Trader Joe’s 

I had a dream last night. It’s a simple story to tell. I met S again, and he proposes to me out on the blue the day we meet, and I say yes, and we live happily ever after.

I wake up, and immediately feel the lightness from the absence of a ring on my finger under the covers. I had apparently gotten really invested in this dream, believing it to be real. Talk about cruel jokes.

I guess with all the hullabaloo over the royal wedding tomorrow, my subconscious thought it could have its own little miracle.

Well, nice try.

While no one reading is likely to be surprised at my inclination for such dreams,  what I am is exasperated. I thought I was past the needing a marriage to be happy. I thought I was finally happy on my own.  I have found purpose beyond landing a guy. I want to become an expert in my field.  I want to become a writer. I want to become a Werq instructor.  I want to do humanitarian work.  I want to raise kids, possibly adopt. And all of these are my dreams that are mine alone,  not necessarily needing a pretty boy by my side while I do them. S? Really? Why can’t I get over that already?

I guess it has to have something to do with the fact that I went to bed sad at my relationship with J. Oh yes, J is still in the picture. Very much so. But it has been a struggle. I have been trying to be more open and understanding and trusting and that seemed to be working well for us. Yesterday was just a small discord,  but the thing with J is,  anytime there’s a little discord he says the meanest things. Things that my poor little heart can’t take. And then I end up having one of those days where I feel at the verge of tears any given moment. Tearful not just cause of that one thing, but because that triggers memories of all the things I shrugged off in the past. Like S cheating. Why did he have to go and do that? Or the horrific memories about people at work during my intern year. Why was I so gullible?

And no,  this is not about just wanting a wedding. Cause J has made it very clear that we are actually headed in that direction.  Last week,  for instance, he told me he wanted to move in.  That he wanted me to meet his mother. He said “That is the natural direction I want our relationship to go, and I hope you feel the same way”.  I mean,  things I had dreamed S would say for years. So then,  shouldn’t I be more happy,  and not be having dreams of engagements with my exes? What more do I need from him?  A 401k? Ugh.

To be fair, in the dream,  while I was certainly happy to be engaged to S, ‘relieved’ was a more accurate description of how I felt.  And oddly it did not feel right.  Like S would have been right for me at one point,  but not anymore. He is perfect for me in so many ways. We share so many likes, and had so much fun. But I wanted more. I wanted my guy to be more enamored with me, a la V, but not that much.  Like I want to feel secure enough to know he won’t cheat on me,  but he should only give me enough attention so I’m kept interested.

Come to think of it,  that’s exactly what J does. He has not exactly been as available like say, a regular guy with a job in finance would have been. And that frustrates me to no end.  We might have gone for plays or the symphony or something. Gone kayaking? Shopped together for groceries at Trader Joe’s? But J has been amazing and wonderful in so many other ways. He is tough, he is strong, he is righteous and honorable. He and I have the same values and politics. I already know he is an amazing father. These are things that may not be the case with the regular fuckboy from finance who goes to Whole Foods. Things that I should not be taking for granted. And, my friends say,  he is actually good looking, which I hadn’t noticed until now – looks aren’t the biggest deal to me. Plus he does have a degree from UCLA – kind of a big deal? He has a passion and career goals in MMA which he’s really good at. He is responsible enough to have been saving away for a college fund for his 3 year old. And, to top it all off, like Sarah Jessica Parker says in Sex and the City, he is an excellent spooner! Wtf is wrong with me?

Ok I should just chill.

Bye.

Birthday Month

So I’ve been struggling a bit this month. Which is ironic almost, because Year Twenty Eight has been the movie-like coming of age year for me in so many ways, and I expected nothing but spring to end my year. But we all know how that goes.

I’ve been working nights this month, almost the last time I would likely have to do that in my life – there aren’t many emergencies typically in Infectious Diseases, my chosen fellowship field starting this summer. Despite the havoc on one’s circadian rhythm, I have almost enjoyed every one of my night rotations previously. You’re on your own, taking care of everyone else’s patients in the hospital while they are gone for the night, and admitting any new ones that come in. You attend to any Rapid Response Team calls or Code Blues that arise. There is a lot of autonomy involved for a resident, and the kind of exhilarating scary that promises a feeling of  ‘who da bad-ass who survived that mofos’ at the end of one’s shift. But this one has been unexpectedly hard for me.

