was dating 4 days early was that a sign?  I had a terrible allergic reaction to the sheets at the ultrasound place was that a sign, or a cause?  I knew I was working too hard was that a cause? At my first prenatal 5 days ago she said my uterus was enlarged, should I have pressed to make sure she thought it was 9 week size?   What earlier sign could there have been to tell me that things were not going well?  What could I have done to change this situation?

It's strange to hope for cramping and bleeding just so this part completes itself.   It's strange to still have symptoms of first trimester even though I know I'm not now.  This directly plays in to my appreciation/distaste for my body (love/hate is not quite accurate).  Of course my body which can't process sugar,  lose weight, and makes unnecessary cysts would fail in these ways:  both in staying pregnant and not allowing it to end when it should. 

I'm hoping the meds did their job and this doesn't linger on.  In someways the physical pain is appropriate to the emotional pain.

I find it hard to give myself permission to feel during this.  As a doctor I'm so used to putting everyone's needs before my own, and yet I'm finding it very hard to care about (or even check) my inbox.  While I know that's probably appropriate, I still feel guilty.  I'm also not dealing well with the other pregnant people around me.  Yep,  I'm I little bitter and jealous at this time.

Part of me wants to hurry up and get this over with so I can move on to the next month. In theory my chances are higher the cycle after a miscarriage, but as I said previously my eggs are old.  So should I just go to reproductive endocrine? I only have about 1 year left of my trying (see TTC), so time is running out.

So why write about this?  I was talking to one of the 6 people, another family medicine doc, who knew who noted that people don't talk about this much even though we know from medicine it is so common.  Why don't we talk about it?  Because it's one of the sad realities of life, maybe.  Is because it feels like failing and people don't like to talk about their failures?  Is it because though I've lost so many people in my life (my Father and Aunt Rose most recently) the loss of potential relationship is harder? I don't know.  But I am writing to process, tell my story, and maybe help someone else feel not so alone.

There are no words for the difficulty of this experience.

TTC

Spring of 2014 I was finishing my intern year of Family Medicine residency.  I would be turning 34 in July, and I was FREAKING OUT.    You see I had gained enough medical knowledge to understand all the things that could go wrong in pregnancy and delivery.  I also knew because of my PCOS I had lower fertility than others my age; also I was 1 year away from the dreaded AMA.

-AMA stands for advanced maternal age.  The term for when you will deliver over 35.  Of course with the update of the diagnostic codes it has been changed from the sad but acceptable "Advance Maternal Age" to "Geriatric Gravida"  which is infinitely worse-

Thankfully I had a visit from a friend who just had her first child who helped put my anxiety to a little bit of rest.  "If you guys have kids you will be great parents and it will be wonderful.  If you don't have kids you will continue to be great people and it will be wonderful."  So I allayed my fears for a few more years and made a plan.   The main way I deal with my anxiety is by making plans.

I figured I'd give myself 18 months to see if I could conceive (by which ~91% couples do).  So in typical fashion I started to research.  I started Pintrest boards, a Amazon wish list for possible registry, and started following some blogs.  I had already been following my cycle since I had an IUD and I added a few more apps specifically for tracking.  There was a whole set back with the Nov 2016 election.  (see Nov 9 2016 330 am)  After that experience I realized that though attempting to have a kid may be a fundamentally bad idea (given the fact that the world is pretty actively terrible), If we the US was not in nuclear holocaust by July 2017 would try anyway.

Armed with 2 new apps I entered a new world of acronyms and short hand.  If you are not apart of this world I will give you a taste because they are truly non-intuitive:

• AF - though I initially thought this was the more common "As F**k" it actually means "Aunt Flo" or period.   
• BD - Baby Dance.  Why people can't just say sex, intercourse, nookie, or any other euphemism I don't know. 
• Baby Dust - Not to be confused with BD-  It is wishing someone good luck, though I sometimes think of it as fairy dust and is therefore wishing more GLBTQ children into the world for fun. 
• DPO & CD - Days post ovulation and Cycle day.  These actually make sense and are useful
• DH - Dear Husband - I first came across this one in wedding groups.  Still don't like it. 
• TTC - Trying to Conceive.  Which is what most people are trying to do on these groups anyway and I'm not sure why this is an acronym.  There should be one for the folks who are not trying.
• BFN/P - Big Fat Negative or Positive in reference to pregnancy tests.  Why they have to be "big and fat'  I am unsure. 
• TWW -  Two week wait.  Also known as the truest purgatory known on earth.  It's the two weeks after ovulation and before your period.  It is HELL.
• EWCM - Egg White Cervical Mucous.  Yep it's what it sounds like.  

So now I'm apart of this very strange community of people actively trying to get pregnant and generally complaining about it/confused/wondering if they can check a pregnancy test 2 days after ovulation, "I mean I know it's really early, but. . . "  

I started out doing more stealth doctoring.  "You know the best medications for PCOS is Metformin low carb diet and exercise."  "There is no evidence to having your legs elevated after sex to insure conception." "No a BFN two days after ovulation does not mean that you have not conceived this month."

