What's next?

That is the question....

Astha told me to write this blog entry, so here it is.

What's next? Astha is finally done with her residency at the end of October... and so we're figuring out what our next steps are going to be. It's an exciting time, but also an anxiety-causing time. I think the anxiety is caused more by the fact that right now our life is stressful and not always fulfilling.

So, we sat yesterday and busted out the whiteboard (as you see).... listing the different 'ideas' we have of what to do next.... and what things we want to accomplish - 'priorities' - not listed in any order. After talking for a while... it was definitely nice to organize our thoughts... and to see that we have so many possibilities in front of us... but we still are figuring out what to do. We want to make the decision soon so we can start planning... looking for jobs... planning for India... whatever it is.

So, friends and family... what do you think? Obviously, the blog isn't the best medium to talk about this, but we thought if we'd put it out there... maybe that can lead to some convos.... and we can take in different perspectives.... so.. shoot us an email is you have some thoughts!

Inspire Reunion

This past weekend, Raj and I went to DC to meet a few folks from Inspire for our annual reunion. Well this is the 2nd one. There is so much to say about Inspire and the connections that have come from it. The biggest probably being I met my husband. And that it changed my life in so many ways. This retreat was so great seeing everyone. A bunch of people from my year were there - Anusha, Sneha. I love you two and it was SO GOOD catching up. Getting to spend time with Raj outside of our craziness was a blessing. And then to the rest of everyone that was there and that we got to visit - Aparna, Karthik, Bhavana, Rachit, Binny, Manks. It was a blur but so fun. And we got to talk with west coast people, Chaiti, Shane and others. We basically had a group therapy session on our current states in life. I will always be thankful to Inspire for connecting me to so many people that are willing to question their lives and ask what they want from it.

I've included a word cloud created from a post retreat email thread we had started to express gratitude for each other's company. Kind of cool. :)

What do you want from life? What makes you happy? What motivates you? All questions I think about a lot and get to explore as I go. Would love to hear from you as well.

Life Lesson: Accept the current situation without being compliant. Don't beat yourself up and it is all part of the journey. :)

Knitting Class 4

The blog is going to go under hiatus soon because I am going to be starting a month of HIV at Cook County. My life will generally be busier and all the fun things that I've gotten to do over these past two months are going to stop unfortunately. I need to prepare myself that hospital will be my main activity in life. It is always so hard to do because I look to these other things to feel somewhat of a decent/productive human being. But regardless, I think right now I just have the first day jitters of working in a new environment. I am looking forward to learning a lot this month so that is a plus.

Thought I would add a picture of my progress so far in knitting. I had missed a class last week because of the Inspire reunion so I went in and made it up on a Monday. Learned how to close in the hat, use some different needles and probably a bunch of other things. Met a bunch of cool people working on some really fun projects. Sweaters, mittens, socks..all sorts of things! :) Its only going to be one picture this time. The scarf is just longer. I started another project all by myself!! But that is a secret and can't show it until the time is right.

Life Lesson: Learn to accept small mistakes; they are insignificant in the bigger picture. (Or it could be a mistake that unravels your whole project...but that is besides the point!)

Knitting Class 3!

Will keep it mostly to pictures today. Class 3 was starting a hat!!! We learned how to use a circular needles, learned how to fix some mistakes, and learned how to read a pattern. All great skills for future projects...if I'm brave enough to venture out on my own. I bought a crochet needle this week too. My knitting supplies are increasing in number. :)

Life Lesson:
When you think you know how to do something, there's always more to learn!

Our Menu this Week!

Raj and I LOVE eating out. It is a bit of a problem. We have our favorite restaurants in each type of food specialty - thai, mexican, ethiopian, etc and basically rotate through those restaurants. Occasionally we will try some new places but for the most part we stick with what we like. BUT in all this eating out, I know I can't control myself and totally end up overeating and being unhealthy. Then I feel gross and so on. The week of Thanksgiving, I swear we ate out almost everyday. I told Raj that if he wants to continue eating out he can, but I need to stop. Sometimes with both our crazy lives, it is so much easier at the end of the day to just go out and grab some food. But, I know I like cooking and feel better when I do it...it just takes so much more effort.

