tag:blogger.com,1999:blog-37986902601695893262024-03-19T00:32:03.533-07:00Go together wellMichelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.comBlogger62125tag:blogger.com,1999:blog-3798690260169589326.post-8390675135983631622021-10-27T06:05:00.002-07:002021-10-28T04:58:01.006-07:005 years laterSomehow five years have passed since I finished residency and since my <a href="https://michelledorwart.blogspot.com/2016/09/for-my-dad.html" target="_blank">dad's retirement party</a> (though he had the party, he has yet to fully <i>retire). </i>The passage of time is a funny thing...often when I'm running behind in my clinic schedule or when a patient arrives at 10:30 for their 8:15 appointment, I'll say something about time being a social construct or, "What even is time?" One of my coworkers and I often misquote Friedrich Nietzsche by saying, "Time is a square circle," which is our way of saying that time is meaningless or nonsensical. (I have just emerged from a deep dive into the <a href="https://en.wikipedia.org/wiki/Friedrich_Nietzsche" target="_blank">Friedrich Nietzsche Wikipedia page</a> where I learned or was reminded that the actual quote is "time is a flat circle" meaning essentially that history repeats itself.)<div><br /></div><div>Philosophies about the nature of time notwithstanding, for some reason I've decided to write a post. (Incidentally, I now have a 3-year-old daughter who occasionally uses the phrase "for some reason.") I started working at the Community Health Centers of Burlington in August 2016. Despite the quotidian challenges of working in primary care in a medical system that puts all its resources into tertiary care (<a href="https://www.pcpcc.org/sites/default/files/resources/PCPCC%20Fact%20Sheet%20PC%20Spend%20Aug%202018.pdf" target="_blank">in spite of clear evidence that increased spending on primary care improves health outcomes</a>), most days I really enjoy my job. I have wonderful colleagues, and I get to work with a fascinating and diverse group of patients, from a 95-year-old who has lived in Vermont since she was born to a newborn first generation American whose Somali mother recently immigrated to the U.S. after 20 years living in the <a href="https://www.unhcr.org/ke/dadaab-refugee-complex" target="_blank">Dadaab Refugee Complex in Kenya</a>. I get to share their joys (welcoming new babies into the world!) and their successes (quitting smoking, getting a new job, becoming a U.S. citizen!), often caring for multiple generations of the same family and figuring out the connections and relationships among people I meet individually. It is always humbling and simultaneously either inspiring or heart-breaking to be trusted with people's stories. I will never cease to be amazed by my fellow humans' capacity for both abject evil and great resilience. </div><div><br /></div><div>Today, I was talking with a colleague who has recently learned of the untimely losses of two of her patients to what have been called "<a href="https://www.vox.com/2020/4/15/21214734/deaths-of-despair-coronavirus-covid-19-angus-deaton-anne-case-americans-deaths" target="_blank">deaths of despair</a>." We reflected on the suffering and tragedy that we so often see, often as a direct or indirect result of trauma. Visible and invisible wounds inflicted on a person by the horrific actions of other people beget more horrific and tragic actions: a cascade of trauma from one generation to the next. As I was walking to my car after work, I got a call from an ER doctor who was letting me know about one of my patients who was there following a terrible incident which I believe occurred as a result of their exposure to the trauma of a civil war. The ways in which people respond to trauma vary, but as psychiatrist and trauma researcher Dr. Bessel van der Kolk posits, "<a href="https://bookshop.org/books/the-body-keeps-the-score-brain-mind-and-body-in-the-healing-of-trauma/9780143127741" target="_blank">the body keeps the score</a>."</div><div><br /></div><div>It can be easy to fall into a pessimistic or fatalistic view of the world when, day after day, one hears of the awful things that people do to one another. But there are also so many kind and thoughtful people who are working to make things better. When I start thinking that humanity is irredeemably flawed, I try to turn my thoughts to the wonderful people I've met who are now scattered around the country and the world. There are those with whom I have only crossed paths briefly but whose warmth and motivation continue to inspire me. And, even if I don't get to see or interact with them regularly, I think of how grateful I am for their existence. How happy I am that the world has the benefit of such beautiful souls so devoted to helping others. </div><div><br /></div><div>I also try to remind myself of my belief that we all have capacity for both good and evil actions and that "<a href="https://www.goodreads.com/quotes/4310504-each-of-us-is-more-than-the-worst-thing-we-ve" target="_blank">each of us is more than the worst thing we've ever done</a>." I try to retain optimism while retaining the motivation for action; all the positive thoughts in the world won't help anyone without thoughtful and timely action. And yet, some days, between work and two young kids, it feels like there aren't enough hours to fit in everything that needs to be done. So I'll keep doing my best and keep misquoting Nietzche. Time really is a square circle.</div><div><br /></div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0lPNHum3JTz4N1FodcMX9-3ekmcNpLOmfQBmycOHUdTMwKhZPqi-kBVKtOWWBMIM9QeA03dbTr37M6c8Dl-ioWCbivUE7StMfF8U83zW43QgddyAa8Z3spRC2ASbsoPPXfNdA6i6r6Jzv/s1160/Screen+Shot+2021-10-27+at+8.59.42+AM.png" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="594" data-original-width="1160" height="205" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0lPNHum3JTz4N1FodcMX9-3ekmcNpLOmfQBmycOHUdTMwKhZPqi-kBVKtOWWBMIM9QeA03dbTr37M6c8Dl-ioWCbivUE7StMfF8U83zW43QgddyAa8Z3spRC2ASbsoPPXfNdA6i6r6Jzv/w400-h205/Screen+Shot+2021-10-27+at+8.59.42+AM.png" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><span style="font-size: x-small;">Overlook Park - South Burlington, VT</span></td></tr></tbody></table><br /><div><br /></div>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com1tag:blogger.com,1999:blog-3798690260169589326.post-49426591894425674402016-09-07T05:55:00.000-07:002016-09-08T05:32:20.929-07:00For my dad<br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "trebuchet ms" , sans-serif;">{Dad, third from right, breaking ground at the site of his clinic, ~1987.}</span></td></tr>
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<span style="font-family: "trebuchet ms" , sans-serif;">On June 24, I graduated from family medicine residency and became the fourth family physician/general practitioner in three generations of Dorwarts. A week later, on July 1, our family gathered in Sidney, Nebraska, to celebrate my dad's retirement after 35 years as a family physician there. I couldn't be prouder of the work my dad has done throughout his career, his dedication to our hometown, his persistence through difficult times, and his unwavering insistence on doing the right thing even when it's not the easy thing. Even though I considered forays into surgery and gynecologic oncology (among other things), I am happy to have found my way to family medicine and to my father's footsteps.</span><br />
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<span id="docs-internal-guid-c6a53ece-c77b-b2b0-0262-507b2ad08e51"><span style="background-color: white; color: #222222; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: "trebuchet ms" , sans-serif;">Although my dad worked long hours throughout my childhood, I never felt like I was missing out because I appreciated the importance of what he was doing. My perception was that he was spending his days saving lives; m</span></span></span><span style="background-color: white; color: #222222; font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">y brothers and I went through a phase of asking him every day when he arrived home from work, "How many people did you save today?" Now that I've experienced life as a doctor, I know that the notion of "saving lives" seems distant when you're getting home late after spending the last few hours of your work day documenting everything that happened and signing prior authorization forms. But however he felt at the end of long days and whether or not he had "saved lives" in our juvenile understanding of the phrase, the fact is that he dedicated his life to his community and worked tirelessly to improve the lives of the people there.</span><br />
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<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">I got to spent my family medicine rotation (a two-month period during my third year of medical school) working with my dad and his colleagues in Sidney. I learned more (or at least more that I still remember and use in my day-to-day practice) in those two months than I did in two years of preclinical coursework. I loved having the opportunity to witness the ways in which my dad practiced the art of medicine. Unlike some teaching physicians, he's not really one for pithy one-liners about his philosophy of patient care. What I learned from him I learned by watching and listening as he interacted with patients. </span></span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;"><br /></span></span><span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">Some stories...</span></span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">(Note: These stories are based on real situations, but I've changed details and diagnoses both to protect patient privacy and because this happened over five years ago...which means that I don't remember the details anyway!)</span></span><br />
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<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">_____________________________________</span></span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">On one of the first days of my rotation, I met an 80-something farmer in the hospital. His wife had brought him to the emergency room the night before because of shortness of breath in the setting of progressive lung cancer. He and his family had been my dad's patients for years. Dad knew all about the man's farm (he's prone to lengthy conversations about such things as irrigation systems and lawn mowers) and had even delivered the patient's grandchildren. When we entered the room he introduced me, as he did to all patients during my time there, by saying, "This is our student doctor, Michelle." When he knew the patients well, he'd pause a moment before adding, "She also happens to be my daughter." Almost invariably, the patients would say something like, "Oh, I thought so!" or, "Of course! She looks just like her mother!"</span></span><br />
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<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">After a brief discussion of the previous night's rain (an eighth of an inch, probably), the conversation turned to the patient's illness. It had become clear to the patient and his wife that the end of his life was approaching. They wanted to try to treat any reversible problems (infection, specifically) and to focus on getting him back to the farm. We discussed the next steps in the man's care, including planning a conversation with the hospice team, before carrying on with hospital rounds and heading back to clinic for a busy afternoon. </span></span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;"><br /></span></span>
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">That night, after dinner at home, Dad asked if I wanted to go with him to check on our farmer. We hopped on bikes and rode back to the hospital where we found that the patient's room was filled with his children, grandchildren, and great-grandchildren. They greeted us warmly, and Dad joined them in telling stories about the patient's life while he (the patient) laid in bed with his eyes closed, smiling and interjecting occasionally. We spent about a half hour with the family before wishing them a good night and heading home. As we pedaled up the long driveway to my parents' house, I realized that we had not done anything "medical" during our visit--no reviewing of labs or entering of orders, no discussion of medication changes. </span></span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">But then, that hadn't been the point.</span></span><br />