I’ve been stressed out, snappy, easy to anger. And that is uncharacteristic of me.  At least the grown up me.  My teenage years were in fact spent as an angry young woman staring down men abusing power and parenting women who were being bitchy. I cringe. It was not my place.

And those edges had been painstakingly smoothed out over the last three years. I remember one particular evaluation from an intern that said “S is super kind and understanding when mistakes are made”. That was one I was particularly proud of. But it feels like I haven’t been deserving of that for the past three weeks. I could say I wonder why. But fact is I definitely know why.

So I have mentioned the depression before. I have mentioned my triumph over it.  While I credit writing, working out and volunteering to my recovery,  I cannot deny the role the right antidepressant has played.  The one that has become second nature now – that single pill I pop right before I dash out the door every morning without a second thought. Well, we all can agree I haven’t needed it for a long time now.  It was like a reasurrance for the powers that be that things were under control, a security blanket of sorts. Needless to say my Psychiatrist and I agreed that it was time I left the blanket behind. Side effects are an inevitable reality for every medication, but they are justified only as long as the benefits outweigh the risks.  Long story short, it was time.

The weaning process has been careful, methodical.  From taking 300 mg daily I was to reduce the dose to 220 mg for 10 days,  then 150 mg for 10 days, then 75 mg daily for 10 days before stopping. But what has been erratic has been the irritability, the snappiness and the pangs of anxiety that made an unwelcome comeback after two years of supreme confidence. It was like I was a teenager again, insecure, unsure of my worth, with a bitch of an imposter syndrome causing a nagging feeling that something, somehow was going to go wrong any minute now. I pondered going back on the meds, every day.  Was the freedom and the ability to feel like myself and the avoidance of further side effects worth the risk of my work suffering? WAS my work suffering? Is this something I should just take all my life? Is the ‘angry young woman’ an illness, or just my personality? If it was, did I want to be that person?

S always said I was a bad judge of people. And by default,  that makes me consider myself a bad judge of me. Am I acting like a crazy person? Would someone tell me if I were?  My dear friend M insisted that I seemed completely fine, amazing in fact. “You are your incredibly kind and good self, as always”, she said. But she hasn’t seen me at work,  which is where all my anxieties manifest.  I decided to take my night co-resident into confidence. She was someone I thought was trustworthy and a decent human. It was not a pleasant conversation to have, but a necessary one. I explained my ‘Past Medical History’ to her,  so to speak, and requested her help. Would she tell me if I were acting, say,  not like a normal person? ‘Of course’, she said.  Besides, she’s always thought I have been so much calmer than her during stressful situations on nights at work this month.  I heaved a sigh of relief,  and thanked her.

I read more about the process of weaning. It was not supposed to be easy.  “Discontinuation Syndrome” was common.  The key was to replace the drug-induced Serotonin in your brain in more natural ways. I started making sure my workouts were consistent.  I started doing yoga almost every day. Bought myself more flowers than usual. Organized my closet and my finances.  Went for long walks. Did my first run outside, that I was training a long time for since being impaired by shin splints.  Slowly but surely,  I found my footing.

Sure, it’s all not perfect. I’m still snappy sometimes, but I have not been beating myself up about it. I just decide it was a mistake and resolve to do better next time. And now, on day 6/10 of 75 mg, I feel like I can see the light at the end of the tunnel. I feel like I can do this. I hope I can. I sure am scared.  But I have to try. I have to do this for my teenage self – I feel for her so much. She had all the talent and intelligence in the world, but was crippled by her anxiety and insecurities. And taken advantage of, for them,  with the loss of many an opportunity which otherwise would have been a piece of cake for her. I have to do this for my sweetheart of a Dad – he has all the talent and intelligence in the world , but is crippled by his anxiety and insecurities. I see how good kind people like him are taken advantage of by the bad guys in life all the time for their insecurities. And I want it to stop. The question is do I achieve that with the aid of drugs that I take for the rest of my life, or do I utilize the infinite power of the human mind to change my detrimental defaults?

I could take the easy, safe, former route and just go back on the pills. But if I succeed with the latter, this will be among my top personal achievements.

I have to try.

Playlist: Women of Pop

One of my favorite things is long car rides listening to music, on earphones if alone, blasting on the stereo and singing along if with friends.