When I told Raj he would have to eat out alone, he suggested we make a menu for the week so we stick to only eating out 1-2 times rather than 4-5. So we did and for the most part we've stuck to it!! Not sure if cooking the Mexican food is going to happen cause we still have a lot of leftovers and I'm tired. It felt really good to cook and eat yummy food. Having some of my mom's food helped with the quantity as well. And raj did this mega grocery run that was so helpful because it meant I had everything prior to cooking.

The menu included some leftovers from Thanksgiving (chole - a chickpea dish and daal makhni, a lentil dish). The stuff I made was some of my famous tortilla soup,(this dish is my specialty made just right everytime) a bean salad that Ekta has given me the recipe for and some of Astha's pasta. If anyone wants recipes, let me know. And if anyone has more recipes to share...please do because I feel like I want to try something new for next week. One more thought..we have been trying to reduce our use of processed, canned goods over time. It comes from many reasons...the extra garbage created, the extra additives and preservatives, the amount it travels to get made, etc. This week's experiment was I made my own black beans and didn't use the can! I soaked them and used the pressure cooker and it was perfect. You could argue the bagged black beans are still traveling and a whole bunch of other things. We know its not perfect but constant baby steps! :) The tortilla soup used to use so many canned ingredients but now the only remaining are crushed tomatoes, a can of corn and the vegetarian stock used for the base of the soup. If anyone has any ideas to replace these, it would be much appreciated!

Life Lesson: Appreciate your incredible mothers and fathers who cook, because this daily cooking stuff is hard work!

Knitting Class 2!

It is amazing how much life changes once I'm back in the hospital again. Yuck!! But that is another story. Posting this blog entry to change my blah mood.

I had my second class this past Friday. They teach a lot of things in 2 hours. The first class I had learned one type of stitch - the knit stitch. This week I learned the purl. The basis of knitting is these two stitches. And basically it depends on how you use these two to get different types of fabrics. For those of you that have never knit before...you basically can alternate or do one of these stitches and create a different pattern to make a piece of cloth. If you guys look at any of your sweaters - they are all basically knit and you will see different patterns.

I started the scarf that I will be making. Thought I would show you guys my progress. Raj and I were trying to be artistic with the pictures but they just ended up dark. Oops. I am using a ribbed knitting fabric which means I knit 2 and I purl 2 and it creates this funky pattern!

Raj suggested I add a life lesson to each blog. I liked the suggestion :)

Life Lesson: You can do more with your hands than just type :) Like make a scarf!

Reflections on the jail

I am ending my rotation at the Cermak Health Center - affiliated with Cook County Jail. Tomorrow is my last day. :( I wanted to do a quick reflection to clear my thoughts in my head and simply share.

It was a really good month. If residency was like this the entire time...wow how amazing would that be. I loved that I was a balanced person in life. I've realized I really love balance. I want to be able to determine how I spend my time and allocate a little bit of time to all of the things I'm passionate about. At work...I loved what I did. I learned so much this month. I was really glad to learn a lot more about HIV and feel so much more comfortable in taking care of patients with the disease. I think there is so much to learn about each patient with HIV. Even asking the simple, yet so personal, question on how one got the virus has led to so many glimpses of people's lives. Some have said a partner gave it to them unknowingly, some say drug use, some say they don't know. Each person takes the news differently and is in various forms of acceptance/understanding of the disease. There is a huge correlation to people of color and in general people that lead "riskier" lives having a higher chance of having HIV. There is a definite disparity in access to care that exists as well. It ties in all aspects of life. In general, all health care should tie in all aspects of life but this disease especially, you have to look at everything all the time. I found out about this program called MATEC from one of the attendings that I am going to look into. Its a series of lectures, conferences and practical information and at the end of it, you get a license saying you can practice HIV in your clinic. At Rush, I don't get the best exposure to HIV patients in general. At Monte, definitely got a lot more. This program if it pans out would be good learning.