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<span style="background-color: white; color: #222222; font-family: "trebuchet ms" , sans-serif; white-space: pre-wrap;">_____________________________________</span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">Several weeks later, Dad and I took another evening bike ride to the hospital--this time because one of his patients was in labor. This was the woman's third child (Dad had delivered the others), and the nurse who called had said that the woman was 8 cm dilated, so we hurried to change into scrubs before heading to the delivery room. The patient and her husband were visibly reassured when Dad walked into the room just as another contraction started. As we prepared for the birth, I stood nervously behind my dad; this would be my first time participating in a delivery. (I had done an OB rotation about 10 months prior but the only hands-on experience I had gotten was holding retractors during C-sections.) Dad prodded me to move in front of him, and as the baby was being born he took my hands and placed them on the head, guiding me in my first delivery.</span></span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;"><br /></span></span>
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">Later, when Dad was out in the hall doing paperwork, I stayed in the room to examine the baby and talk with the parents. As I was handing the newborn back to his mother, I told her that this had been my first hands-on delivery. She told me about her previous childbirth experiences and how she was so happy my dad had been there with her for all of them. The nurse added, "You know, I've worked with Dr. Dorwart for a long time. He may act like a tough guy, but the look on his face every time he delivers a baby...it's pretty special. Like he's witnessing a miracle." </span></span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;"><br /></span></span>
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">_____________________________________</span></span><br />
<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;">There are many other stories I could tell about my rotation or about other times from Dad's 35 years working in Sidney. Of course, there were rough times, days when the hours of work exceeded the hours available, years when the "<a href="https://www.youtube.com/watch?v=xB_tSFJsjsw" target="_blank">damn computer</a>" got in the way of just taking care of patients. There may have been a few patients who didn't appreciate his candor, a few medical students who were intimidated by, "Are you asking me or telling me?," and a few nurses who didn't love hearing, "What's your big emergency?" when they called...but he has always been unapologetically, unabashedly himself. And that self committed more time, energy, integrity, and love to his vocation than any other doctor I've met. My dad is, to me, the consummate family physician. For that example, I am endlessly grateful.</span></span>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "trebuchet ms" , sans-serif;">{With my parents at my residency graduation, June 2016}</span></td></tr>
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<span style="color: #222222; font-family: "trebuchet ms" , sans-serif;"><span style="background-color: white; white-space: pre-wrap;"><br /></span></span>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com2tag:blogger.com,1999:blog-3798690260169589326.post-42961737867386482672016-03-08T11:28:00.000-08:002016-03-10T20:08:31.515-08:00From Valentine's Day to International Women's Day<div class="p1">
<span style="font-family: "trebuchet ms" , sans-serif;">On Valentine’s Day, as I was walking back toward the hospital after buying a Coke from the Red Cross canteen (a little shop adjacent to the hospital “car park” where they sell snacks, soft drinks, and <a href="http://www.bbc.co.uk/food/recipes/manyatis_vegetable_35397" target="_blank">sadza</a>), a man about my age walked briskly toward me, saying, “Hi doc, I’m sorry to interrupt you but can I ask a personal question?” My mind jumped to: where’s the rash? Instead, he continued, “It’s about my wife. She was admitted to the labour ward for an induction today, but now they’re sending her back to the antepartum ward because she isn’t having contractions.” (The labour ward has a strict no visitors policy, which also means no husbands.Throughout the rest of the hospital, visitors are only allowed for two hour-long periods each day.) </span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;">He went on to tell me about the recent course of his wife’s pregnancy, and I was becoming curious about what the “personal question” would be. After a few minutes, he asked simply, “Do you think she’ll be okay? Do you think the baby will be okay? Do you think it’s okay for her to be transferred?” I reassured him that what was going on with his wife seemed normal and that the doctors caring for her wouldn’t transfer her if they didn’t think it was safe and appropriate to do so. We spoke for a few minutes about what he could expect moving forward before he said, “Do you think you can do one thing for me? When you go back inside could you find her and check on her? Her name is Cecilia. I just love her so much. I want to be sure she’s doing okay.” His words were so heartfelt and his eyes so full of love and concern that I could feel my own eyes brimming with tears. I gave him a hug and promised him that I would find her. </span></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "trebuchet ms" , sans-serif; font-size: x-small;">{entrance to the labour ward}</span></td></tr>
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<div class="p1">
<span style="font-family: "trebuchet ms" , sans-serif;">Fortunately, when I went back inside, Cecilia was still in the labour ward (which has 13 beds compared to 50+ in the antepartum ward). I found her curled up on her left side (all women in the labour ward are encouraged—or perhaps one might say <i>mandated</i>—by the no-nonsense midwives to lie on their left because it maximizes blood flow through the placenta) in one of the cubicles. She was breathing deeply and was clearly very uncomfortable. I passed along the message from her husband and talked briefly with her about her plan of care. Before I left her bedside, I said, “It’s obvious that your husband adores you.” She smiled, and through her tired eyes, I could see that the feeling was mutual. <table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: x-small;">{labour ward on a quiet morning}</span></td></tr>
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<div class="p1">
<span style="font-family: "trebuchet ms" , sans-serif;">I tried to find Cecilia the next morning, but I didn’t have any luck (it’s not as simple as typing a patient’s name into the electronic medical record to find a room number). A bit later, when I was getting a ride home from one of the registrars (doctors in training—similar to residents), we drove past the outdoor family waiting area. The husband (whose name I have forgotten but whose kind eyes made a lasting impression) saw me; he smiled broadly and waved. I wish I could say that he was holding a baby in his arms (for confirmation that all had gone smoothly), but he wasn’t. I have taken his big smile as an indicator of a positive outcome (which is probably reasonable given what I had learned of Cecilia’s pregnancy, but <a href="http://www.who.int/maternal_child_adolescent/topics/maternal/maternal_perinatal/en/" target="_blank">it’s certainly not as sure a bet as it might be elsewhere in the world</a>). </span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjglwEyZCdMm6JdbnB1rrojknE_43unDtOpK1vtZXWGCPag22sL8H44ulLhoO353mdkqy6S7MY62ad18DZaAMx-H6PYzO-wcCNQW8APCtNFMh48hAuDceq-oP3vxo55hH3IOBt3Lq5CUFvO/s1600/IMG_0870.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjglwEyZCdMm6JdbnB1rrojknE_43unDtOpK1vtZXWGCPag22sL8H44ulLhoO353mdkqy6S7MY62ad18DZaAMx-H6PYzO-wcCNQW8APCtNFMh48hAuDceq-oP3vxo55hH3IOBt3Lq5CUFvO/s320/IMG_0870.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "trebuchet ms" , sans-serif;">{Dave & me - with a new mama (not Cecilia) & baby, <br />a midwife, and a nursing student}</span></td></tr>
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<span style="font-family: "trebuchet ms" , sans-serif;">I am so pleased to have met Cecilia and her husband when I did—not just because they brightened my Valentine’s Day when I was 63 degrees of latitude away from my husband—but because they showed me a happier example of gender relations than I had been seeing in the preceding days. Recent examples included a woman in her third trimester of pregnancy who had learned a few weeks prior that her husband tested positive for HIV after he had been away on business (<span style="font-family: "trebuchet ms" , sans-serif;">it is not uncommon to hear of men "<span style="font-family: "trebuchet ms" , sans-serif;">taking<span style="font-family: "trebuchet ms" , sans-serif;"> multip<span style="font-family: "trebuchet ms" , sans-serif;">le wives<span style="font-family: "trebuchet ms" , sans-serif;">," which<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;"> seems to be another way of saying that they are </span>engaging in extramarital affairs</span></span></span></span></span></span></span></span>), a Bible verse posted in the admissions area of the maternity hospital about how God will multiply a woman’s pain during childbirth yet she will still desire her husband because he RULES (yes, in all caps) over her, and a <a href="http://www.omniglot.com/writing/shona.php" target="_blank">Shona</a> pejorative (<i>Ngo mwa</i>) which means “completely useless” and is used to refer to infertile women. </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjbpPl26YgIlXSDm__JDGKt9QA3GvoTNJlGV9zb1s86_S23AAN9Bez3mqGTTVEnKs2MiLB8f2mbeJdq7AGuEh0VsMCyw-mSDjyYos5HfvdeFb9yCLaF9hEZ-yBhtgSVBcPmmDMI5_Cf6ek/s1600/12794329_10100390548409976_8260004311349950773_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjbpPl26YgIlXSDm__JDGKt9QA3GvoTNJlGV9zb1s86_S23AAN9Bez3mqGTTVEnKs2MiLB8f2mbeJdq7AGuEh0VsMCyw-mSDjyYos5HfvdeFb9yCLaF9hEZ-yBhtgSVBcPmmDMI5_Cf6ek/s320/12794329_10100390548409976_8260004311349950773_n.jpg" width="240" /></a></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Of course, the concept of gender inequality was not a new discovery to me on this trip, but for some reason it was especially troubling this time (perhaps it’s because I was working in a maternity ward serving a particularly impoverished population or perhaps the disparity is more overt in Zimbabwe than in other places I’ve traveled). I was discussing it with one of the registrars, who said (completely unironically), "I don't really understand why women want equal rights. Why would they want to go to work all day and then have to go home and take care of the kids and the house and cook dinner?"<span style="font-family: "trebuchet ms" , sans-serif;"> Of course, that led to a longer conversation in which I unsuccessfully attemp<span style="font-family: "trebuchet ms" , sans-serif;">ted to teach him th<span style="font-family: "trebuchet ms" , sans-serif;">at advancing women's right<span style="font-family: "trebuchet ms" , sans-serif;">s is better for everyone - <a href="http://www.nytimes.com/2013/06/02/opinion/sunday/coontz-the-triumph-of-the-working-mother.html" target="_blank">healthier, more </a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.nytimes.com/2013/06/02/opinion/sunday/coontz-the-triumph-of-the-working-mother.html" target="_blank">ful</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.nytimes.com/2013/06/02/opinion/sunday/coontz-the-triumph-of-the-working-mother.html" target="_blank">filled women</a><span style="font-family: "trebuchet ms" , sans-serif;">; <a href="http://www.forbes.com/sites/hbsworkingknowledge/2015/05/15/kids-benefit-from-having-a-working-mom/#20e58b714924" target="_blank">daughters who end up earning more</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.forbes.com/sites/hbsworkingknowledge/2015/05/15/kids-benefit-from-having-a-working-mom/#20e58b714924" target="_blank"> and son</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.forbes.com/sites/hbsworkingknowledge/2015/05/15/kids-benefit-from-having-a-working-mom/#20e58b714924" target="_blank">s who end up contributing more t</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.forbes.com/sites/hbsworkingknowledge/2015/05/15/kids-benefit-from-having-a-working-mom/#20e58b714924" target="_blank">o the care of their families</a>; <a href="http://www.huffingtonpost.com/soraya-chemaly/international-womens-day_b_1324219.html" target="_blank">reduc<span style="font-family: "trebuchet ms" , sans-serif;">tion of</span> gender ster</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.huffingtonpost.com/soraya-chemaly/international-womens-day_b_1324219.html" target="_blank">eoty<span style="font-family: "trebuchet ms" , sans-serif;">pes fo<span style="font-family: "trebuchet ms" , sans-serif;">r both <span style="font-family: "trebuchet ms" , sans-serif;">women and men</span></span></span></a>; <a href="http://www2.unwomen.org/en/what-we-do/economic-empowerment/facts-and-figures" target="_blank">stronger national e</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www2.unwomen.org/en/what-we-do/economic-empowerment/facts-and-figures" target="_blank">c<span style="font-family: "trebuchet ms" , sans-serif;">onomi<span style="font-family: "trebuchet ms" , sans-serif;">es</span></span></a>; and<span style="font-family: "trebuchet ms" , sans-serif;">, most importantly, creating an environment of <span style="font-family: "trebuchet ms" , sans-serif;">mutual respect </span>that a<span style="font-family: "trebuchet ms" , sans-serif;">llows members o<span style="font-family: "trebuchet ms" , sans-serif;">f all gend<span style="font-family: "trebuchet ms" , sans-serif;">ers t<span style="font-family: "trebuchet ms" , sans-serif;">o pursu<span style="font-family: "trebuchet ms" , sans-serif;">e a life of <span style="font-family: "trebuchet ms" , sans-serif;">happiness and love.