I've found that there are 3 large categories in these groups.  1) TWW screams from purgatory:  to check or not to check, how sucky this, I just checked but I can check again.  2) What to try next: better supplements,  fertility meds experiences,  should I go to the doctor?  (I generally answer yes) 3) Hoping: baby dusting, wishing they could by baby clothes, hoping this is the month.   

Then I realized this is a group of strangers who don't know I'm a doctor and I can ask stupid questions that I also already know the answers to.  I also realized that though there is a group of people going through the same thing, TTC is a very isolating experience.  Though my partner is amazing and there is a group (though sometimes questionable) of people going through the same thing, at the end of the day it's still what's going on with my body.   While I can track my basal temperature, check my cervical mucous, take my meds, try to exercise and fit in nookie with my new grown up doctor job which inconveniently schedules events every fertile weekend so far, it still feels wildly out of my control.  I'm still AMA, PCOS, in a high stress job, and my body doesn't seem to like to cooperate. 

It's a month to month rollercoaster over 4 weeks ultimately waiting to find out if I am infertile enough to get help or will it magically happen.  Using my planning skills I have kept myself on track with adding something every 2 months or so.  First adding cheap ovulation tests, then the expensive ovulation tests. 

(Can we take a minute to talk about how unreasonably expensive conception items are.  American consumerism truly makes all large events in life more expensive than needed:  Weddings, TTC, actually having a baby.  I mean really. It should not be 45 dollars for 1-2 months of ovulation tests and 39$ for one month of a supplement that actually has medical evidence.)  

But I digress

After 4 months I added Pregnitude which actually has evidence of supporting ovulation for people with PCOS. Then after 6 months I officially get to go get the whole fertility work up as appropriate for people over 35 TTC.   I am hoping that with the work up that more things keep getting added, because I need a plan, and my plan runs out in January. 

I realize I'm only 5ish months into this journey and I'm already over it.  I would like to know if my body will cooperate or not.  I also feel comfortable with my limits.  I'm not doing IVF or any truly invasive procedures.  If I'm in that 9% then I shouldn't be having kids I can just get an IUD and a dog. 

Dear LeVar Burton,

Caveat:  This is a reforming and updating of a previous letter I wrote while I was in Peace Corps Namibia (Group 20 Represent) approximately the spring of 2003.  I wrote the letter and literally had no place to spend it.  It had been years since I saw the PO Box that came up at the end of Reading Rainbow and the internet was not where it is today.  I'm not entirely sure what happened to this letter.  I think I tried to send it to PBS, but it also could be in some of the Peace Corps boxes I still haven't completely unpacked.  (I was warned this would happen literally and figuratively.)  I've thought about this letter repeatedly and how to possibly get it to him.   Should I do a series of tweets (a long series)?  Maybe on Facebook it could work (too personal or impersonal)?  This desire was rekindled as I started listening to "Levar Burton Reads".  When he showed up on my favorite podcast "Another Round" I figured I had to do something.  As this is a testing ground for my memoirs someday I figured . . . 

Dear LeVar Burton,

  Like many children born in 1980 I remember coming home from kindergarten and first grade and watching Mr Rogers, Reading Rainbow and Square One TV.  I was excited to get any book that had the stamp of approval "Reading Rainbow Book."  I loved watching all of the shows new and old. I still remember the plot from "A Chair for My Mother," and all the words from the song in the Team Work episode.  The concepts of "Ty's One Man Band," that everything can be music (not to mention Ben Vereen's song), continues to enhance my daily life.   At one point in my childhood (maybe when I was 7)  I wanted to be a book refurbisher, an idea I got from the library of congress episode.  

I took for granted that every afternoon I could go on a new adventure to find out what happens at fashion week, or on a farm, or all night in New York City.  As a teen and I caught a rerun here and there (at one point I wanted to work for PBS [also wouldn't life be better if we all lived by the things we told children to do?]).  Watching Reading Rainbow as a teen I started to realize who the readers of the books were.   Finding out that Phyillis Diller read "Ludow Laughs" and Hoyt Axton read"Meanwhile Back at the Ranch,"  I started to appreciate Reading Rainbow on an whole other level.  

As a Star Trek fan raised on TNG you were one of  my favorite characters.  The only collectable TNG characters I had were a small Enterprise NCC-1701-D and Geordi LaForge. My short lived - incomplete TNG fan-fiction was about Geordi LaForge finally getting his love story. (Even as a 14 year old my Trekkie friend and I could tell that this was an injustice.  Yes there was that episode or two with the designer of the engines but that really doesn't count.)   I was elated with the cross-over episode between TNG and Reading Rainbow. I didn't realize how much I took your place in my life and the things I loved for granted until I was in Peace Corps.  