J is away for a bit. He had to go back home to LA for a family emergency. I decided to give him some time and space away. It would do us both good I think. He can come back whenever he’s ready. Part of me wants to be there for him, support him through this. But I get the sense that my current stance is preferable. I told him I’m here for him if he needs anything at all. Besides, it’s given me some time to focus on me a little, indulge in some reflection on long car rides over music.

Content and peaceful. Those are the words that come to mind thinking about my mental state these days. I’m okay, after 28 somewhat tumultuous years. I’ve found my footing, it feels like. Of course, it took a lot of hard and painful life lessons to get here, but they’re what got me here, so I’m okay.  I’ve made peace with the past and the future. I’m truly living in the moment, as cliched as that sounds. There’s no dream I’m trying to achieve, for the first time.  I’m exactly where I want to be, personally and professionally.  Anything good that comes along would of course be appreciated, but in a natural course of things way. Anything bad will be seen as life being life. Humblebrag is the only way to say, I really like who I’ve become. I only wish I had gotten here sooner. Lots of cringeworthy moments with S especially come to mind.  I’m not really surprised he did not propose all those years anymore – for the first time, I get my past imperfections. But I’m definitely not beating myself up about it – I was just working with the life experience I had until then. It would have been nice to have someone just teach me all the hard lessons as an eight year old.  But I guess that’s not how it works.  Well, I’m gonna try anyway when my kids are eight,  if I have any that is.  Until then, I hope to continue to work, read, write, sing, dance, go to spin class, do yoga and be kind. There’s no white picket fence I want anymore.  There’s no academic laurels I want to earn anymore. I just want to live and love the best I can.

I guess that’s a good note to go back to Spotify on.

Until next time,

S

Giddy and scared. 

It was 1 am. The lights of the night sky filtered through my window onto my bed. It was March, but Winter and Spring had yet to make up their minds about which one of them was on that night. The air was cold, but it was cozy under my covers. I had to wake up at 4:45 the next morning. But I did not care one bit. I was happy, peaceful, content, as I lay on my side, my back against his chest, my head resting on his arm. He held me tight, his fingers absently running across my bare skin. He had just put on his favorite Selena song on iTunes. The one he used to listen to with his brother growing up. He pushed my hair behind my ears. I don’t remember what he was talking about. But I do remember that he frequently paused, to plant tender kisses on the back of my neck, my cheek, my forehead. I smiled with each one, my eyes closed, my soul warm.

Then he sang along.

“Dreaming all tonight…
Till tomorrow and for all of my life
And there’s nowhere in the world I’d rather be
Than here in my room dreaming with you endlessly..”

His voice was broken, soft, almost breathy. As if he was whispering a promise. Like the ones he had done earlier in the evening.

“Will you marry me?” He had asked.

I had nodded fervently, through tears.  How could I not? How could I not give this wonderful man and his son all the love in the world? They had been through so much. I have always thought of myself as having an infinite capacity for love. And they deserved every bit of it. “I will move anywhere, with you”, he had said. “It will be you, me and E from here on forever.”
It was perfect.

The kind of perfect that made me giddy and scared at the same time. ‘Cause I knew it was not going to be this way always. I knew there was most likely going to be a lot of hurt in our future.  But I did not want to think about all that for now.

‘Cause for now, my heart was doing cartwheels.

Him

You know, I really need to write about him. I mean, he’s all I think about all day.

No, its not romantic. Its annoying really. Because most of the thoughts are perplexities. Is that a word? Yeah, seems like it – I don’t see any grammar lines.

Am I really only in this relationship because he is an amazing kisser, and I just really really like being kissed? And kissed well, may I add – he does the whole ‘looking deeply into your eyes, framing your face with his palms, kissing you, tenderly at first, then passionately, then pulling back, looking into your eyes again, smiling as if you are the last fucking woman on the planet, while pushing your hair back from your face’ move that guys in movies do. So yeah.

Well, to be honest he also is great at hugs. One of my favorite moments with him is every time he comes over and I go downstairs to let him into my building – he walks in, his jacket all wet from the rain or snow, smiles, looks me in the eye, kisses me tenderly and then hugs me tight, as if he never wants to let go. In his arms I feel all my stresses of the week melt away, as I hold onto him for dear life…

..for who knows when I might see him again.