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">It's been a<span style="font-family: "trebuchet ms" , sans-serif;">bout a month since I met Cecilia and her husband, so now I'm writing my Valen<span style="font-family: "trebuchet ms" , sans-serif;">tine's Day post <span style="font-family: "trebuchet ms" , sans-serif;">on <a href="http://www.internationalwomensday.com/" target="_blank">Inter</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.internationalwomensday.com/" target="_blank">national Women</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.internationalwomensday.com/" target="_blank">'s D</a><span style="font-family: "trebuchet ms" , sans-serif;"><a href="http://www.internationalwomensday.com/" target="_blank">ay</a><span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-family: "trebuchet ms" , sans-serif;">,<span style="font-family: "trebuchet ms" , sans-serif;"> </span></span>which also seems appropriate<span style="font-family: "trebuchet ms" , sans-serif;"> as <span style="font-family: "trebuchet ms" , sans-serif;">the story h<span style="font-family: "trebuchet ms" , sans-serif;">igh<span style="font-family: "trebuchet ms" , sans-serif;">lights both how far we<span style="font-family: "trebuchet ms" , sans-serif;">'ve come (in some ways) and how far we have to go (in many other ways) in order to advance the rights of women<span style="font-family: "trebuchet ms" , sans-serif;"> (and men and children!) around the world.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiulnsc9WyPqMl34FduiB1JWB9tT-9SjelM7M541LaTo3fq2uiO6JWC92oTYZIL4hn0gOcIrlV4kvKCuQX6GpYiETiPrKiLwSEUE5t16KvNpUIGy1S6wPncp8Cjzw5EkVf8Ii3sen7VEBkc/s1600/12719273_10100388030600686_3163114983830366080_o.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiulnsc9WyPqMl34FduiB1JWB9tT-9SjelM7M541LaTo3fq2uiO6JWC92oTYZIL4hn0gOcIrlV4kvKCuQX6GpYiETiPrKiLwSEUE5t16KvNpUIGy1S6wPncp8Cjzw5EkVf8Ii3sen7VEBkc/s400/12719273_10100388030600686_3163114983830366080_o.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "trebuchet ms" , sans-serif;">{why not end with a gorgeous picture of the Zambezi River?}</span></td></tr>
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<span style="font-family: "trebuchet ms" , sans-serif;"><br /></span>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com2tag:blogger.com,1999:blog-3798690260169589326.post-20584628250995076122016-02-17T11:52:00.000-08:002016-02-23T11:59:27.019-08:00Water & giraffes<div class="p1">
<span style="font-family: "trebuchet ms" , sans-serif;">After a couple of weeks of rounds with "the <a href="http://www.uz.ac.zw/index.php?option=com_content&view=article&id=965:professor-patson-zvandasara&catid=246:obstetrics-and-gynaecology" target="_blank">Zvandasara</a> firm" (they refer to teams of doctors as firms, which makes me feel like I'm in a John Grisham novel) and delivering babies with the midwives, Dave and I are hitting our stride and understanding (at least at a basic level) how things work here. We continue to be amazed by the number of babies born at Harare Central Hospital every single day, and we are relishing the opportunities and experiences we’re gaining.</span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHBBl58vXRAUEDiH0mTBqnZ0a4y1mhkpXRiqSV018-vWK5OQFc6wNHM2LzMYcGNSavUHaDSp6ZHXxtAlXCvt7Wp2Abr03HpKcPgcerLqbm-hb5R6YfdGRRVdq0C17TDFwU8RLJxMopkt8/s1600/Screen+Shot+2016-02-19+at+8.29.16+AM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHBBl58vXRAUEDiH0mTBqnZ0a4y1mhkpXRiqSV018-vWK5OQFc6wNHM2LzMYcGNSavUHaDSp6ZHXxtAlXCvt7Wp2Abr03HpKcPgcerLqbm-hb5R6YfdGRRVdq0C17TDFwU8RLJxMopkt8/s200/Screen+Shot+2016-02-19+at+8.29.16+AM.png" width="158" /></a></td></tr>
<tr><td class="tr-caption" style="font-size: 12.8px;"><span style="font-family: "trebuchet ms" , sans-serif;">{Me with a baby I just delivered and dressed in a<br />very warm outfit!}</span></td></tr>
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<span style="font-family: "trebuchet ms" , sans-serif;">Although it is no surprise that there is significant poverty in Zimbabwe (after all, it is a developing nation</span><span style="font-family: "trebuchet ms" , sans-serif;">), I have been struck by the dramatic ways in which the scarcity of jobs and resources affect people’s health. A recurring theme in gynecology clinic is: woman diagnosed with cancer (or probable cancer) a year ago, did not have the recommended treatment at that time because of inability to pay for it, now returning after having saved up for a year but with more widespread or severe disease (which will be more difficult to treat and perhaps now impossible to cure). Imagine finding out that a loved one has cancer and that their ability or inability to get the necessary treatment is contingent upon your selling enough roasted corn on the side of the road.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Another thing that has been both interesting and eye-opening is how difficult it can be to access such basic needs as water in a place where the infrastructure is old or, in some places, nonexistent. For example, for the week prior to our arrival, there was no running water in the dormitory building where we’re staying (there was an issue with the water pressure such that the water just wasn’t making it all the way to the faucet). People who were staying here had to bring in their own water in large bottles from the grocery store (for drinking) and in buckets from an outdoor well (for washing, flushing the toilet, etc.). The water pressure issue has now resolved, but since we have been here the entire university campus and surrounding area has been without hot water (if it weren’t so hot all the time the freezing cold showers would be especially unpleasant!) We are told that a boiler (or something) is broken. Additionally (and more importantly), the tap water in Zimbabwe is not safe for drinking; it must be boiled or otherwise filtered before drinking in order to avoid the risk of diarrheal illness (which could be deadly for people here). </span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">In the US, it is easy to take clean, safe water for granted and to forget all the steps it takes to get that water from its source to our kitchen sinks. This has been a good reminder that regular hot showers are a luxury rather than a necessity (because we could just as easily clean ourselves with cold water)! </span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">To end on a lighter note, I'll share a couple of pictures! Last weekend, we were lucky enough to go on a day trip to an animal park last weekend. There, we saw lions, hyenas, baboons, giraffes, zebras, wildebeests, and gazelles! </span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhs4eWwKUAIOLi68a0OJqNHbr2B3gabXqZNxS3r1TzasBA0JYO_b1Ftqu1Dh3blKMi0HTOE8XNNiUBDjILnrFHyeryiUVOm2ENdiYNX9dpSNqiZ_RxBkhJKhZE3OHTt-vG-8YOB6RVWU_vj/s1600/Screen+Shot+2016-02-19+at+8.30.21+AM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="301" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhs4eWwKUAIOLi68a0OJqNHbr2B3gabXqZNxS3r1TzasBA0JYO_b1Ftqu1Dh3blKMi0HTOE8XNNiUBDjILnrFHyeryiUVOm2ENdiYNX9dpSNqiZ_RxBkhJKhZE3OHTt-vG-8YOB6RVWU_vj/s320/Screen+Shot+2016-02-19+at+8.30.21+AM.png" width="320" /></a></div>
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0tag:blogger.com,1999:blog-3798690260169589326.post-64583207082207463742016-02-10T10:58:00.000-08:002016-02-15T13:16:26.345-08:00Arrival and first week<div class="p1" style="background-color: white; color: #222222; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px; line-height: 18.48px;">
<span style="font-family: "trebuchet ms" , sans-serif;">It’s been a week since we (my fellow UVM resident, Dave, and I) arrived via a bumpy landing at Harare International Airport to start a month-long obstetrics rotation at one of Zimbabwe’s tertiary medical centers. At times cautiously navigating a foreign system and at others readily integrating into seemingly universal medical practices (daily rounds, admissions, systematic gathering of patient data), we are learning that being a doctor in Zimbabwe is in some ways unrecognizably distinct and in others comfortable, familiar. </span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Before I go further, I want to clarify something: throughout my preparations for this trip, I received a lot of undue praise from friends, family, and patients about how great it is that I would travel to Zimbabwe for a "medical trip," with the assumption being that I am somehow going to accomplish something great or to "save" people from death or illness. While I would love to be able to end vertical HIV transmission or to vaccinate everyone against HPV, to claim the title of humanitarian or rescuer of orphan children, the purpose of my trip is comparatively self-serving. I am here to gain perspective—to observe, to experience, and to learn what little I can in this short time about medicine and childbirth in a setting where healthcare resources are scarce, complications are frequent, and the only reasonable <a href="http://michelledorwart.blogspot.com/2014/04/birth-plans.html" target="_blank">birth plan</a> is for both mother and baby to survive. (According to <a href="http://countryoffice.unfpa.org/zimbabwe/drive/ZMPMSreport.pdf" style="color: #888888; text-decoration: none;" target="_blank">a study</a> published by the Zimbabwe Ministry of Health and Child Welfare, in 2007 there was one maternal death for every 138 live births and one <a href="http://www.who.int/maternal_child_adolescent/topics/maternal/maternal_perinatal/en/" style="color: #888888; text-decoration: none;" target="_blank">perinatal</a> death for every 35 births.) </span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">Prior to departure, we were encouraged to read <a href="https://medium.com/the-development-set/the-reductive-seduction-of-other-people-s-problems-3c07b307732d#.sp341box2" style="color: #888888; text-decoration: none;" target="_blank">this interesting article</a>, which discusses the and arrogance of privileged westerners who imagine that we can swoop in for a month or two—or even a year or two—and solve what we presume to be the readily solvable problems facing developing nations. Although I wish I had the power and ingenuity to solve the health systems problems here in Zimbabwe (and at home in the States), the more I experience I have in healthcare, the more I understand that each seemingly simple problem is a confluence of social, <a href="https://www.dallasfed.org/assets/documents/institute/annual/2011/annual11b.pdf" style="color: #888888; text-decoration: none;" target="_blank">financial</a>, political, <a href="http://www.historyworld.net/wrldhis/PlainTextHistories.asp?historyid=ad28" style="color: #888888; text-decoration: none;" target="_blank">historical</a>, <a href="http://www.telegraph.co.uk/active/12122794/Low-water-levels-at-Victoria-Falls-highlight-southern-Africas-worst-drought-in-30-years.html" style="color: #888888; text-decoration: none;" target="_blank">environmental</a>, and religious factors. To make meaningful change in any one area requires more than just money or equipment or a new perspective from an outsider (<a href="http://www.theguardian.com/commentisfree/2009/nov/24/africa-charity-water-pumps-roundabouts" style="color: #888888; text-decoration: none;" target="_blank">here's an unfortunate example</a>). Of course, I hope never to become jaded or to lose hope for a healthier, more just world…but I continue to learn that nothing is as simple as it seems.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">We've been in Harare for a week now, and it has been jarring and heart-wrenching at times, humbling and heart-warming at others. With few exceptions, the Zimbabweans we've met have been warm and smiling, eager to extend a warm welcome to “Zim.” I’ll share a couple of stories from the past week here. </span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">One morning on antepartum rounds we encountered a woman who had been admitted for management of a miscarriage at 34 weeks. The patient was sitting up in bed, distraught, with tears rolling down her cheeks. My heart ached for her as the doctor presenting her story told us that this was her second third trimester miscarriage. I couldn't have imagined the next thing he was about to say: "And early this morning we learned that her husband has died after being attacked by a group of thieves in South Africa." Dave and I looked at each other, shocked, as the rest of the team continued discussing the patient's care. While they of course found the woman's story to be terribly sad, it was as unsurprising to the rest of the group as it was incomprehensible to us.</span></div>