 I was a Peace Corps Volunteer in Namibia in a small Ovambo tribe about 20 km from the Angolan boarder.  In order to get to my homestead you had to drive about 1.5 hours from the nearest town.  After the tarred road turns into a dirt road you travel about 30 more minutes then walk another hour and fifteen minutes into the desert until you get to the village of OshiKuKu and my homestead.   Namibia has 3 desserts that converge and the landscape is fairly barren save a few bushes, anthills and the occasional tree.  The water was a public tap where community members can collect water in 5,10, and 20L jugs and take it back to their homesteads.  There was no electricity to the village though the school was wired for it and did have a telephone. 

The Leaning Tree landmark on my walk from the dirt road to home

The folks at the water tap my last night in my village

As a Peace Corps Volunteer at the Illonga School I taught English and Science to grades 8-10 as well as art classes.  I was also raised in a house that fostered a love of reading and books.  I was surprised to find out that the school library was stored in the teacher's office and had a very small selection.  I was even more shocked when I saw an occasional book weather-worn just laying in the sand.  Children treated their books roughly and without the respect and care I was taught.  What was sadder to me was the lack of imagination.  I would ask my English students to make up a story or write poetry and all of the responses were very concrete.  Rarely would I have a student write about something that had not actually happened.  If we had just read a story they would mostly repeat what they had heard or understood.   This limitation in imagination was more obvious in art class.  When I asked them to draw items it was mostly copied from what they saw in front of them be it a magazine, picture, or item in the classroom.  

My school first thing in the morning

 

My 10th Grade Class - I'm in the center with my dog Nando


I started to seriously consider why students'  imagination was so limited.  I figured the landscape was one reason  Though the landscape could be breath taking during the rainy season, during the dry season (which was most of the time) it's pretty bland

My walk to school in rainy season

I then started thinking about my influences as a child.  Though I lived in Cincinnati, OH I had seen what New York and New Orleans were like, because of your show.  I knew about different careers in aerospace as well as farming because of your show.  I realized that through Reading Rainbow I had an understanding of vast worlds beyond that which was in front of me.  This is an advantage my students did not have.  I had book donations to the library and encouraged reading, but I wish I could have shown them your show. Though I come from a family of readers you show made it clear how transportive reading could be.  

Moreover I saw all of these things hosted by a Black man.   I can not state the significance of this enough. 

 Every afternoon I had a Black man on my television taking me on new adventures and teaching me We would laugh, learn, and I always knew I would  "see him next time."  I had a pretty stable childhood with two loving Black American parents; I can't imagine what you meant to those who did not have this.  I never wondered if there would be people of color in space because of you (and Mae C. Jemison.)  As I grew up, I realized I had a very revisionist history of my childhood TV.  I found out: "Benson" was not the governor, "Gimme a Break" was not about a Black woman adopting three White children, and "Sliver Spoons" was not about the friendship of a rich White kid and rich Black kid.  However you and your roles stayed true and genuine.  

I know you are a human being and I appreciate you letting us see that side of you as well in your interviews and conversations.   I remember on one of the PBS promos you mentioned your own children.  It was kind of like when you see your teacher at the grocery store and you realize they are a person. When I got back from Peace Corps (and India, and had enough people bug me to do it) you were the first person I followed when I joined twitter.  I was so excited to hear that you had a new podcast. When I got to listen to your first podcast it brought tears to my eyes.

Thank You LeVar Burton.  Thank You for showing children worlds beyond what they can see in front of them.  Thank You for being an example of a Black man that much of America pretends does not exist.  Thank You for teaching our past showing our present and the possibility of our future.  Thank You for continuing to act, teach, and inspire.  

Thank You for being You.

Honestly &  Sincerely,

 Margarette MD, MPH

Cheers

Mzungu

I saw a white dude with a t-shirt that said Mzungu.   Now most people would not know what this shirt meant.   It's probably just a funny word to them.  I -- having worked in Southern Africa -- knew this was the word for white people said by Africans.   As I continued to look I noted that the shirt was in fact from Tanzania. So it probably did mean what I thought it meant.   Being that I live in Asheville -- Home of hippies, hipsters,  and people who will sing along with you at the gas station (that actually happened) -- I figured I would ask.

"Excuse me,  I noticed that your shirt says Mzungu and is from Tanzania.  Since I worked in Southern Africa I know that means white person.   I was just wondering why you would wear that shirt."
White guy looks awkward "Yeah it's from Tanzania,"
"I was just wondering why you would wear a shirt that pretty much just says white guy."
He now looks even more uncomfortable and starts to ramble.  "Oh well, it reminds me of being in Tanzania when I was at this awesome snake ranch, we were hiking,  and this kid bought me this shirt . . .  It reminds me of good times I had there . . . It's not racial."