I also finished my Bupe training. Finally! For those that don't know, buperenorphine, is an alternative to methadone. It is basically meant for those people that are addicted to heroin or any sort of opioid substance such as prescription pain pills. I first started getting involved with addiction medicine at Monte working with a harm reduction organization called Washington Heights Corner Project. I got to learn about what addiction means, see people that the "heroin addicts" but learned so much more about them then just the label. I could get into a lot of detail on this but maybe some other time. Buprenorphine helps people that want to quit heroin or their addiction to pain pills and does it in a less stigmatic way. It puts people more in control and allows them to be treated in the office instead of an organization that dispenses methadone on a day by day basis. You need to have a special license to prescribe it and it took a little over a year for me to finish a stupid 8 hour online course. But it is finally done! I got another connection at the jail to possibly work with this other doctor at the CORE center and actually practice prescribing the medicine and working with people that want to quit.

All in all, I just felt like I was with like minded people again this month and it helps my perspective so much. At Rush, sometimes I feel like I'm drowning in subspecialty, fellowship driven medicine and I want to scream out at the top of my lungs. While there were definitely people at the jail that saw people as "criminals" and nothing more...for the most part people cared and just wanted to work with people. I got to network and have 2 things that I can continue to pursue. Especially now that the end of residency is in sight..(basically 1 year and 1 month!!!!), I have been thinking about next steps a lot. I want to continue to work with the community, I want to continue to build relationships and go deeper. Its hard to do while in residency. This month has made me realize I really like HIV. And then the long term picture would be how can I integrate holistic health in all of these subtopics of medicine. How can we take a step back from all the disease labels and look at a person as a whole and make connections to live happier, healthier lives?

Some final thoughts...I am apprehensive about this next rotation. It is infectious disease which I've always found interesting but it is in the setting of the hospital that always brings me down. My balance will be taken from me and I never do well with that. Who knows how much I will be blogging. I am thankful for these months because they are always a breath of fresh air. I had one last ah ha moment but its slipped my mind. Till next time! Would love to hear people's thoughts! Or any other suggestions for next steps.

Kettle Moraine State Park

Blogspot is really annoying in its formatting. It doesn't allow pictures to go where you want them to. So I thought I would only do pictures on this post but I think this one is ok. Maybe. A bunch of us went to Kettle Moraine State Park today! The weather was BEAUTIFUL!!!!! It was so nice to get out of the city and in nature. This is one of Raj and I's FAVORITE activities. Whenever we have some time...we get in the car and pick a pretty state park. I think in the span of our relationship, we must have gone to over 10-15 state parks across the country. We've been to places all over California, New York, Illinois, and Wisconsin. We love looking for little critters. Today's was a garden snake that Raj almost stepped on. We had great company. Met some of Shilpa's friends as well. All in all just a great way to spend the day.

Knitting - Class 1 :)

When I ended this year's India trip, I had come up with a fool proof plan for myself. This plan was basically just a list of the things I look forward to in life and a source to turn to when residency affects me more so than normal and affects my ability to stay sane. One of the things listed was to work with my hands more in general. We had the opportunity in India and I was inspired by Chaiti and her ability to make so many crafts with her hands. She had knitted us some hats for our wedding and was working on a variety of projects during and after the trip. It inspired me to learn knitting as well! So I've signed up for a class that will take place 5 times for the next 5 Friday's! It started tonight. They include the starting materials and we'll learn how to make a scarf and a hat. I have partially learned in an attempt to make a blanket for my nephew. While I didn't do anything with his blanket, I did start to learn the basic process.

The class was really informative for the first one. There was only one other student and one teacher so a small, personal setting. We learned how to cast on with a long tail cast on and we learned how to do the knit stitch. I think the coolest part is my mom attempted to show me and I was so confused. Had no idea when I messed up or just didn't understand the basics. But now that someone has explained it to me, it is so GREAT. This class is really going to set a foundation for future projects. I've gotten some requests already - socks from Farah. :) And I want to make a lot of gifts for Ishan. Some pictures of the first class and the practice knitting. The hat and the scarf are what we're making. The blue yarn is what I picked. And then some practice and some other randoms.

Ishan!!!!