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<span style="font-family: "trebuchet ms" , sans-serif;">While there are many more sad and shocking examples of delayed medical care and severe complications of pregnancy, it has also been fun to join the excellent team of doctors and midwives working in the "labour ward" where 40-50 babies are born every day! There are no epidurals, no birthing tubs, no electronic fetal monitoring--just a lot of amazingly strong women birthing a lot of adorable babies. Below is a picture of 7 babies that were born within 15 minutes of one another--and shortly after this was taken, 4 more were added to the crowd. </span><br />
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0tag:blogger.com,1999:blog-3798690260169589326.post-51077495843942841842015-03-26T09:20:00.000-07:002015-03-31T19:43:24.791-07:00Mysteries<div style="background-color: white; font-family: 'Trebuchet MS', Arial, Helvetica, sans-serif; font-size: 14px; line-height: 1.6em; margin-bottom: 1em; margin-top: 1em; padding: 0px; text-align: left;">
I'm in the middle of my sixth year of medical training (seventh if you count the year of public health), which at times seems like a lot and at times seems too few. It's both startling and comforting to recognize that I will never know all there is to know about medicine, no matter how long I practice or how much I study. I just hope that, in spite of occasional frustration and fatigue, I will be able maintain compassion, humility, and hope of understanding the unknown, while recognizing that there will always be some things that are unknowable.</div>
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“Truly, we live with mysteries too marvelous<br />
to be understood.</div>
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How grass can be nourishing in the<br />
mouths of the lambs.<br />
How rivers and stones are forever<br />
in allegiance with gravity,<br />
while we ourselves dream of rising.</div>
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How two hands touch and the bonds<br />
will never be broken.<br />
How people come, from delight or the<br />
scars of damage,<br />
to the comfort of a poem.</div>
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Let me keep my distance, always, from those<br />
who think they have the answers.</div>
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Let me keep company always with those who say<br />
“Look!” and laugh in astonishment,<br />
and bow their heads.”</div>
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- Mary Oliver<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgD2TH5GcswQNSfaq03ijACSNrDGq5uR9Cz7ZOQvFo32KKAC7HqxQk9tbxwW7c-4gYuiMBiSU_RDgzedrLgk6eqP9pMK2d1RtTx0AjafWkSDVEKYy3Cb9r_tT3SFKEkECQoA54fVbraP5wO/s1600/IMG_4388.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgD2TH5GcswQNSfaq03ijACSNrDGq5uR9Cz7ZOQvFo32KKAC7HqxQk9tbxwW7c-4gYuiMBiSU_RDgzedrLgk6eqP9pMK2d1RtTx0AjafWkSDVEKYy3Cb9r_tT3SFKEkECQoA54fVbraP5wO/s1600/IMG_4388.JPG" height="400" width="266" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">{Tessie B. Dog}</td></tr>
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com1tag:blogger.com,1999:blog-3798690260169589326.post-87809266487364818422015-03-08T11:43:00.000-07:002015-03-08T11:43:51.897-07:00Inpatient + influenza<div class="separator" style="clear: both; text-align: left;">
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfSZWIuWAD2vF_1sG4HxpZf0y9FQqf1SlQpFoFxdfGDP7pNroOCN_FD7BCCZR7LJtcvq8W5AYCDCRCrEjqh0fuV2uEa2dTRkwIlxsLbL-nNZese7L-Xs2YquEyyM3yJ0f40HI0YeMH81Oz/s1600/IMG_4784.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfSZWIuWAD2vF_1sG4HxpZf0y9FQqf1SlQpFoFxdfGDP7pNroOCN_FD7BCCZR7LJtcvq8W5AYCDCRCrEjqh0fuV2uEa2dTRkwIlxsLbL-nNZese7L-Xs2YquEyyM3yJ0f40HI0YeMH81Oz/s1600/IMG_4784.JPG" height="320" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{College hockey is really growing on me! UMass Lowell vs. UVM.<br />And a new scarf made by my dear Vickie!}</span></td></tr>
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<span style="font-family: 'Trebuchet MS', sans-serif;">Okay, so posting a daily picture has proven somewhat difficult--especially since I simultaneously started an inpatient rotation and started getting sick on Monday. Anyway, I took my first sick days of residency, and I think I'm on the mend now. Here are a few pictures from the past couple of weeks: </span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYLrPwaZhHjZ9F7a19a4G4d9AneaC5vJkehq43O0ATSyBP7_yBe4yI5NnnorQI2oI-_7dXlr4I3nBzC-G-lN2kAJBr7Kz4f_Q4KpLC8ZVsZQyNcQUp5RWVAMhe5u6SFNzJtZG_Z1PVEVLM/s1600/IMG_4664.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYLrPwaZhHjZ9F7a19a4G4d9AneaC5vJkehq43O0ATSyBP7_yBe4yI5NnnorQI2oI-_7dXlr4I3nBzC-G-lN2kAJBr7Kz4f_Q4KpLC8ZVsZQyNcQUp5RWVAMhe5u6SFNzJtZG_Z1PVEVLM/s1600/IMG_4664.JPG" height="400" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Zoey's first ice cream -- from the Ben & Jerry's factory!}</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgD8-TzW2MENrjOl5a8288LIZbl3-1pymxfePth_Gg1f-DeEk2Xw1ydUQzdFBh1kphrjqpqhQuCfTPlH0rriVlMSRZeHv5-BPte2-B_AAiGvsE7rOEuDdfkGeatSQR7isM8rUZApJRiZxh-/s1600/IMG_4641.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgD8-TzW2MENrjOl5a8288LIZbl3-1pymxfePth_Gg1f-DeEk2Xw1ydUQzdFBh1kphrjqpqhQuCfTPlH0rriVlMSRZeHv5-BPte2-B_AAiGvsE7rOEuDdfkGeatSQR7isM8rUZApJRiZxh-/s1600/IMG_4641.JPG" height="400" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{A daily occurrence during our "Vermont vacation week,"<br />which is actually a thing for schools in Vermont. <br />And I took the week off too, because why not?}</span></td></tr>
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<tr><td style="text-align: center;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaSP7eaW_Ch-T_CV2S_DWBb0FblwolNNhCO_OoUHBeBQQUc-0JdVt2ONfiUMt0KCtGjPQDSmLLv7d9z0cUih9kRmdVyzL7fjWvBcBP5LH6_BQZCAXQQlGOe4Igrd36YpFcH8qMXP4oorbo/s1600/IMG_4706.JPG" height="320" style="margin-left: auto; margin-right: auto;" width="240" /></td></tr>
<tr><td class="tr-caption" style="text-align: center;">{<span style="font-family: Trebuchet MS, sans-serif;">"Must. Lick. Baby." You can sort of see<br />my hand holding back Tessie's head}</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9EIe7XziFe0_BZlkhWfZN9iD-NWI9Zat0wU7guvcgoIANLPK2NSN2EAGq2L0RKzZJ2uYRJmZ0apSLEGX-f5YvFe39FJUlu3YbhGAL4PYLOw80H194sOrcvUyNRGCQ4aEUg3eRs1vxF_KJ/s1600/IMG_4729.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto; text-align: right;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9EIe7XziFe0_BZlkhWfZN9iD-NWI9Zat0wU7guvcgoIANLPK2NSN2EAGq2L0RKzZJ2uYRJmZ0apSLEGX-f5YvFe39FJUlu3YbhGAL4PYLOw80H194sOrcvUyNRGCQ4aEUg3eRs1vxF_KJ/s1600/IMG_4729.JPG" height="320" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Sweet cheeks!}</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAKN0Jpz0KTIOhVe6APsBLHyDiLD4WrYzYKjuzFVEPlSf-mIBErazPeeY3k3tD8816Phj5XouZcdh2PEY7npaisVGCjRe90pZMvAU9D5AobmVV79F2L2OGw30Rvxmi-_fOrxvsD5uLFPCQ/s1600/IMG_4780.JPG" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAKN0Jpz0KTIOhVe6APsBLHyDiLD4WrYzYKjuzFVEPlSf-mIBErazPeeY3k3tD8816Phj5XouZcdh2PEY7npaisVGCjRe90pZMvAU9D5AobmVV79F2L2OGw30Rvxmi-_fOrxvsD5uLFPCQ/s1600/IMG_4780.JPG" height="400" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Zoey likes cheek raspberries}</span></td></tr>
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0tag:blogger.com,1999:blog-3798690260169589326.post-37699922930060846012015-02-23T17:51:00.000-08:002015-02-23T17:51:02.482-08:00A few days<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<b style="font-family: 'Trebuchet MS', sans-serif;">Friday</b></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEguWbs3XfhHX8yP_2ySF9lXhYJXn7bDR714C16H0D3j_hz2aQ7cmzTjMFzpgUZi0XwfvZIQENpvnoZfegxTShbsM23zJwefKyE8FPmF_FdwsL3vndLE0svy9bTQA1nhHBZw0Od1PLKJCnDh/s1600/IMG_4564.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEguWbs3XfhHX8yP_2ySF9lXhYJXn7bDR714C16H0D3j_hz2aQ7cmzTjMFzpgUZi0XwfvZIQENpvnoZfegxTShbsM23zJwefKyE8FPmF_FdwsL3vndLE0svy9bTQA1nhHBZw0Od1PLKJCnDh/s1600/IMG_4564.JPG" height="400" width="300" /></a></td></tr>
<tr><td class="tr-caption"><span style="font-family: Trebuchet MS, sans-serif;">{a pager on the nightstand at home is better than a pager in a hospital call room <br />is better than staying up all night with a pager on my belt}</span><b style="font-family: 'Trebuchet MS', sans-serif; font-size: 12.8000001907349px; text-align: left;"><span style="font-size: small;"><br /><br /><div style="text-align: center;">
<b style="font-size: 12.8000001907349px;"><span style="font-size: small;">Saturday</span></b></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQ0FYMixjz5pb3CYMPT6LRek7zaoGL0oUJAs8sW84wKo_y1ycRayXMsnfyxmm_rCSf5JV5yoCDGu9SiEYhVL8sc9FdGIuyr41OrdLScv2HJrPrTjbepgG9NG_LgRGHIenA2wH94wOi2DLA/s1600/IMG_4638.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQ0FYMixjz5pb3CYMPT6LRek7zaoGL0oUJAs8sW84wKo_y1ycRayXMsnfyxmm_rCSf5JV5yoCDGu9SiEYhVL8sc9FdGIuyr41OrdLScv2HJrPrTjbepgG9NG_LgRGHIenA2wH94wOi2DLA/s1600/IMG_4638.JPG" height="320" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{winter bonfire with hot chocolate...with coconut rum}</span></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Mule Bar for a beer after skiing! And a thumb spica cast.}</span></td></tr>
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<b style="font-family: 'Trebuchet MS', sans-serif;">Monday</b></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Bill & Michelle arrived here today with Zoey Zo-Zo!}</span></td></tr>
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<span id="goog_476085420"></span><br />Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0tag:blogger.com,1999:blog-3798690260169589326.post-16127693309751788342015-02-19T19:08:00.002-08:002015-02-19T19:08:48.456-08:00Frozen lake<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjNtBzJvr-cm8-7wnnbAyLy2-jXDvrogUAUiqvTWNcZlYACl4QVD86DYSoTOgidYMIHYZ-j7kF5YIIXjrxPTeMIFm-cE2SOJHn_zlxvDmrS1VQV37mwti0aokS5Ld5CMOM352sqTT1luZLM/s1600/IMG_4561.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjNtBzJvr-cm8-7wnnbAyLy2-jXDvrogUAUiqvTWNcZlYACl4QVD86DYSoTOgidYMIHYZ-j7kF5YIIXjrxPTeMIFm-cE2SOJHn_zlxvDmrS1VQV37mwti0aokS5Ld5CMOM352sqTT1luZLM/s1600/IMG_4561.JPG" height="320" width="320" /></a></div>
<span style="font-family: Trebuchet MS, sans-serif;">Today I crossed Lake Champlain to work in a clinic in Plattsburgh, New York. The drive was treacherous in a few spots because of blowing snow, so I was relieved when I drove on board <a href="http://www.sevendaysvt.com/vermont/carving-the-commute-crossing-lake-champlain-in-winter/Content?oid=2325395" target="_blank">the ferry</a> and put the car in park. (The link is an article from a local newspaper about how the ferry captains manage in the winter.) I took the above picture of some chilly ducks on the frozen lake through my dirty car window as the ferry was pulling into the dock in Plattsburgh. It's blurry, but you get the idea! </span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">In the car, I started listening to the podcast <a href="http://serialpodcast.org/" target="_blank">Serial</a>...which means I'm a little behind the times, but I'll catch up someday (maybe)!</span>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0tag:blogger.com,1999:blog-3798690260169589326.post-65519072348409135732015-02-18T19:08:00.000-08:002015-02-18T19:13:45.698-08:00February 2015!?<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: 'Trebuchet MS', sans-serif; text-align: left;">I will blame residency for another lapse in posting! The days (and many of the nights...) have been full, and as I move from one rotation to the next, I am increasingly pleased with my match in family medicine. It is very fulfilling, though at times overwhelming, to be a witness to the full range of the human experience. I get to be the first person to hold a newborn baby, to support a family through the dying process, and to be there for people at every stage in between. There are daily reminders both of how difficult and of how great life can be. Every day is an adventure!</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">A few updates: </span></div>
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<li><span style="font-family: Trebuchet MS, sans-serif;">After 30 fracture-free years, Chris has broken both his collarbone and his right thumb this year, on separate occasions...</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">In spite of his fragility, he has had a great time working as a junior high teacher.</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">I'm more than halfway done with residency, which is crazy!</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">I was elected as a chief resident for next year.</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">Tessie is still awesome.</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">Vermont has been super cold but with great skiing conditions (see first bullet).</span></li>