At this point I could tell he was feeling pretty uncomfortable.  He probably had never thought about his shirt before or that someone would ask him about it. I could see clearly one of the Peace Corps Guys wearing a T-Shirt that said OshiLumbu ironically. (Actually I think the group before us did make those shirts ironically.)  They would've probably noted that's what they were called all the time and laughed.  I tried to give him an opportunity to let him in on the joke.

"I just saw the shirt and knew the meaning and wondered if you were wearing it ironically, or if you were wearing it just for the memories."
"Just for the memories."

So he was not in on the joke.  This is was probably a white male who had never thought about it.  I realize that most of the white men in my life have had to recognize their color and privilege at some point. My husband who wears "Not an accurate representation of a white person" T-Shirt ironically.  My best friend who I had frequent debates with in High School.  While he was coming out and we discussed our disadvantages, I told him that walking down the street no one could tell he was gay, but everyone could tell I was black.  That statement pretty much ended the debate.  All of the guys in Peace Corps had to deal with their whiteness on a daily basis.  But this guy had probably never really thought about it.

I could tell he was uncomfortable; in retrospect I wish I had let him sit with his discomfort.  Why shouldn't he think about his whiteness, or how what he wears means something.  But on instinct if rushed in to make him feel better.  I joked about how I was called Oshilumbu myself even though it means white person.  How my Namibian students told me I was not black.  His female companion joined and we laughed it off has he left the area and I could order my coffee.

But I wish I had let him sit in his racial discomfort.  I wish as a Black American Woman my training and instinct was not to make sure that the white guy is okay, even in this small moment of discomfort.

Reconciliation

Today in the shower I had a reconciliation of sorts.  I said "yay thighs."   Now for most people such a statement may not mean much, but for me that was monumental.  I have not had the best relationship with the top half of my legs.  It probably started around the age of 10.  As I started to develop, having a little bit of curves was something I wanted.  Mostly I wanted breasts (irony), but a booty was okay too.  However what I did not forsee was the mental havoc that would be wrought by my legs.

Honestly it may not have even been a thing, if it wasn't for Shane Parish. (That's right I just name dropped) My parents moved from the country to the suburbs of Cincy when I was 9.  I went from inner-city (primarily Black-American) elementary school to E. H. Greene in Blue Ash (primarily white).   This transition was hard enough (changing classes every 2 weeks because they put me in remedial classes, working my way back up to gifted classes, trying to find new friends, riding the bus for the first time instead of walking), but gym class made it that much harder.

 We had gym on Tuesdays and Thursdays.  We were all working for the presidential fitness test: running a mile, sitting up, pushing up, trying to do pull ups.  You know all the "up" things.   Over the summer I had started to wear a bra (ooh) and had more weight on my legs.  I honestly did not think about my thighs much other than wearing cords or track suits that now made sounds as I walked.  But when I stepped into the gym I now heard every step echo.  The green gym shorts were not the most flattering either. However what made it life scarring was Shane Parish calling out "Here comes Large Marge with Thunder Thighs," every time I walked into the gym.   It was terrible.

Even now my heart rate increases thinking about the anxiety caused by trying to figure out when to walk into the gym.  Was there a way to walk in without him noticing?
With a group of girls - nope.
Right before the bell - nope.
Maybe super early before anyone else was out - well I just never changed that quickly.
Suddenly for the second half of the year I came down with a terrible illness Wednesday night which would cause me to miss school for Thursdays and many Fridays.   If I went to school I would be sent to the nurse before PE with a fever up to 101.9.  My parents took me to my pediatrician, Cincinnati Children's and specialists trying to figure out what was wrong.  I had tons of lab work done, which I enjoyed more than walking into the gym.  Suddenly when I started the summer and then went back to school in 6th grade when Shane was no longer in my class I didn't have the end of the week illness.

Only when I was in medical school did I learn that this is a common and normal coping strategy for children.

Though I no longer had to hear him say those words; the image and the sound stuck with me.  I stopped wearing shorts in the summer and only wore long baggy pants.  Luckily it was the 90's and this was the style.  I gave up on wearing women's clothing and shopped in the men's section where I could buy a 40+" waist which I knew would go over my hips.  All of my skirts or dresses had to go below the knee.  That experience started anxiety, stress, and dislike of my thighs which so far has lasted over a quarter of a century.

In college I came to terms that my thighs were never going to change size and get smaller (my hip bones are actually set wider than others) and they were either going to be fat or muscle.  So I danced and worked to make my thighs as much muscle as possible.  But I still didn't like them.  I actually managed to lose weight in Peace Corps, but still didn't like my thighs.   I did yoga and jumped rope in India, and fortunately saris and most Indian clothing covers the entire legs so less worries.  I was getting my legs waxed regularly and there are few things worse than holding your fat taut so someone else can remove hair.