And that’s the problem here. He disappears. For days at a time. No calls, no texts. No nothing. Well, not nothing. I can see he’s using my Netflix so that’s there:/ So its not like he is busy working or with his son. As I write this I can picture Jared Freid shaking his head at my typical-girl-naivete. I really should be breaking up with this guy shouldn’t I? He really is just fucking around with me isn’t he? Ugh. Ok I’m gonna do it. Maybe the next time we meet, whenever that is.

*30 seconds later*

But he said he loves me! What if he meant it? What if he actually meant every single thing he has said so far. The things that make it so fucking hard for me to let go. The things that every woman hopes her guy says to her like one, two or in my case with S, seven years into the relationship? And its been barely a month. He wanted to be exclusive on day two – “I don’t like the idea of you spending time with a guy you meant to have a date with, even if you are not interested anymore, but you are free to make your own decision, and I will always respect your choice. But just so you know, as of this morning I cut out all the people I had been talking to and cancelled any dates I had planned, cause this is important to me.” Okay then, so that’s decided. He said ‘I love you’ on the third date. He said ‘you are the girl I’m going to spend the rest of my life with’ on like day fucking fourteen, I think? “I know you don’t see it, but you are going to be my wife one day, I promise. You’ll see.” Well, cue swoon I guess.

I was teasing S about it the other day, saying maybe the universe is making it up to me for him not proposing for a decade by having all these guys be talking marriage in two weeks. First V, now J. I mean yes, a former me would have taken all this at face value. But well, you know by now I’ve been burned enough times to be vary of all mush. The Betches always say when a guy moves too fast, that’s a red flag. He just is saying whatever it takes to sleep with you. Also, guys can say a bunch of bullshit and it doesn’t mean anything apparently. Its what they do that matters. And so far there has been zero effort from his part. Well not zero. He does have to drive 40 minutes to get to my place. But that’s the thing – after our first date there have been no ‘dates’ – there’s only been do-you-want-me-to-come-overs? Ugh. I am so fucking stupid.

Unless you count that one time we went to IHOP after sex. Which I highly recommend by the way. Or ordered Mexican. See that’s the thing – whenever I am with him its really fun. I mean, I am not even kidding, but we made out for a solid hour in the middle of a Women’s Rumble Watch with pro wrestlers looking on, for our first date. I don’t think most first dates are that exciting. It definitely is not the kind of intellectually superior back and forth that gets me going usually – and that’s another red flag. Would I be bored out of my mind in two months? Once the initial infatuation fizzles out? Although, I’m not even sure there is infatuation here. I mean, I do really really care for him, and love him in a way. But am I ‘in love’ with him?

Then of course there’s the part of me that’d rather me be the one who’s hurt. After S and V, I know that breaking up with someone is particularly hard for me. I don’t have it in me to hurt someone who loves me like that, and I’m not trying to be a saint when I say that. Its almost selfish – I just cannot deal with the guilt. So I think, the ideal scenario here would be for him to like ghost me or whatever. That would suck, but also would be for the best.

Which might actually happen, considering I haven’t heard from him since Tuesday morning.

Ok so that’s decided then. I am not going to reach out. I’m going to pull back, wait for him to come to me. If he wants. If not, well at least I got laid at 28.

Love story

So yeah I really don’t know where to start. Its been a while I know, and obviously that is because stuff happened. Stuff I am trying to process. Its been so emotionally exhausting that I don’t even have the energy to write this. I wish I could just say random words and be comprehensible enough. Random words like…..

Boyfriend. Yes. Long story. Short story – great kisser. Me – vary. Me – way out of boy’s league. Me – give him a chance. Red flags. Sex. Third date. He – I love you. He – wants forever. He – you are going to be my wife, I promise, you’ll see. He – has kid. Kid – adorable. Me – let’s guard down. Me – falls hard. He – cancels dates. Promises more. Cancels again. Excuses legit. Or are they? Me – sweet. He – rude. Kid priority. Me – tries to understand. Friends – break up with him. Me – got the feels. Me – confused. Mixed signals. Why. Did not need this. Fuck.

Sigh.

Am I slipping?

I woke up at 3 am today.  Then again at 5 am. Early morning awakening. A classic sign of depression. Am I slipping?

I had to write.