<li><span style="font-family: Trebuchet MS, sans-serif;">We now have family in Vermont! My cousin Joey, his wife Andy, and their darling daughter Lucille have moved to Montpelier!</span></li>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{I started this blog as a way to keep family & friends updated on our lives,<br />and I haven't done a great job of it lately!<br />My new goal is to post a daily (or almost-daily) photo.<br />This is the first one...but I'm cheating, because I actually took this picture 4 days ago.<br />A lovely Valentine from a lovelier friend.}</span></td></tr>
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<br />Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com3tag:blogger.com,1999:blog-3798690260169589326.post-20814926239585157742014-09-18T18:53:00.000-07:002014-09-18T18:54:15.827-07:00Update<div class="separator" style="clear: both; text-align: center;">
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Lake Champlain sunset}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">The summer was busy, but I made it to my second year of residency! I'm enjoying an outpatient procedure month and working on a few different projects, including <a href="http://www.farmatvycc.org/#!health-care-share/cr43" target="_blank">Health Care Shares</a> and a group working on expanding the number of people with <a href="http://michelledorwart.blogspot.com/2014/04/birth-plans.html" target="_blank">advance directives</a>. And Chris got a job teaching junior high at a Catholic school that's 10 minutes from our house! We've gone apple picking twice so far this fall, and we're looking forward to the fall colors. Although I spent most of my summer in the hospital, there were a few highlights:</span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif; font-size: small;">{a new niece! adorable Zoey Elizabeth}</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQmPWMRbk2fx6vTf1uLAfvLSzj1QUcjilZh9EueVoYBodszmeOxCJWMIqFx9NDiC5AE0A7oKKgmjblLVbf3GC2izvBF8GRm2Ws02c8JPD8bRYheidzgcuhNvwwhfZVSI4Yawb1qBBRpQYk/s1600/Screen+Shot+2014-09-18+at+9.48.16+PM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQmPWMRbk2fx6vTf1uLAfvLSzj1QUcjilZh9EueVoYBodszmeOxCJWMIqFx9NDiC5AE0A7oKKgmjblLVbf3GC2izvBF8GRm2Ws02c8JPD8bRYheidzgcuhNvwwhfZVSI4Yawb1qBBRpQYk/s1600/Screen+Shot+2014-09-18+at+9.48.16+PM.png" height="304" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{<span style="font-size: small;"><a href="http://www.vtbrewfest.com/" target="_blank">Vermont Brew Fest</a>}</span></span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif; font-size: small;">{visitors, hiking, and <a href="http://www.highergroundmusic.com/event/545343-nickel-creek-shelburne/" target="_blank">a concert</a> (with <a href="http://www.benjerry.com/" target="_blank">free ice cream</a>)!}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3IgeauNyqGnuvjE5mHL_1LaygjZpdOVXq7hfelh4Kv3R3-RICI649lW10floRSnCsAIlaHLZ656dYw1Xd_VtFucxgZEgNX2JbNjhqs7DGmym68HzkyqkkaY87zYdW9XT-7A9MwNgoUOjG/s1600/10401488_10100136264866236_7089001339409280458_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3IgeauNyqGnuvjE5mHL_1LaygjZpdOVXq7hfelh4Kv3R3-RICI649lW10floRSnCsAIlaHLZ656dYw1Xd_VtFucxgZEgNX2JbNjhqs7DGmym68HzkyqkkaY87zYdW9XT-7A9MwNgoUOjG/s1600/10401488_10100136264866236_7089001339409280458_n.jpg" height="640" width="640" /></a></span><br />
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-8221257727763366452014-06-15T20:02:00.002-07:002014-06-15T20:05:21.027-07:00Happy Father's Day!<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYBZOhr2UB6hQUWdfc-Jg_nG_YPYrS3eLGxMWMy-zbaXdd4g1rmpWPpuhHT5AOPTUXMYrKLo_s1iGF6juPGSsOnNP_iGFv-OctdA15YgbR16caVHBXGz09yI4yBHSaFqFmXInPqJjXrpYT/s1600/photo+(1).JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYBZOhr2UB6hQUWdfc-Jg_nG_YPYrS3eLGxMWMy-zbaXdd4g1rmpWPpuhHT5AOPTUXMYrKLo_s1iGF6juPGSsOnNP_iGFv-OctdA15YgbR16caVHBXGz09yI4yBHSaFqFmXInPqJjXrpYT/s1600/photo+(1).JPG" height="400" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{My dad with a very chubby baby me}</span></td></tr>
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<span style="font-family: 'Trebuchet MS', sans-serif;">The other day, one of my fellow residents said to me, "Your dad really seems to have a lot of great tricks!," at which point I realized that I reference him quite a bit. </span><span style="font-family: Trebuchet MS, sans-serif;">I think about what he might do in any given situation, especially when I don't know what to do. He has a very practical approach to medicine, and he doesn't get too excited about things. He genuinely cares about his patients, and he has dedicated his life to caring for his community. I feel very lucky to have such a great role model, and I'm happy to have joined the "family business"! </span><br />
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<span style="font-family: Trebuchet MS, sans-serif; font-size: x-small;"><a href="http://michelledorwart.blogspot.com/2013/06/fathers-day.html" target="_blank">{Last Father's Day}</a></span>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-21360770716002157112014-05-10T19:00:00.001-07:002014-05-10T19:00:29.749-07:00Happy Mother's Day!<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7GmXqazu2ot-2nkCCzbqrN_7eem2LT9lEuGZXH4UXyPbT4rqNIKXAE0x5hjYnkSUXuGZB0425Z0S4wemw3pw5RqJnb9BthB8pkV312H6RqVf1TH1il4XJevu5QuIOwdeiNGL1ieAQZgLa/s1600/photo.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7GmXqazu2ot-2nkCCzbqrN_7eem2LT9lEuGZXH4UXyPbT4rqNIKXAE0x5hjYnkSUXuGZB0425Z0S4wemw3pw5RqJnb9BthB8pkV312H6RqVf1TH1il4XJevu5QuIOwdeiNGL1ieAQZgLa/s1600/photo.JPG" height="400" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{My mom & a 9-month-old me}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">My mom was 30 years old when I was born. And, as of today, it is 6 months until I turn 30. I don't know how she did it. I can hardly imagine having one child at this point, much less three! I feel tired enough as it is...today I slept until 11 (which is something I haven't done since college)! Granted, l</span><span style="font-family: 'Trebuchet MS', sans-serif;">ife has gotten very busy over the past week...I've been spending long days in the intensive care unit, taking care of people who are critically ill with the very diseases that I, as a primary care doctor, strive at each outpatient visit to help them avoid. I've enjoyed a day off today, and I'll be back in the ICU tomorrow for a 7-day stretch...so before that starts, I wanted to say how much I appreciate my lovely mother! </span><br />
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<span style="font-family: 'Trebuchet MS', sans-serif;">She stood outside many a department store dressing room with piles of jeans in hand, trying to find a single pair that was long enough for me while I cried inside. She drove thousands of miles to attend every single sporting event of every one of her four children. She has listened for hours while I vent on the phone about an arrogant doctor or a frustrating patient. I just can't say enough about how lucky I am to have her as my mom. </span><br />
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<span style="font-family: 'Trebuchet MS', sans-serif;">(A tradition that I share with my dad is sending cards late...to extend the celebration! So...your card will be coming later in the week, Mom!)</span>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-76707905162056814222014-05-02T21:08:00.000-07:002014-05-02T21:09:39.114-07:00Treat yo' self (to homemade pasta!)<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: Trebuchet MS, sans-serif;">Today was my last vacation day of my intern year, and it was a <a href="http://www.huffingtonpost.com/2012/12/11/parks-and-rec-treat-yo-self-new-episode_n_2276550.html" target="_blank">treat yo' self</a> day for me. I've been doing outpatient family medicine for the past month, and it has actually been a pretty relaxed time. I didn't have to get to work until 8 am, I took several days off when Chris's parents and <a href="http://michelledorwart.blogspot.com/2013/04/tbt-throwback-travel.html" target="_blank">brother</a> were in town for Easter, and, as an intern, I usually only see 8-9 patients per clinic day. But I needed a preemptive vacation for the 4 straight months of inpatient medicine that will start on Cinco de Mayo (ICU, family medicine inpatient service, inpatient pediatrics, and another month of family medicine inpatient service).</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgpvj2OEW-7pzpZ3dDvUQMD5PfQY5N6TSKxbQr-lj5B1-daLwRnoFivuTTZVqqrGO24PU25V7CePXElsRBAZIp_qKzfGdbDt-uQQoajuNh3mzLpIxGuli9xRaH1bi26M3kbmWayIWUj6hj/s1600/Screen+Shot+2014-05-02+at+10.56.39+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgpvj2OEW-7pzpZ3dDvUQMD5PfQY5N6TSKxbQr-lj5B1-daLwRnoFivuTTZVqqrGO24PU25V7CePXElsRBAZIp_qKzfGdbDt-uQQoajuNh3mzLpIxGuli9xRaH1bi26M3kbmWayIWUj6hj/s1600/Screen+Shot+2014-05-02+at+10.56.39+PM.png" height="178" width="320" /></a></div>
<span style="font-family: 'Trebuchet MS', sans-serif;">So today, as suggested by my lovely husband, I treated myself to a haircut AND an hour-long massage.</span><span style="font-family: 'Trebuchet MS', sans-serif;"> I woke up late, took Tessie for a leisurely stroll, did a few </span><a href="http://www.yogajournal.com/practice/1040" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">sun salutations</a><span style="font-family: 'Trebuchet MS', sans-serif;">, and headed over to the </span><a href="http://www.obriensavedainstitute.org/" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">Aveda Institute</a><span style="font-family: 'Trebuchet MS', sans-serif;"> (I tend to seek out </span><a href="http://michelledorwart.blogspot.com/2013/04/friday-april-12-2013-happy-things-day.html" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">Aveda schools wherever I live</a><span style="font-family: 'Trebuchet MS', sans-serif;"> for haircuts because of the price, the tea, and the scalp massages). It was glorious. And it cost a total of $59 (plus tips). After my spa morning, I came home, </span><a href="http://www.nytimes.com/2010/11/14/books/review/Weiner-t.html?pagewanted=all" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">did some reading</a><span style="font-family: 'Trebuchet MS', sans-serif;">, watched a couple of episodes of </span><a href="http://www.pbs.org/food/shows/a-chefs-life/" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">A Chef's Life</a><span style="font-family: 'Trebuchet MS', sans-serif;">, ate a maple-glazed donut that Chris bought me on his way home from work, drank an iced latte, and relaxed. </span><br />
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<span style="font-family: 'Trebuchet MS', sans-serif;">For dinner tonight, we made our own pasta (Chris has done this before, but I feel very excited when I participate in making dinner)! One of Chris's students sells eggs from his family's chickens by placing an icebox full of eggs at the end of his driveway next to a lock box and a sign that reads, "$2 per dozen eggs." And people actually leave money in the box! Chris was lucky enough to have his eggs hand-delivered by the purveyor, and we used those eggs to make our very own pasta. </span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgQCP9fv-XujRndGGMTzRsbbNLUt5XbvYULxN8JhuW6VCRmc88bsiHP8THoTCEa1UPhDBHvsruvrc13E2uSvua_flAGXRHn9e2fDFZMxmHaeXP2pMFqsJpwBKbq0UUW_6u-S0YH2tWFvPa/s1600/Screen+Shot+2014-05-02+at+8.16.41+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgQCP9fv-XujRndGGMTzRsbbNLUt5XbvYULxN8JhuW6VCRmc88bsiHP8THoTCEa1UPhDBHvsruvrc13E2uSvua_flAGXRHn9e2fDFZMxmHaeXP2pMFqsJpwBKbq0UUW_6u-S0YH2tWFvPa/s1600/Screen+Shot+2014-05-02+at+8.16.41+PM.png" height="320" width="320" /></a></div>
<span style="font-family: 'Trebuchet MS', sans-serif;">It was actually quite easy: eggs + flour for the dough, roll it very thin, then roll up the thin sheet, slice it thinly, and unroll the strips before placing them in boiling water for just a couple of minutes. </span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHhhlVPKXFNWdwUM1oOzN9gr7AEjKzBJ9E6CtLVYLVanMbxADkveVtNbcWTFkXtSqndnCvNT7GFv-0wf5oMVIzYFg2hKzE-d7AHh3OG_2ii0jx9IHJ2STupiW5D7vq6pEsH4TxR-6pehaH/s1600/Screen+Shot+2014-05-02+at+8.15.20+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHhhlVPKXFNWdwUM1oOzN9gr7AEjKzBJ9E6CtLVYLVanMbxADkveVtNbcWTFkXtSqndnCvNT7GFv-0wf5oMVIzYFg2hKzE-d7AHh3OG_2ii0jx9IHJ2STupiW5D7vq6pEsH4TxR-6pehaH/s1600/Screen+Shot+2014-05-02+at+8.15.20+PM.png" height="319" width="320" /></a></div>