In pubic health school I started volunteering at Shadowbox.  (If you live near Columbus Ohio and don't know what this is do yourself a favor and go)  Shadowbox (Sketch Comedy and Rock & Roll) is known for having people of all sizes in all costumes.  So I had some fun and got into the spirit.  I forgot my pants one day and needed to borrow the skirt from one of the cast members.  I was amazed to find the skirt fit when I always thought she was way smaller than I.  So as a volunteer with fishnets I showed my thighs for the first time in years.
 

I still pretty much only show above the knee for performance or costume.  But with continued exercise and time I got to the point where I don't actively hate my thighs.  I can appreciate what they do for me on a daily basis; start to like them.  I can even say "yay thighs."

Nov 9 2016 3:30 am

I am scheduled to get my IUD taken out Thursday.  It's a little more complicated because they can't find the strings; I have to go over to the Ob's and have a ultrasound an likely paracervical block.   It is likely going to suck.  What is worse that now I have to scramble to see if I can get a new IUD placed.

I don't let myself get excited about things until it is really happening.  Travel, new adventures, even graduations I don't acknowledge until I'm in the moment.  I also am an over planner. I've been looking at pregnancy and labor information for the last 18 months.  I'm 36 and my fertility is falling (not as fast as it will in a few years) but fast.  As I've told others it is time to poop or get off the pot.

But now I feel 30 minutes into a Trump presidency that it would be irresponsible for me to try to conceive.  We were alway dubious given the world as it is: global warming, overpopulation, the state of Black American life.  But people were at least talking about change and possibility, and my time was getting short.  I have been worried for sometime about what could happen to me and my family with police violence.

I keep hoping that something will come up and prove that this is an error.  That the country that I live would not elect someone who has committed sexual assault, suppresses minorities and endorses violence.  I recognize that this is without the voting rights act and gerrymandering occurred, but Hillary ceded.  I don't know what could change in the next 24 hours that would make me trying to conceive responsible.

I am genuinely sad and mourning not just for my country but for my personal loss.  Maybe in a year things will look reasonable again, and I will feel okay possibly conceiving.  But of course my fertility will be even lower at that point and it will be less of a chance.

Damn it I really wanted to try.  

"Are You Ready, Are You Excited?"

These are the two questions I've heard repeatedly for the last 2 weeks and up until now they have just made me want to scream, "NO, I have a list of about 1400 things that still need to be done and right now I'm just exhausted and daunted."   Somehow in the last 36 hours I've actually started to realax.  I know part of it is because I've had awesome help from friends.  I can't tell if we are through the storm or if we are just in the eye.  My loving husband to be has become a full fledged and embraced the fact that he is a groomzilla.

 So in between creating detailed notes for our posse so they know what they are doing I have to keep reminding him that he won't be there to make sure it is done correctly.  We'll be taking pictures :-).   Meanwhile my wedding has become a full fledged family event.  So I knew they were going to have a celebration for my Aunt's 80th birthday the afternoon of the day after the wedding.  But what I was not expecting that my informal Sunday brunch to become the formal celebration for her birth.  I also get company when getting my nails done, but not for the bride to be, to celebrate my cousin's birthday.  So now members of my family are now talking about how great it is to be there to celebrate everyone else and I'm thinking. . . Is it wrong to think my wedding weekend should be about my future husband and me?   Alright back to washing dishes and getting ready for the weekend.  So am I ready and I excited. . . I'm starting to be.

Unforeseen Wedding Crazies and Match Day Results

So,  I see myself as a pretty low key non-stressy bride.   I intend not to be a Bridezilla and have made it so those participating in my wedding have max flexibility.  For example,  I'm not choosing dresses for my party but allowing them to chose their own within a certain color spectrum.  So far my fiance has been way more of a Groomzilla with demands that no sneakers be worn and that certain members of the party should wear hats, and freaking out when little things don't come together.

However, there is something about weddings that make people lose their sense of agency and need to ask the bride about every little thing.  I've been asked everything from what shoes (which I think is reasonable) to how to wrap our wedding present (which is not).   It's like we are Ta'veren and everyone is just waiting for our approval.  More frustrating is the lack (possibly American lack as I've talked to others before) of ability to look things up.  Though the website is chock full of info and we've sent out numerous emails & google docs with information people still ask me.  Even though I've clearly said in other emails that I don't have this information, people still ask me.

 Apparently I was looking so defeated today that everyone seemed to feel the need to console me and tell me not to worry.  All of our service people have been super excited and we're crossing fingers for no rain next Saturday.

Of Match Day I will be heading down to wonderful Asheville, NC to join the Mountain Area Health Education Center MAHEC.  That's right I get to be warm have a beautiful view, southern hospitality, in a hippie liberal refuge. That's right it's NC version of Austin or Yellow Springs on steroids.  :-)  Here's a shot before we found out where were going.

Now we're heading to Shadowbox for a combined Bachelor Bachelorette-esque party.  Can't wait to chill out and have some fun. On other news I gave a successful talk on White Privilege to FreeThought thanks to TWIB NET. Shout out to the chatroom and all my wonderful friends who are helping me remain sane by tying ribbons and gluing corks.  ONE WEEK LEFT.