This past weekend I spent 4 lovely days in the Bay area. The primary purpose of the trip was the spend lots and lots of time with my adorable little nephew, Ishan. Then obviously the rest was to spend time with my growing family/friends. The random thought that popped into my head is that it is crazy that my world has expanded so much after meeting/marrying Raj. I have gained a sister, brother, new set of parents and loads and loads of cousins/friends. And now this
latest addition, my first immediate nephew. (many cousins babies but this is the first direct). And oh is he precious. He lights up my world completely. One smile and I melt. Do you know that he wakes up each morning so excited to start his day. He is literally giddy to start crawling and moving and laughing. He'll sit in bed with you and crawl towards you with the CUTEST smile. (at this point you are supposed to not be reacting to him so he goes back to sleep...but so hard to do..i have to turn around to keep myself from smiling back). I've watched him grow up and it is fascinating to see him take in the world. Discovering his hands, learning to crawl, grabbing food...the things we all take for granted but we forget we learned these moves. It is the funniest thing watching him crawl over a bed...boy has no depth perception, no fear and will go right off a bed if you don't watch him. If we all still had that fearlessness. (not to fall flat on our face but to have the guts to try anything.) It was a GREAT weekend. Missed my husband :( But got to see a lot of people that I hadn't seen in a while. And much more calm then a wedding weekend. Major quality time. Smiles all around thinking of it. Thanks to Ami(r), Mom, Dad, Mom's cousins, Sunil, Pooja, Sushil, Kev, Priya, Biggie....the list goes on for an AWESOME weekend. :)

Also check out some other pictures from the weekend.

Farah and Taham's Wedding Week

It was one of my best friend's wedding this past week. Farah and I have basically grown up together. We initially met in high school and have been close since. This past week was spent being part of her big wedding day. She married an awesome human being (Taham) who is absolutely perfect for her and the whole thing just makes me smile. It was a blessing to be part of their day. Unfortunately, I missed another wedding (Sam and Payal's) who are also dear friends. Raj and I wanted to be at both but because both took place on the same day, we chose to split to represent both weddings individually.

The whole wedding week was beautiful and Farah was stunningly beautiful throughout. :) We all couldn't stop staring :) Tons of Masallah's being spoken throughout. I think my favorite parts included getting to have mendhi put on, getting to be Farah's chauffeur (great bonding moments), and all in all just being part of it. Everything was organized perfectly. They had the band Funkadesi playing and it was great to see such a diverse group of people creating music together. Thank you guys for letting me be a part of your big day, for being such gracious hosts, and Farah for being an AMAZING friend all these years. Taham, welcome to the family!!!














Final thought...I've realized I truly love Pakistani culture. This was my first Muslim wedding and I find it amazing to see the grace that exists. There are obviously so many things that are similar to Indian culture - the language, the rituals. But there is also this extra grace/poise/poetic nature that was present. I don't know if I'm making sense but I felt something that was just nice to be a part of. Then part of me always thinks about the tensions that exist between Pakistan and India and if only we could all realize that we have so much more in common then different.

I thought the above was the final thought, but to throw a shout out for Sam and Payal, I want to include an amazing video that their video people put together by the time of the reception. So sad I wasn't there guys but can't wait to visit both couples (they're both going to be in Boston) soon!

Sameer + Payal SDE from Avec Lumiere Productions on Vimeo.

Lock Down!

I am currently in Division 17 of the jail, basically stuck, because there is a level 5 security threat and no one can come in or leave. The rumor mill is saying that someone supposedly brought a gun in at the 3pm check in. So I might be here a while. Unfortunately it is Diwali and Raj and I had plans. :( But it makes for a good story.

I guess this would be a good time to give the basic layout of the jail. This what I know, I'm sure there is tons more I am missing. Basically the Cook County Jail is the largest pre-detention holding facility in the country. It averages 100,000 people a year and an average daily population of 9000. It takes in all the people that are awaiting their trial and or final sentencing. This ranges from the pettiest of crimes to the murder cases. It is split up into different divisions. The highest number I have heard is 17. Each division is categorized by amount of security and the type of crime. Women and men are separated. There is a separate division for those with chronic medical problems that are in prison. I know Division 4 is the general floor for women, Division 17 is for women but much gentler and has a lot of treatment programs available for mental health and addiction. Division 9 or 11 is the big gun and is where a lot of the missed medications happen. The judge assigns you to which division you go to and how long. Cermak is the health center affiliated with the jail. It provides for all the medical care in the jail. The amount of services it provides is actually quite incredible if you think about it. Every person that comes through the jail goes through intake. Which is basically a quick run down of your medical problems, your addictions, your medicine. Then you get triaged accordingly - given any immediete meds (you hope) and then if need for f/u, an order gets put in to see the appropriate medical provider (for example an internist, psych, etc). There is an ER that handles anything that comes up acutely in the jail. The ER has its own CT scan, Ultrasound machine, Xray. It has a radiology reading room. Then all the divisions have their medical clinics that run on a daily basis for the chronic care follow up and the acute stuff that comes up. In terms of public health stuff - there is a large scale sexually transmitted disease screening that takes place for women. It has become opt out in the sense that it gets done for everyone unless someone says specifically no. They are trying to get that for the men as well. Espcially for HIV testing because this is a huge population that could potentially be going undiagnosed. They have tuberculosis screening for everyone that comes in too - everyone gets a chest xray. They have care for the HIV patients - a clinic that runs everyday.