<span style="font-family: 'Trebuchet MS', sans-serif;">While I was rolling and slicing the dough, Chris made an awesome <a href="http://www.nytimes.com/2013/12/16/health/mushroom-ragout.html" target="_blank">mushroom ragout</a>. We had a discussion about ragout versus ragu (which was fruitless--I still don't know the difference, aside from one being French and one being Italian. Maybe there is no difference?) and laughed about the time that we went to an <a href="http://www.vierestaurant.com/" target="_blank">upscale restaurant</a> and I ordered "rag-out." French pronunciations aren't really my thing.</span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfj4MdIkcg6mA5tgtlhlgUze3Svl-byCCBK5m32WcilBecTWVa0OMh_qjSlxTf_as8ZaUBD6kCiCryD6HZpoa_PB0XTRmSjCra5gKXSxZnHeDZAWHlBLyuW2amgZ-0wvmrThaMfPFGC0N_/s1600/Screen+Shot+2014-05-02+at+8.18.04+PM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfj4MdIkcg6mA5tgtlhlgUze3Svl-byCCBK5m32WcilBecTWVa0OMh_qjSlxTf_as8ZaUBD6kCiCryD6HZpoa_PB0XTRmSjCra5gKXSxZnHeDZAWHlBLyuW2amgZ-0wvmrThaMfPFGC0N_/s1600/Screen+Shot+2014-05-02+at+8.18.04+PM.png" height="320" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{the final result}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">We don't have much planned for the weekend, aside from a <a href="http://michelledorwart.blogspot.com/2014/04/life-in-green-mountain-state.html" target="_blank">Vermont Restaurant Week</a> trip to a <a href="http://henofthewood.com/" target="_blank">popular restaurant</a> in a nearby town tomorrow night (it's so popular, in fact, that I called 3 weeks ago and the only reservation available was for the last night of restaurant week at 9 pm). Aside from that, we will probably drink some coffee and enjoy my last two-day weekend for...a while.</span>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-35941737046775906622014-04-26T20:26:00.000-07:002014-04-27T12:05:28.273-07:00Life in the Green Mountain State<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFiSLtEP9uwjrbexQbc9qM7_orDe8OaS66GO9pTj9jjEj16lr20IRRtbe-NizbIcV0rPAZEJtqYtyfquG1zoYI2lm4D8vdBJzQp0YjT3A36RxSwNIMgzFJFtRc6azWDEHn6Q2KzvkCxqxa/s1600/Image.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFiSLtEP9uwjrbexQbc9qM7_orDe8OaS66GO9pTj9jjEj16lr20IRRtbe-NizbIcV0rPAZEJtqYtyfquG1zoYI2lm4D8vdBJzQp0YjT3A36RxSwNIMgzFJFtRc6azWDEHn6Q2KzvkCxqxa/s1600/Image.jpg" height="400" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{views of Vermont}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;"><a href="http://michelledorwart.blogspot.com/2013/07/vermonters.html" target="_blank">We've been living in Vermont</a> for about 10 months now, and we've found that there's a lot to love about this state and all its quirky crunchiness. I'm a big fan of making top ten lists as a way to embrace the good things in life (especially when I get stuck in a <a href="http://joannagoddard.blogspot.com/2011/11/do-you-worry-too-much.html" target="_blank">worrying rut</a>, as I occasionally do)...so here is my Vermont top ten list!</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">10. Recycling: everyone's doing it. </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">{</span><a href="http://www.anr.state.vt.us/dec/wastediv/solid/act148.htm" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">Universal Recycling Law</a><span style="font-family: 'Trebuchet MS', sans-serif;"> & </span><a href="http://blog.fletcherallen.org/community/greening-the-operating-room/" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">Green OR's</a><span style="font-family: Trebuchet MS, sans-serif;">}</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">9. The beer. </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">We've been to 9 <a href="http://www.vermontbrewers.com/" target="_blank">breweries</a> so far...just 20 to go! </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">{<a href="http://www.fiddleheadbrewing.com/?month=1&day-num=1&year-num=1984" target="_blank">Fiddlehead</a> & <a href="http://www.hillfarmstead.com/main/" target="_blank">Hill Farmstead</a> are my favorites.} </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">8. Farmers' Markets galore </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">{<a href="http://www.fletcherallen.org/services/administrative/nutrition_services/farmers_market/" target="_blank">There's even one in the hospital!</a>}</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">7. People are generally laid-back and low-key. </span><br />
<span style="font-family: Trebuchet MS, sans-serif;">{Lots of jeans, fleece vests, and duck boots}</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">6. So. Many. Baguettes. </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">{<a href="http://augustfirstvt.com/the-baguette/" target="_blank">August First</a>, <a href="http://www.redhenbaking.com/" target="_blank">Red Hen</a>, <a href="http://www.klingersbread.com/" target="_blank">Klinger's</a>, <a href="http://www.obread.com/" target="_blank">O Bread</a>, <a href="http://www.sevendaysvt.com/vermont/his-daily-bread/Content?oid=2132082" target="_blank">Gerard's</a>...}</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">5. The food--which deserves a separate bullet point from the baguettes! </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">Everything on the menu has a name (<a href="http://www.uvm.edu/sustainableagriculture/Documents/farmLAPLATTE.pdf" target="_blank">LaPlatte River angus</a>, <a href="http://www.petesgreens.com/" target="_blank">Pete's Greens</a>, <a href="http://www.doesleap.com/" target="_blank">Does' Leap</a> cheese...) because everything comes from a local farm!</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">{I love <a href="http://revolutionkitchen.com/" target="_blank">Revolution Kitchen</a> & am so excited for <a href="http://www.vermontrestaurantweek.com/" target="_blank">Vermont Restaurant Week</a>}</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">4. The seasons.</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;"><a href="http://michelledorwart.blogspot.com/2013/08/a-prairie-home-companion.html" target="_blank">Summer</a>: gorgeous! green! no A/C required!</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;"><a href="http://michelledorwart.blogspot.com/2013/10/orange-you-glad-its-fall.html" target="_blank">Fall</a>: apples! leaves! amazingness!</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">Winter: long...but <a href="http://michelledorwart.blogspot.com/2014/04/birth-plans.html" target="_blank">SKIING!</a> snow! coziness!</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">Spring: wet...but <a href="http://www.vermontvacation.com/discover%20vermont/made%20in%20vermont/sugaring%20season.aspx" target="_blank">sugaring</a>! <a href="https://www.slopesidesyrup.com/" target="_blank">syrup</a>!</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">3. Forward-thinking health care systems. </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">{<a href="http://gmcboard.vermont.gov/" target="_blank">Green Mountain Care Board</a>, <a href="http://www.fletcherallen.org/services/primary_care/specialties/chronic_care/" target="_blank">Community Health Teams</a>, & <a href="https://www.youtube.com/watch?v=iYOf6hXGx6M" target="_blank">Bernie Sanders</a>}</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">2. Outdoor activities. </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">{Hiking, biking, skiing, snow shoeing, kayaking, sailing...}</span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">1. Overlook Park. </span><br />
<span style="font-family: Trebuchet MS, sans-serif;">{And all the other awesome natural beauty. I just can't get enough of it!}</span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqxXF4wmqh2ZoZ75eVzfHlF7SDVMlde_c4SrvVjtDgrCCwC6jFAV356-ATRZU9YF7oWK0bxGynLW-oS5en5GzfMy3IyKcMSBpBrKlNR4ZP3mkl58gSOpUwgVKjFzHhNvcLBHsVI5F19NA9/s1600/Screen+Shot+2014-04-26+at+11.14.46+PM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqxXF4wmqh2ZoZ75eVzfHlF7SDVMlde_c4SrvVjtDgrCCwC6jFAV356-ATRZU9YF7oWK0bxGynLW-oS5en5GzfMy3IyKcMSBpBrKlNR4ZP3mkl58gSOpUwgVKjFzHhNvcLBHsVI5F19NA9/s1600/Screen+Shot+2014-04-26+at+11.14.46+PM.png" height="372" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Overlook Park}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">P.S. <a href="http://michelledorwart.blogspot.com/2013/05/top-ten.html" target="_blank">Top ten</a> & <a href="http://michelledorwart.blogspot.com/2013/04/life-in-charm-city.html" target="_blank">Life in the Charm City</a></span></div>
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-25497742241633294942014-04-13T19:15:00.001-07:002021-10-28T05:02:58.422-07:00Birth plans<span face="Trebuchet MS, sans-serif">The past few months have been full of long work days and as much skiing as we could squeeze in on days off. Over the course of this ski season, Chris has had more opportunities to ski than I have--and he has gone from being nervous on the bunny hill to cruising down black diamond runs. I'm very proud of his progress and excited that he's providing me with a new ski buddy!<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiIqPPJG0eLeW6yoGKTQTt7xhxH1bEGiefkPqBDrJZGAHNvj4wHgz2ZfhSFl2zgpXtefuIx1h9aHXjfu3Pw4qJhAts6mGpnWjrydq6wJhJadnJ44DVFU2S0o_TiHUiWMAMllwgY55jaS836/s1600/photo.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiIqPPJG0eLeW6yoGKTQTt7xhxH1bEGiefkPqBDrJZGAHNvj4wHgz2ZfhSFl2zgpXtefuIx1h9aHXjfu3Pw4qJhAts6mGpnWjrydq6wJhJadnJ44DVFU2S0o_TiHUiWMAMllwgY55jaS836/s1600/photo.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">{View from the top! <a href="http://www.sugarbush.com/vermont-real-estate/base-area-renovation" target="_blank">Lincoln Peak</a>; <br />
A spring skiing day in early April}</td></tr>
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<span face="Trebuchet MS, sans-serif">Over the past month, whenever I haven't been out skiing (i.e. most of the time), I have been catching babies on labor & delivery. </span><span face="'Trebuchet MS', sans-serif">I have been fascinated by the degree to which expectant parents try to plan their respective birth experiences. They arrive to the labor & delivery unit bearing detailed outlines of how they want the process to unfold. The bullet points vary widely: </span><i style="font-family: "Trebuchet MS", sans-serif;">We would like to listen to music</i><span face="'Trebuchet MS', sans-serif">, </span><i style="font-family: "Trebuchet MS", sans-serif;">I want to experience an <a href="http://abcnews.go.com/Health/story?id=6120045" target="_blank">orgasmic birth</a></i><span face="'Trebuchet MS', sans-serif">, </span><i style="font-family: "Trebuchet MS", sans-serif;">we would like to </i><a href="http://parenting.blogs.nytimes.com/2012/03/25/i-regret-eating-my-placenta/" style="font-family: "Trebuchet MS", sans-serif; font-style: italic;" target="_blank">bring the placenta home</a><span face="'Trebuchet MS', sans-serif">, </span><i style="font-family: "Trebuchet MS", sans-serif;">I want a <a href="http://www.fletcherallen.org/services/womens_health/specialties/midwifery1/services/birthing_care/waterbirth/" target="_blank">water birth</a></i><span face="'Trebuchet MS', sans-serif">, </span><i style="font-family: "Trebuchet MS", sans-serif;">no medical students in the <a href="http://www.fletcherallen.org/services/womens_health/specialties/birthing/patient_resources/birthing_center_virtual_tour/birthing_center_virtual_tour.html" target="_blank">delivery room</a>. </i><span face="'Trebuchet MS', sans-serif">Most of the requests are fairly reasonable, though some are a bit bossy: </span><i style="font-family: "Trebuchet MS", sans-serif;">Dad SHALL NOT be asked if he would like to cut the umbilical cord</i><span face="'Trebuchet MS', sans-serif">. </span><br />
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<span face="Trebuchet MS, sans-serif">I am wholly in favor of education about and preparation for the delivery process. In fact, it would be even better if people were more educated and prepared for the <i>entire </i>pregnancy before it begins: </span><span face="'Trebuchet MS', sans-serif"><a href="http://www.plannedparenthood.org/" target="_blank">planning the timing of the pregnancy</a>,</span><span face="'Trebuchet MS', sans-serif"> <a href="https://www.womenshealth.gov/pregnancy/before-you-get-pregnant/preconception-health.html" target="_blank">o</a></span><span face="'Trebuchet MS', sans-serif"><a href="https://www.womenshealth.gov/pregnancy/before-you-get-pregnant/preconception-health.html" target="_blank">ptimizing the mother's health</a>, </span><span face="'Trebuchet MS', sans-serif"><a href="http://my.clevelandclinic.org/healthy_living/pregnancy/hic-fetal-development-stages-of-growth.aspx" target="_blank">understanding the stages of development of the fetus</a>...the more {health-focused} education and preparation, the better! Knowing what to expect is empowering. It reduces fear and stress, which is ultimately healthier for everyone involved. <i>And </i>I'm in favor of limiting interventions as much as possible--why interfere with the process if it's going well? (I'm fortunate to be training in a very non-interventionist hospital; I've definitely been in hospitals that are far on the opposite end of the spectrum.)</span><br />