3, 2, 1 AHHHHHhhhhhhh

So I'm at O'Hare airport on my way to Kansas City for AAFP's cluster, and I stil can't get myself to focus enough to completely read through last year's report.  So apparently I'm blogging

For the last couple weeks I've been having fun saying , "In 4 months I'm graduating, 3 months getting married, 2 months Matching, and going to  Swaziland in 1 month.  Then it all crashed down.  Wait no, not 4 months, 3.  I'm going to Swaziland next month (which is a whole other discussion) . . Ahhh wait no I did again.  I'm going to Swaziland next week.  Actually this time next week I'll be landing in Johannesburg.  So with the realization I'll be basically out of touch with everyone for a month I've been trying to get things squared away.  Like emailing the entire family to RSVP for the wedding since for some reason most of my family didn't.  This is especially important since we have an A, B and C list and people keep wanting to bring guests.  120 people can come to the wedding.  That is it we are against fire codes here people. 

To add to the craziness I have to make sure my schedule is finalized. Work on my talent show entry (since I am the reining champion for the last 3 years).  Make sure my research FINALLY gets through IRB so I can graduate. And oh yeah at some point I should pack for leaving the country.  But wait there are some wedding things that I need to tend to before I go.  And I have to turn in my badge for my Women's Health elective and, and and . . . . 

At least my Rank list is done.

I'm pretty sure I don't look as crazed as I feel since Airport Security haven't dragged me away yet.  Okay.  I'm going to get back to actually preparing for the thing happening later today.  Fingers crossed there are no more delays. 

Wedding in less than 3 months!!

 So my wonderfully DIY wedding seems to becoming less and less so by the week.  So first we were going to do a DIY photobooth.  Then my great friend Jared found me an amazing photographer for a very reasonable price so we had it in the budget to just rent a booth.   Now the dessert buffet that we were going to have Stephan's Dad make for us.  But he said he's not going to be able to take the time off and is willing to just pay for us to have a local Baker make the desserts using our recipes.  On the up side we are still mostly local, and of course there is the center pieces etc that are all DIY as well.   Finalized my wedding hair style today :-) Which will be a slightly messier version of this.  Now I just have to figure out my make-up and underwear and I will be all ready for the wedding . . . well ready look wise.  I still have to do favors and a bunch of other stuff as well.

Meanwhile on the Residency front Stephan and I are going to sit down and figure out what we are putting first 2nd and third tomorrow.  And enter the RANK LIST.  I have my fabulous Excel spreadsheet and residency rater app to help.  Which has me down to a top 3, but figuring out after that may be harder.  Hopefully I'll get it done.

Why I'm Pro Choice

I was raised to be pro choice, literally.  My father is a medical doctor who was trained during the pre- roe v. wade era.  He saw first hand the effect that lack of legal and safe abortion had.  I remember him coming home from work one day and stating how important it is that it is legal and safe because otherwise women die.   Remember the scene from Dirty Dancing when Penny is crying on the bed and Baby runs to get the doctor?  My Dad was that doctor in a rural part of Kentucky for many years.  I heard stories about the bleeding, the hangers, and the self sterilization that occurs when abortion is not safe and legal or even when women are just too afraid to seek it due to the stigma. My family is Christian and I was raised that sex before marriage was a bad choice.  In my family you lived with your poor choices, because choices had consequences.  Because of this much of my youth I was personally pro-life.  But because of the teachings of my father I was always politically pro-choice.  Who was I to tell someone else what to do.

As I grew older I learned how many children were stuck in the foster system, how many American children go unadopted every year.  I started to understand that there are good and bad times in life to have children, and talked to friends who had abortions.  Through my young adulthood I became personally and politically pro-choice.  These convictions were solidified as I worked in Reproductive Health throughout my time in Peace Corps Namibia, America Service Corps in India, and my Masters in Public Health in the US.  All over the world and here girls and boys, women and men are given incorrect and half information about their sexual health.  Reproductive health in all it's aspects became one of my passions.

Now as a future (in 4 months) physician being trained in Family Medicine I am seeking training to become an abortion/termination provider.   I love to have prenatal visits and deliver babies.  I also love to educate about contraception.  As a family physician I look forward to being able to take care of women and families throughout the different stages.  To me providing comprehensive care means being able to provide most all of the clinic services my patients need.  As a family practice doctor providing safe legal abortions I know I will be living up to the lessons my father taught me as a child and saving women's lives and futures.

Finished Interviewing and Small Wedding Rant

So I finished interviewing. . . HOORAY.   I had Wright State today and Lancaster on Monday.  My Rank list is going to be difficult.  What's more. . . taxing is all of the kiss up letters - AKA - stay in contact letters I'm going to have to write.  I know my number one (wouldn't you like to know :-p)  but the rest of my list is totally up for grabs.