I could go on but thats a basic start. My role in all of this is basically experiencing the different medical flavors of the jail. This time around as I mentioned, I've been spending a lot of time w/ HIV patients and in Division 17 - the more rehabilitative program for women. Last time, I did a little bit of everything. Its something different everyday and that is part of its appeal along with many other things. For now, all I want to do is go home and this stupid lockdown to be done! If anyone has any connections, get me out!

First of many entries on the jail

I've been at the Cook County Jail now for 2 days and I'm amazed at how much I like it there. I've been there before and in general the first time around was just getting used to the culture and there were so many things to take in. Observing the whole prisoner/guard dynamic. Then there is the provider/prisoner dynamic. Then even the guard/provider dynamic. I got warned a lot about watching myself, being careful, the typical. But I think what stuck with me is that these "criminals" are people in the end. Yeah some of them have probably done horrible things but the majority of them end up making not the smartest decisions. A lot of them have addictions that lead them to jail. A lot of mental health issues. It is amazing to see how prevalent the racial lines are when it comes to prison. The number of black/hispanic compared to white is simply incredible. The waiting line for the family/friends that are visiting outside of the prison all come from minority backgrounds. I read this book called Courtroom 302 that gave me a lot of insight into the Cook County Justice system.

The second time around, I think I really just see myself actually being able to be a part of this world and getting deeper. I have been focusing on HIV care in the past two days and working with a really cool attending - Dr. Z. His bedside manner and ability to just be real with the patients is really inspiring. There are some ridiculous stories of injustice that happen to people that need their medications and totally don't get them because of the system. The attendings that I've worked with care (there are your share that whine, but what work place doesn't have that) and overall its a friendly work environment. I don't know, the whole experience feels very real. It is real people, real stories and you see so many aspects of our society collide - health, justice, the role poverty plays, the role race plays, politics...I could go on. This was just a brief entry. Call me naive but I truly believe that there are no bad people in the world. Things happen to them that make them make bad decisions. Talking to these people allows me to break the stereotypes in my head and reminds me that in the end, "crimnals/prisoners" are people. They deserve respect and they deserve a system that actually works at rehabilitating rather than blind punishment. I'll describe how the system works in another entry. I am not allowed a camera in the place but I'm going to post some google images of what I walk into. I feel like there is so much to say but this was just an intro.

We're back - at least one of us!

I know its been a while since either of us have posted. I was inspired by a certain someone (thanks Sonz!) to keep a blog. I was going to create a new blog but then thought it would just be easier to add onto this one. In this coming month, I will be working at the Cermak Health Center. It is the health center affiliated with the Cook County Jail. I've done 2 weeks there before and think it is a really interesting aspect of health care. I learned a lot and am truly considering working there post residency. I'll keep you guys posted on how it goes. It is also an easier month and a month that I can enjoy the randomness of life. I usually have some pretty crazy adventures and was going to use this blog to share.


Some adventures thus far...Raj and I went to Occupy Chicago yesterday. Had been wanting to check it out for a while. Thought it was powerful just hearing people rally for a cause. People from other cities that were part of the occupy movement were there sharing their stories/experiences. It is powerful to think that if enough of us gather together, maybe we could stop making money the center of our universe and focus on building a stronger community together. The movement really tries to make it a true democratic movement - having things build in for everyone to speak their mind, a human microphone so that everyone can hear...and lots of other things that I could go on about. All in all a cool movement to observe and if I get time, definitely want to be part of it more. Didn't have my camera but posting a picture from the website.