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<span face="Trebuchet MS, sans-serif"><i>However</i>, I do wonder whether some of the preoccupation with having a magical birth experience is misdirected--if a baby is born by c-section because of a <a href="http://emedicine.medscape.com/article/252810-overview" target="_blank">placental abruption</a> or induced because of <a href="http://emedicine.medscape.com/article/261137-overview" target="_blank">premature rupture of membranes</a>, should the parents be upset because their experience was ruined? Is their baby's life off to a "bad" start? After all, if mom and baby are healthy in the end, how important is it that there was a medical student helping hold one of mom's legs or if the doctor (heaven forbid) offered dad the scissors to cut the cord when he hadn't wanted to do it? </span><br />
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<span face="Trebuchet MS, sans-serif">Another factor that I find troubling is how people in general spend relatively little time <a href="http://www.nlm.nih.gov/medlineplus/advancedirectives.html" target="_blank">planning for the opposite end of life's spectrum</a>--that is, planning how we would like to die. Too many times, I have seen lives prolonged (or, often more aptly, hearts continue beat) as a result of painful, unnecessary, or futile interventions simply because of a lack of thoughtful discussion ahead of time. </span><br />
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<span face="Trebuchet MS, sans-serif">Perhaps it's because "birth plan" has a much more pleasant ring than does "<a href="http://online.wsj.com/news/articles/SB10001424127887324577304579054880302791624" target="_blank">death plan</a>"? Maybe the <a href="http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289" target="_blank">advance directive websites</a> are less appealing than is <a href="http://thebump.com/"><span style="color: purple;">thebump.com</span></a>? Or perhaps we find the prospect of a loved one's death is so terrifying that we are willing to subject their failing bodies to veritable torture for even a glimmer of hope that they will pull through and go on living as though they hadn't had a stranger cracking their ribs and shoving tubes into every bodily orifice. While some people may wish to have the doctors "do everything" to save their lives, when I ask patients about their <a href="http://www.huffingtonpost.com/brian-secemsky/hospital-codes_b_2892700.html" target="_blank">code status</a> (as is required with every hospital admission), almost invariably they will say, "I don't want to be kept alive with machines."</span><br />
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<span face="Trebuchet MS, sans-serif">Like birth, death is something that happens to all of us. Of course, with both birth and death, we may simply have no choice about how events transpire. But it's possible that we (or our family members by proxy) may have some say in the medical care we receive at the end of life--<a href="http://www.nytimes.com/2013/11/20/your-money/how-doctors-die.html?_r=0" target="_blank">shouldn't we try to plan for that too</a>?</span></div>
Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com1South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-31124432305333686662014-03-09T12:36:00.000-07:002014-03-09T12:36:07.749-07:00My fellow residents<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQjYvf61hGdMgfA90dBVWDJ4dzuDSXp3_TyrQAHLiWFZUMsfY6qMETBMBqCxvWBHGJFDwio3I5LKfWrsN-w3I2ldNCdPpfeGGObyH5sIdTq0CsHnnTrWIndxDhHRRPquyyjBPFVfLSHUVF/s1600/1982086_982870926946_238698423_n.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQjYvf61hGdMgfA90dBVWDJ4dzuDSXp3_TyrQAHLiWFZUMsfY6qMETBMBqCxvWBHGJFDwio3I5LKfWrsN-w3I2ldNCdPpfeGGObyH5sIdTq0CsHnnTrWIndxDhHRRPquyyjBPFVfLSHUVF/s1600/1982086_982870926946_238698423_n.jpg" height="480" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Family Medicine residents at <a href="http://americanflatbread.com/restaurants/burlington-vt/" target="_blank">American Flatbread</a>}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">My intern year has flown by (to the point that I haven't had a single post since <a href="http://michelledorwart.blogspot.com/2013/11/recent-happenings.html" target="_blank">November</a>)! I've managed to make it through 9 of 13 rotations so far: ER, labor & delivery, inpatient cardiology, NICU/newborn nursery, urgent care, inpatient family medicine, general surgery, outpatient pediatrics, and inpatient pediatrics. Tomorrow, I'll start back on labor & delivery -- week 37 of my intern year (I'll be delivering babies conceived at around the time I started residency)! </span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">The year has definitely been challenging, and I couldn't be more grateful to have the support of a <a href="http://gme.fletcherallen.org/programs/family_medicine/programs_offered/family_medicine_residency/resident_bios/" target="_blank">fantastic group of residents</a> and <a href="http://providers.fletcherallen.org/Default.asp?P=Y&ProviderType=8&SpecID=92" target="_blank">attendings</a>! Wednesday was our spring retreat, and we got to spend the day doing yoga, eating pizza, and cross-country skiing -- I think I'll stick with the downhill (read: faster) version, but it was fun to try something new! </span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">Match day is coming up very soon, and I'm looking forward to finding out who'll be joining us in July!</span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{interns with Dr. Koutras at <a href="http://www.aafp.org/about/initiatives/also.html" target="_blank">ALSO</a> last July}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;"><br /></span>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-7224789082649864682013-11-17T13:59:00.000-08:002014-02-02T07:13:45.827-08:00Recent happenings<span style="font-family: Trebuchet MS, sans-serif;">On Monday, October 28, my first niece was born! That morning, my brother sent me a text message at 6 am (4 am for them), stating that they were at the hospital, 8 cm dilated. Twenty minutes later, another message: Marion Jean Dorwart, 6 pounds 12 ounces, 19 inches (the name was inspired by <a href="http://en.wikipedia.org/wiki/Marion_Ravenwood" target="_blank">this Indiana Jones character</a>, and the middle name by baby's maternal great-grandmother). She is beautiful, and I can't wait to meet her in person!</span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{Dad/Grandpa, Dan/Dad, & Baby Marion}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">Halloween weekend, I made a trip to Philadelphia with a group from my residency program to attend the Family Medicine Education Consortium, leaving Chris to hand out candy to a number of dragons and football players. I learned about leading <a href="http://healthland.time.com/2013/08/07/need-to-see-the-doctor-you-may-have-company-on-your-next-visit/" target="_blank">group medical visits</a> and heard a great speech about the future of primary care by Dr. <a href="http://www.pcpcc.org/profile/ted-epperly" target="_blank">Ted Epperly</a>, while representing <a href="http://gme.fletcherallen.org/programs/family_medicine/programs_offered/family_medicine_residency/" target="_blank">my residency program</a> to potential future residents. </span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">After the conference, I took a $3 <a href="http://us.megabus.com/" target="_blank">Megabus</a> ride to Washington, D.C., where I got to see a cousin, 2 uncles, and 3 great friends (one of whom happens to be a one-year-old) and to gather the remaining items we had left in storage at my uncle's apartment. </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">I rented a car and drove back to Burlington via a <a href="http://www.wjla.com/articles/2013/11/paramus-mall-shooting-police-release-video-and-911-calls-96930.html" target="_blank">random Ikea in New Jersey</a>, where I purchased a <a href="http://www.ikea.com/us/en/catalog/products/50213589/" target="_blank">china cabinet</a> that we assembled on my arrival home at 9 pm, in order to be prepared to host a dinner for 6 residency applicants and several of my fellow residents the following night. Chris was lovely enough to have spent the weekend making 3 delicious stews for the group, so we were well prepared <a href="http://www.buzzfeed.com/ariellecalderon/why-building-ikea-furniture-is-probably-satans-fa" target="_blank">after our cabinet was assembled</a>.</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;"><br /></span><span style="font-family: Trebuchet MS, sans-serif;">On November 7, our nephew turned one:</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">On November 9, Chris turned 30! And on November 10, I turned 29! We spent the weekend in Boston (and Lowell, MA). </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">And this week, we had our second houseguests since moving to Vermont! I was able to take a couple of days off to show Rachel, Dave, and Emily our new home. We checked out Stowe and the <a href="http://www.trappfamily.com/" target="_blank">Trapp Family Lodge</a>, toured the <a href="http://www.benjerry.com/scoop-shops/factory-tours" target="_blank">Ben & Jerry's Factory</a> (my third visit and second tour), ate some awesome food (<a href="http://revolutionkitchen.com/" target="_blank">Revolution Kitchen</a>, <a href="http://pennycluse.com/" target="_blank">Penny Cluse Cafe</a>, <a href="http://www.farmhousetg.com/home.html" target="_blank">Farmhouse Grill</a>, and <a href="http://skinnypancake.com/" target="_blank">Skinny Pancake</a>), visited a <a href="http://www.vtcheese.com/members/willowhill/willow.htm" target="_blank">cheese farm</a>, and learned about <a href="http://www.slopesidesyrup.com/" target="_blank">making syrup</a>. We're so glad they could come, and we're looking forward to hosting many more visitors!</span></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><a href="http://www.trappfamily.com/blog/brighid4tfl/2010/06/happy-herd" target="_blank">{Scottish Highlander cows at the Trapp Family Lodge}</a></span></td></tr>
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-6005544563248890972013-10-07T17:31:00.000-07:002013-10-08T04:21:52.357-07:00Orange you glad it's fall?<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: Trebuchet MS, sans-serif;"><a href="http://www.discovernewengland.org/" target="_blank">New England</a> is famous for its <a href="http://www.fodors.com/news/photos/the-6-best-fall-foliage-drives-in-new-england#!1-intro" target="_blank">beautiful fall foliage</a>, and so far we have not been disappointed! The past few weeks have been very fall-y, which has been glorious!</span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjw5hQTvmCJ2ydKxVHMQbPTOXhsiSgrK1IuTytO-T1N3y7PEw-tUVIj0e82nfcKeotMP0GDV-drkVo4STWRvw8UXtSSTVcuhqaBOHD4_yTDm8cnc2ILyg6iXyxOFRKhCkeW1tXdkYe1sr-N/s1600/Screen+Shot+2013-10-07+at+5.28.01+PM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjw5hQTvmCJ2ydKxVHMQbPTOXhsiSgrK1IuTytO-T1N3y7PEw-tUVIj0e82nfcKeotMP0GDV-drkVo4STWRvw8UXtSSTVcuhqaBOHD4_yTDm8cnc2ILyg6iXyxOFRKhCkeW1tXdkYe1sr-N/s1600/Screen+Shot+2013-10-07+at+5.28.01+PM.png" height="400" width="397" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{a lovely morning walk near our house}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">The last weekend of September, we celebrated the beautiful weather by going <a href="http://www.vermontapples.org/orchard-listing.php" target="_blank">apple picking</a> (with some incidental <a href="http://leafpeepers.com/" target="_blank">leaf peeping</a> on the way)! The only hard part was deciding which orchard to visit, since we live in the state with the most farmers' markets/CSA's per capita (<a href="http://www.upworthy.com/new-york-and-california-are-conspicuously-absent-from-one-ranking-of-coolness?g=2" target="_blank">by far!</a>)! Chris convinced me to return again this past weekend (not that I needed much convincing) by dropping a few hints:</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibOlYOeQUPP_w9nosu4I9g1I6MFlXc53Rj9hKO6b_g7jV0Pfk9-zgrVCWa-P4vUCQa5wLUPdFarn0rUHkeBPa_2a_DtTEWPhRgaXoAhS2H2oYoQ7_Is9CUUeRl0Ho1nTLZTwSCuxl2N3To/s1600/Screen+Shot+2013-10-01+at+3.27.56+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibOlYOeQUPP_w9nosu4I9g1I6MFlXc53Rj9hKO6b_g7jV0Pfk9-zgrVCWa-P4vUCQa5wLUPdFarn0rUHkeBPa_2a_DtTEWPhRgaXoAhS2H2oYoQ7_Is9CUUeRl0Ho1nTLZTwSCuxl2N3To/s1600/Screen+Shot+2013-10-01+at+3.27.56+PM.png" height="227" width="320" /></a></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{<a href="http://www.vermontapples.org/" target="_blank">apple picking</a> & <a href="http://www.travelchannel.com/interests/road-trips/articles/leaf-peeping-road-trip-tips" target="_blank">leaf peeping</a>}</span></td></tr>