As for wedding stuff.  There are some details that still left to be in done: Hair, Mehndi, Chuppah, Make-Up still all need to be decided and defined.  Oh How I wish People would RSVP !!!  More than 1/2 the list hasn't yet, and the ones who have want to bring other people.  It's like. . . uhmmmm where are they going to sit?  We are literally against fire codes here.  120  that is all.  But here's the real rant.  When looking up garters for larger thighs why do they always show skinny little thighs in the picture?  I asked for plus size.  Seeing this woman whose thigh is as large as my calf doesn't help me determine if this will fit on my large thighs.  A very poor selling point and just darn annoying.  Yes I know my thighs are large, don't keep rubbing it in!!!

Alright.  Back to writing thank you emails.  They say 4th year is fun. . . I'll let you know when it starts.

The "Aha" Moment

The other day while in neurology I had a patient's room number I didn't recognize.  "Where is 5702" I asked my colleague.  "Oh it's in the new cardiac building.  I think you have to cross over on the 4th floor or something."  "Oh yeah."  Though I only vaguely thought I knew where the floor was, I proceeded to go down to the 4th floor,  through ICU to the new building and immediately find my patient on the 5th floor.  Then I realized . . . I know my way around.  All hospitals are mazes and starting at community hospitals in 3rd year I was pretty sure I'd only know where a few things were (residents lounge, cafeteria, patients for one service).   Then to my surprise I find by the 3rd month of my 4th year I actually know my way around.

Every year of medical school seems to have an aha moment.  A moment where you're doing something you never thought you would.

• 1st year you realize - wow I am actually reading all of this information.
• 2nd year - you have the moment when you are not actually panicing about Step 1 of the boards (at the moment
• 3rd year- Is the moment when an attending tells you to go see a patient and you do.  You don't think about it.  You don't freak out and go through in your head what am I supposed to ask them.  You just see the patient
• Now 4th year when you realize you know your way around.

I've often heard from attendings that 3rd year is the transition from patient to doctor for medical students and by the time you are at the end of 3rd year and beginning of 4th you are pretty much a doctor.   What I didn't realize is that certain things just become automatic when that happens.  Like doing an History and Physical and finding your way around.  Here's to Fourth Year !

--> Interview Update <-- amaze="amaze" an="an" and="and" another="another" as="as" asheville="asheville" at="at" atividad="atividad" aybe="aybe" be="be" but="but" change="change" cherry="cherry" coast="coast" coming="coming" could="could" did="did" do="do" done="done" end="end" fall="fall" for="for" get="get" group="group" have="have" health="health" hill="hill" i="i" idn="idn" in="in" ind="ind" interview="interview" interviews="interviews" it="it" list="list" love="love" me="me" my="my" nbsp="nbsp" nc.="nc." now.="now." now="now" of="of" p="p" place="place" rosa.="rosa." santa="santa" stands="stands" t="t" the="the" this="this" ut="ut" week.="week." west="west" will="will" wish="wish" with="with">

Wedding Planning Interrupted by Residency Interviews

So I kinda fell off again.  Mostly due to 3rd year craziness. Here's a hint of what I went through

  Now it's Fall and Interview Season.  I'm interviewing for Family Med. So far I've interviewed at Beth Israel in NY, and Washington in PA.  Next up are Williamsport in PA, Asheville and Hendersonville in NC.  Then I start on my west coast set in northern CA and Seattle.  There's only one I'm waiting to hear back from (and of course it is my number one right now) Santa Rosa (sigh).  Every time I go to the website I find something new I love about the program. Anyway.  The website is done.  Invitations are out and I'm just waiting to get all of the RSVPs back at this point.  Will post how all of that looks.  Through the help of friends we found a brilliant photographer jennifer elizabeth and did some amazing engagement photos.

Now I Just have all the personal stuff to finish.  Find makeup, and work on hair.  Oh yeah and I really need to find who is going to do my mehndi.

The Hair Delema

So this isn't quite in pattern with wedding decisions but is is one of the things I worry most about.

Just Curly  and Free

Anyone who knows me knows about my thick, curly, sometimes unruly hair.  I love my hair.  I have extremely thick and curly natural Black American Hair.

Somewhat contained

Due to how long it takes to blow out my hair (3 hours) and flat iron it (another 2-3 hours)  I only wear my hair straight when one of my friends is willing to do it this, usually at their request, and usually they only do that once. 

Blown Out

Twisted

I have plenty of fun styles I like to wear,  but weddings are supposed to be something great.

Normal day to day look

Out and Free-er in Israel

So now for my rant, inspired by I Do My Do

There are almost NO good ideas for naturally curly wedding hair styles.  Most of the ones I find just show people who have their hair either in a 'Fro, twisted, or straightened for the wedding.  I know there are natural styles out there, why don't people display them more.   Moreover when they do show a curly style it is for someone who has extremely loose curls or very thin hair.  ARGH!