I could go on about what brought this sudden change on, but I’m too exhausted to tell stories right now.  I just have the headspace for writing about my feelings.  It had to do with two uber drivers who asked me out, my being completely naive about men in America, and as my friend A put it, for whatever reason, my standards being “very very low right now”.

I still value these experiences. I have only fallen in love with people I know,  never ‘dated’ technically. Now I have. Now I know what sleeping with someone is like.  It had to happen at some point I guess. It is out of my system now. How can you say you’re actually an adult if you’ve never had a crazy  experience in love – like having your heart broken by two uber drivers in the same week?! I mean, oh my god.  What the fuck was I thinking?!!

I always thought my kindness was my greatest strength. This week I learnt it is also my greatest weakness.  Even with red flags waving in my face frantically,  I decided to give these men a chance because, as I said to a friend before embarking on this ridiculous episode, ” I don’t want to be superficial’. I had always valued intelligence, wit, humor, accomplishments and integrity in men.  I remember always thinking that I could only be attracted to someone more or at least as intelligent as me. Here, all I had to go on was their perceived integrity.  “Perceived” being the operative word. Again, what the fuck was I thinking?!!

Was I desperate? Did I just want to get over S and V for good at any cost? I guess I was, and I did. But also, I just wanted to be like…held. 2.5 years without any human physical contact in a strange fucked up country (sorry America, but I’m mad right now) can make you do crazy things you’d never do otherwise.

I think my lesson here can be best summed up by my text exchange with my bisexual friend who has come to become the perfect relationship advisor. I mean I don’t think the perspective can get any better – a guy who has dated women before, but now is into men? That is just pure gold.

Oh well.

The Last Straw

I stand in the shower, my head resting against the glass, letting the hot water fall on my neck and back, like a caress, a back rub. I did not have to stand here. I had washed off all the sadness already. But I was too scared to go out into my bedroom. I was too scared to find out he had not texted me back. I just wanted to be here, in limbo, where my heart was protected. Where no one could hurt me again. This was the last straw. I’m out.

Today

Today was a day I will not forget for a long time. It was one of those days when you really want to go into a storage room at work and cry alone but cannot afford the luxury because you just don’t have the time.

It began like any other call day. I woke up with a jolt at 4 am realizing I had completely forgotten to finish my clinic notes from yesterday – was supposed to do them after the gym last night but had a long hot shower and crashed instead – it had completely skipped my mind! Well, good thing I had my laptop near my bed from last night’s The Office binge. I stayed under the covers and finished all three notes within the next hour and a half. My mind was surprisingly fresh. I remembered all the details from the previous day – I gave Ms A her Flu shot but Mr B refused to get his Shingles vaccine. Ms C was due for her colonoscopy – but she wanted to think about it. I put in a little reminder note for when she comes in next. It was great. I finished by around 5:40 am, and then snuggled back under the covers for twenty more minutes. Then it was the hustle of the morning – a blur of eggs over easy, coffee, trying to use concealer on my bruised upper lip in vain (don’t even ask) and searching for my ID in frustration while Alexa played Honest by The Chainsmokers in the background. Ahh, my life was so hot and perfect.

Walking into the ICU sign-out room at 6:55 am with my usual ‘hey guys’ I plopped myself down, a little giddy.  This had been my favorite rotation in my entire residency. I find myself actually looking forward to the uncertainity of my days in the ICU. Soon, the night team walked in, a little too solemn for having just finished their shift. Before we could ask, J said, ” I have bad news… Bed 12 passed away last night”. I was briefly disoriented. For a moment I wondered if he was talking about someone else. Wait, what?! Bed 12, who had just last evening laughed and joked with me? Bed 12, with the amazing girlfriend of 20 years I had bonded with – ‘I’m gonna marry him now, she had said..I had cold feet the last time he asked me..but now I know for sure..I have to marry him the minute he gets discharged’. I had been delighted at their story – they had met in Kindergarten and reconnected many years later (yes, like V and I). I remember thinking she was so lucky – he had coded twice in the cath lab, and had been succesfully resuscitated, and had improved so much in two days that he was  sitting up in a chair and joking around, eager to go home. Only he never got to. And she never got to marry him. He possibly had another clot in his LAD, they said. I couldn’t believe how fucked up this was. I sat through sign-out trying to focus, but my mind was already numb.

Well, I couldn’t afford to stay that way much longer – it was barely 8 am and my pager was going off incessantly.  The ER attending was calling ICU consults with a vengeance. I wasn’t rattled though. I shrugged and got to work. I downgraded the less sick patients to a regular floor/Telemetry, and worked in earnest stabilizing the others. As I went through my day I marveled at how much my efficiency and confidence in my clinical decisions had improved over the last three years. I could almost do this in my sleep now.

Around 1 pm, I had finally almost caught up. The anion gap had closed and sugars were under control for the young newly diagnosed Diabetic patient with Ketoacidosis. The 91 year old with COPD exacerbation was now off BIPAP, saturating well on nasal cannula at 5 L. Labs were cooking for my post op patient in Room 13. He had had a hernia surgery, with small bowel resection, developed a post op anastomotic leak, had that repaired, and then developed a retroperitoneal bleed , with wound dehiscence, and was taken to the OR again today. I had started him on some sedation and pain management as my attending had advised. He was hemodynamically stable. Maybe I have a minute to finally start working on my consult notes, I thought, ignoring my pangs of hunger. I had barely sat down when my pager went off again. CODE BLUE IN 32 SOUTH, the overhead announcement repeated. I ran, 32 South was the ICU. I burst in through the doors when R directed me to the back of the unit. ‘It’s 13′, he said. Fuck.

We coded him for 20 minutes, and then finally got a pulse. Barely. He had become hypotensive and acidotic once he got on the unit while I was down in the ED, and my attending had been working on keeping him afloat, putting him on three pressors and pushing bicarb. His systolic blood pressure was still in the 70s. He was bound to code again. We called the family, asking them to come in as soon as they can. They wished for us to try all we can until they got there. We obliged. He coded again. We resuscitated him again. He held on until the family got there. My intern had his first go at the difficult conversation. Would they want us to continue to try and resuscitate him, when that may just prolong his suffering? I did not expect them to know the answer. And they did not. We decided to give them time. Meanwhile, we called the Chaplain for them so he could get his last rites.

But time is elusive. It slips by before you know it. CODE BLUE IN 32 SOUTH was called again. We ran over, to find 13’s lovely nurse N waving her arms indicating NO. They did NOT want us to pound his chest anymore. He was DNR now – Do Not Resuscitate. We let him go.

N was hugging everyone in the family tight. Tears were rolling down all of their faces. I blinked back mine. He was a good man, the wife said. We got them a bereavement tray  – I truly do not know what that entails – some food and other things to provide comfort, I was told. I hope it helped.”I have to get the fuck out of here’, the son said in anguish before walking out of the room where his father lay cold. I called my intern over. ‘Have you ever done a death exam before? Come, let’s do it together’  I told her the steps. He was not responding to verbal or tactile stimuli. His pupils were dilated and fixed.  We each listened to his heart and lungs and checked his pulses. We flashed a light in his eyes. We checked his reflexes. Time of death: 16:30.

ER paged again. My second COPD patient who had his blood CO2 level so high it was unmeasurable, was having second thoughts about his code status. He wanted a tube now. The Catholic in me secretly rejoiced – it has been a constant struggle for me to be the one who has these conversations with patients – I wanted them all to want to live! ‘Protect life from conception till death – my Catholic medical school had taught me. This whole DNR business was new for me. I explained his options to him again. I am always careful to start these conversations reiterating that this is something I am required to ask every patient in the hospital – asking them their code status does not imply that they are going to die the next minute. But in this case it could go either way. He was alert and awake at that CO2 level. COPD patients sometimes live at these higher levels of CO2. I truly could not predict his prognosis in the next 24 hours. But naturally, that is what the family wanted to know. What do you think his chances are? I tried to explain the facts while trying to not make the decision for them. The daughter tried to get her father with mild dementia understand the question again. She began to repeat my explanation to him, and then broke down unable to continue. I got her a tissue and rubbed her back pathetically.

The rest of the day was a blur of similar emotions. I know I did good today. I actually played doctor. I helped some people through their worst nightmares. I was efficient, effective. I got the job done. “You guys were terrific today’, the ICU ACLS coordinator said to my intern and I. ‘Thanks’, I smiled feebly.

It is 8:30 pm. I opened the door to my apartment, switched the lights on, took my coat off. Then I crumbled to the floor, sobbing.