On the upside I have managed to find a great, affordable hairdresser in Dayton who is creative and willing to work with me.  Best believe there will be plenty of pictures posted when we do it properly.

So for anyone who has naturally curly hair and wants wedding hair style ideas, here are some pictures from my idea folder that I've been collecting for the last 3ish years.   I don't own the rights to any of the pictures and hope I'm not violating any laws.

And I challenge Pantene, Carol's Daughter, or any of those hair product places who love to rave about how they can do anyone's hair to try mine  ;-)

Choosing the Date

Solitaire Trillion Sapphire in White Gold.  I know it's hot!

I got engaged April 19th, 2008 to a fabulous man.

Our first decision, as prompted by most wedding books, was to choose a wedding date.  I still had a year left of my masters degree, and was applying to medical school (which would add on another four years). With a bit of consideration we thought it would be great to have the wedding around the same time as the engagement.  We wanted an outdoor wedding so it had to be warmish.  Since we are paying for the wedding ourselves, we also wanted time to save money.  So we finalized the date

April 20th, 2013.

This would allow us plenty of time to plan, bargain hunt, and save money along the way. It also would not interfere with my schooling or his, and there would be less expectation to be Dr. Goodwin instead of Dr. Shegog (more on this later). It was a Saturday, between our two birthdays (February and July) so no build up of present buying; silly but yes I think about these things.

So here are some things to consider when choosing the date

• Who is paying? (saving money takes time)
• What else is going in the next year or so (multiple big life changes take time to prepare for)
• Do you really have time to plan a wedding (the more time you have the less you have to spend on it right now)
• Indoors or Outdoors?  (Big consideration for seasons and dress - check average forecasts for your location)
• What is there to wait for or rush for (Job changes or other big family event may call for a longer time line, Elderly grandparents may cause a rush)
• Fridays and off season is usually cheaper for everything (Photographer, flowers, DJ, name it, it's cheaper)
• Notification timing (If you really want your uncle the surgeon to come, you should give him a years notice or at least 6-8 months)
• When do you want to celebrate your anniversary (Do you really want to overlap on big holidays)
• Beliefs and Custom (Will it require you not living together and in a long distance relationship,  or do you think it is more important that everyone have the right to marry before you tie the knot?)

Still some ask "Why so long an engagement."  When we get married we will have been engaged for 5 years, and together for more than 6.  With finishing my thesis, moving to a new city, starting medical school, the last 3 years have been busy.  But we've had the time and could look for things on non-exam weekends and over breaks.  Now with 2 years to go, most of the big stuff (location, flowers, dress, food, centerpieces, etc) are done, purchased, or decided.  Such a time line has even given us time to grow our own plants for centerpieces and find some incredible deals. 

Though many, MANY of my friends have gotten engaged and married before we will, I still appreciate the time I took to plan.

The day I got engaged I sent this picture to my friends and family

So choose a date,  even a far one.  What's the rush?

New Rationale Wedding Blog

Whereas: I have now been engaged for 3 years and much of our wedding planning is done.
Whereas: Our wedding is going to be extremely different from the "typical"
Whereas: Friends and family who hear about our wedding keep saying that we should be on a television show it will be so different.
Whereas: There is probably someone else who would like to know what I know.

Therefore Be it resolved that Yop, while having a few updates on my life in Medical School, will now be a outlet for the interesting things I've learned about in wedding planning and detail some of the fun things we are doing.

Yop!!! Lives

6 or so months later

I'm still working on my thesis. Oy they seem to last forever. I've now officially been on the project team about a year. But I should start making some great strides soon . . . like tomorrow. Still engaged. Still hoping to hear back from another school. However I did make it in to Ohio State's Medical Program. It's a five year instead of a four year program, but I'm in, which is the important thing.

That time of the year again

Yes it is that time when money seems to fall away like the cold rain off my window shield and the biggest question of the day is how will I make it to next quarter. The second biggest question of the day is what am I going to get my family for Christmas.

Meanwhile back at the macbook I'm still chugging away at a few more secondaries before Dec 1st. No matter how much I planned to have them done a month ago things just got drawn out. On the up side of things I'm submitting a mini grant proposal today for my thesis project and my adviser doesn't seem too put out that I ended up about a month behind where I wanted to be.

MIA for a Year or So

So I realized I haven't posted in a really. . . really long time. That's mainly because I haven't had time. I don't really have time now. I'm doing research for my thesis, working on medical school secondaries, starting a new job tomorrow, starting my last year at OSU School of Public Health Wednesday, and. . . something else maybe. Life hasn't been this busy the whole time, but nearly so. There is the added fact that I'm engaged and try to spend as much time as possible with Stephan. Which isn't much since he lives two hours south in Fairfield Ohio. Anyway, I will try to be a bit more diligent, or at least give more than one post a year.