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<span style="font-family: 'Trebuchet MS', sans-serif;">In addition to apples, we also bought pumpkins, cider, apple donuts, pears, and butternut squash at the orchard. We integrated half of the squash into a </span><a href="http://www.marthastewart.com/343497/chicken-potpie-with-puff-pastry" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">chicken pot pie</a><span style="font-family: 'Trebuchet MS', sans-serif;"> (very easy...frozen puff pastry!), and Chris used the other half to make butternut squash pasta sauce!</span></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg90q68EYcY-nDsmNokaxF3G7Go9dIdtL8zlWgSsZAnCnWh_erDEcWSZVacUgDuBV4YbGOqp-r_BS0xs8SrZNvAbJj1PMTrPlxjCXtkG_A9P1YYe1G3lHRc5kKF9Ee5IrRt_LNwktlHasmK/s1600/Screen+Shot+2013-10-07+at+7.55.47+PM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg90q68EYcY-nDsmNokaxF3G7Go9dIdtL8zlWgSsZAnCnWh_erDEcWSZVacUgDuBV4YbGOqp-r_BS0xs8SrZNvAbJj1PMTrPlxjCXtkG_A9P1YYe1G3lHRc5kKF9Ee5IrRt_LNwktlHasmK/s1600/Screen+Shot+2013-10-07+at+7.55.47+PM.png" height="210" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{chicken pot pie with squash & <a href="http://www.womansday.com/recipefinder/jack-o-lantern-chicken-sweet-potato-potpies-recipe-123644" target="_blank">jack-o-lantern crust</a>}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">More fall fun:</span><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6iNqeAvqUcnWGN6LbBuCqF6YhigpgnsYSKOyCCWSyVltTFANBqPNzeTMHXJnjE9wXzyUmzp9fmgawLacfMO88eO-N503kxnDVLlk0hbiWP8LV6RWfReqEaJ2G0D84kxhoE_SOn_MTqw0p/s1600/Screen+Shot+2013-10-07+at+7.48.59+PM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6iNqeAvqUcnWGN6LbBuCqF6YhigpgnsYSKOyCCWSyVltTFANBqPNzeTMHXJnjE9wXzyUmzp9fmgawLacfMO88eO-N503kxnDVLlk0hbiWP8LV6RWfReqEaJ2G0D84kxhoE_SOn_MTqw0p/s1600/Screen+Shot+2013-10-07+at+7.48.59+PM.png" height="209" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{I really liked this truck-and-tree combo, <br />a <a href="http://www.chicagobears.com/" target="_blank">Chicago Bears</a>/<a href="http://gocreighton.com/" target="_blank">Creighton Bluejays</a> pumpkin, <br />Chris wanted me to support the <a href="http://www.ebaumsworld.com/video/watch/38858/" target="_blank">Bears</a> with my fingernails}</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPcEk-FdhGQDD9nV5pAUPHRk-xnRABP3D0dn9Z42oLIGJaZIlVF362aMaiTi6vwL2xzKtqtabnzz1XPXI-qlgqQ2Uby0GatW7RPXttfK_byviNKFuct-5UYQtTnMyYMof9viMm_KBr-6Fl/s1600/Screen+Shot+2013-10-07+at+7.49.17+PM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPcEk-FdhGQDD9nV5pAUPHRk-xnRABP3D0dn9Z42oLIGJaZIlVF362aMaiTi6vwL2xzKtqtabnzz1XPXI-qlgqQ2Uby0GatW7RPXttfK_byviNKFuct-5UYQtTnMyYMof9viMm_KBr-6Fl/s1600/Screen+Shot+2013-10-07+at+7.49.17+PM.png" height="220" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{delicious fall food: <a href="http://www.meatlessmonday.com/pumpkin-pie-pancakes/" target="_blank">pumpkin pie pancakes</a> with <a href="http://vermontmaple.org/" target="_blank">Vermont maple syrup</a>,<br />pumpkin spice latte à la Chris (way better than Starbucks),<br />homemade chili with homemade croutons...but <a href="http://www.cheesetraders.com/" target="_blank">we bought the cheese</a>}</span></td></tr>
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-88024351822015118982013-10-03T21:18:00.000-07:002014-04-26T20:42:56.587-07:00Adventurers<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisKrB7R_6kSoKw3D7ioduyUPRIWJb5icDeHripQ9NKJqjsljqOGyKTz17mxZ4IfPHbH-EsU3CEcE6SPadrEX1mB11K_3CcqCbvx4F3BndwsfyViv4VcVL6weBe8RARjbkvODHMDgVPQyJ6/s1600/Screen+Shot+2013-10-01+at+3.21.55+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEisKrB7R_6kSoKw3D7ioduyUPRIWJb5icDeHripQ9NKJqjsljqOGyKTz17mxZ4IfPHbH-EsU3CEcE6SPadrEX1mB11K_3CcqCbvx4F3BndwsfyViv4VcVL6weBe8RARjbkvODHMDgVPQyJ6/s1600/Screen+Shot+2013-10-01+at+3.21.55+PM.png" height="170" width="640" /></a></div>
<span style="font-family: 'Trebuchet MS', sans-serif;"><br /></span><span style="font-family: 'Trebuchet MS', sans-serif;">After a month of feeling constantly as though I was struggling to keep my head above water, I am feeling much more relaxed...at least in part because I am no longer working on the chaotic cardiology service! I have moved on to <a href="http://www.secretsofbabybehavior.com/" target="_blank">taking care of babies</a>--two weeks in the NICU, then two weeks in the newborn nursery. </span><br />
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<span style="font-family: 'Trebuchet MS', sans-serif;">At one point during my cardiology rotation, Chris said, "Life is a lot more enjoyable when we view it as an adventure instead of as a chore." Which is very true--and easier to enact at some times more than others. But, in addition to being an adventure, life is a work in progress! </span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">In a few days, it will be 7 years since the day Chris and I met at a bar in <a href="http://michelledorwart.blogspot.com/2013/04/tbt-throwback-travel.html" target="_blank">Granada</a> and our shared adventures began. </span><span style="font-family: 'Trebuchet MS', sans-serif;">We've done a lot together since that time: we've traveled to 4 countries, lived in 4 states (and traveled to...20?), earned 5 degrees between the two of us, raised a puppy, and made lots of great new friends (while also enjoying our "old" friends). Every morning when I wake up, and every night when I get home from work (throughout the day too!), I am just so happy to have Chris (and Tessie) by my side as I experience all the ups and downs (and sidewayses?) of life. I can't wait to see what other adventures we have in store! </span><span style="font-family: 'Trebuchet MS', sans-serif;">(Good thing we have </span><span style="font-family: Trebuchet MS, sans-serif;"><a href="http://www.amazon.com/Indiana-Jones-Handbook-Denise-Kiernan/dp/1594742219" target="_blank">this book</a>--which I got Chris for our <a href="http://michelledorwart.blogspot.com/2013/07/third-anniversary.html" target="_blank">first wedding anniversary</a>--to help us prepare for whatever we might face</span><span style="font-family: 'Trebuchet MS', sans-serif;">!) </span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif; font-size: x-small;">{Chris's first impression of me, as shared by a friend after we got engaged}</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJKHHxZMuFczc_cDsX-xeKxTGi-4jbgyfTzDQvCNz3W_mXz8_5LaTAZWDScXZIcNqbUIJAQP0P_Q_pIuR00DuGe30dRPTPr98BHiRCYwSED1KEz7mGCv2_4vi-in8yEohxbTg_NTVRmKN3/s1600/Screen+Shot+2013-10-03+at+11.51.21+PM.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJKHHxZMuFczc_cDsX-xeKxTGi-4jbgyfTzDQvCNz3W_mXz8_5LaTAZWDScXZIcNqbUIJAQP0P_Q_pIuR00DuGe30dRPTPr98BHiRCYwSED1KEz7mGCv2_4vi-in8yEohxbTg_NTVRmKN3/s1600/Screen+Shot+2013-10-03+at+11.51.21+PM.png" height="247" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{I happened upon Chris's student ID from the CLM today<br />while searching for documents to register our car.<br />My first impression of him included bleached-blonde hair...}</span></td></tr>
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<span style="font-family: Trebuchet MS, sans-serif;">Some fun links:</span><br />
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<li><a href="http://www.spainontheroadagain.com/" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">Adventures & delicious food in Spain</a><span style="font-family: 'Trebuchet MS', sans-serif;"> (a TV show we've been watching lately, which has inspired Chris to go on a cooking-Spanish-food-every-night kick...which I enjoy thoroughly)</span></li>
<li><a href="http://www.wikihow.com/Be-Adventurous" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">How to be adventurous</a></li>
<li><a href="http://dsc.discovery.com/tv-shows/man-woman-wild/videos/man-woman-wild.htm" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">The ultimate adventure duo</a></li>
<li><a href="http://abcnews.go.com/Health/Wellness/surprising-heart-attack-triggers/story?id=20182514#" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">Surprising heart attack triggers</a><span style="font-family: 'Trebuchet MS', sans-serif;"> (as a follow-up to my cardiology rotation)</span></li>
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0Burlington, VT, USA44.4758825 -73.21207199999997844.385267 -73.373433499999976 44.566497999999996 -73.05071049999998tag:blogger.com,1999:blog-3798690260169589326.post-56229157352990049012013-08-26T18:54:00.000-07:002013-08-26T18:56:47.916-07:00Second guesses<span style="font-family: Trebuchet MS, sans-serif;">I finished up my L&D month with 20 deliveries*! And one of the chief residents told me that my cervical checks were "good all along," which was lovely to hear, although I do have my doubts as to the veracity of that statement.</span><br />
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<span style="font-family: Trebuchet MS, sans-serif; font-size: x-small;">*or "I caught 20 babies"--some people get touchy about doctors/midwives saying, "I delivered a baby," because they want us to say, "I caught a baby." I just think it sounds weird to say "catch a baby"...so I don't say it. But in saying "I delivered," I am not implying that I somehow did more work than the mother. By no means! The mothers do all the work! I just don't want to start saying "catch babies," because it sounds weird and overly colloquial to me...</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">I will miss the <i>amazing</i> view of Burlington, Lake Champlain, and the Adirondacks from the labor and delivery lounge (most cardiology patients are a few floors down from the L&D floor...with a less impressive view). I can't imagine a more beautiful place in which to birth a child! If we decide to add to our family while I'm in residency, I will put in a request for the corner room with a view (and perhaps we should attempt to have an October due date to enjoy the fall colors)! </span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">Today I started my month of cardiology. Or "catching heart attacks...?" It should be interesting. Lots of intervention, lots of money...lots of "<a href="http://www.youtube.com/watch?v=xYeAmafTGCA" target="_blank">downstream</a>" management of problems that could often be averted if more time were spent on the "<a href="http://www.upstreampublichealth.org/" target="_blank">upstream</a>" prevention. But...as many of my MPH professors said, "if I'm having my heart attack, I'll want a doctor who knows how to do all the right interventions." In other words...we can't not treat people just because they chose to smoke, eat Whoppers, and not exercise for 67 years of their lives. I'm sure it will be a very educational month! </span><br />
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<span style="font-family: Trebuchet MS, sans-serif; font-size: x-small;">(The only bad part is that I am not able to take time off, that I will be working 6 loong days each week, and that we will be missing the wonderful wedding of our lovely friends, <a href="http://katherineandrandal.wordpress.com/" target="_blank">Katherine & Randal</a>, in Indiana this coming weekend. This is the 4th wedding we're missing this summer and the 10th(ish) we're missing in the past year due to location, schedule, and lack of money. Sometimes I wonder about my life choices...)</span><br />
<span style="font-family: Trebuchet MS, sans-serif;"><br /></span><span style="font-family: Trebuchet MS, sans-serif;">Speaking of life choices, I often think that people are overcompensating for something when they act as though the decisions they've made in life are so wonderful and so perfect and that they wouldn't have wanted it any other way. Really? Because there are very few decisions I've ever been that certain about, even in retrospect. I still wonder about everything! What if I would've gone to Notre Dame for undergrad instead of deciding on Creighton. What if I would've been an English major? What if I applied for a Fulbright in Spain instead of Botswana? What if I had done Peace Corps? What if I had started a surgery residency right after med school instead of doing an MPH? What if I had become an OB/gyn? What if I had ranked a different family medicine residency higher than UVM? I think it's possible to be happy with a decision while still wondering about the alternatives. I even think it's possible to be happy with a decision while <i>wishing </i>for the alternatives. I don't really think there is <i>one </i>right path for anyone. </span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">Right now, I'm second guessing...well, basically everything. Last week, it was, <i>"Is this cervix 5 cm dilated or 7? Is it 40% effaced or 70?" </i>Today it was, <i>"Should I be worried about a potassium of 5.4 in an elderly man with severe cardiac disease?" </i>And in addition to the clinical second guessing, I'm wondering, <i>"Should I have tried to match in the combined family medicine-preventive medicine residency in Baltimore?" "Should we have looked into the availability of teaching positions more thoroughly before ranking UVM so highly?" "Did we make the wrong decision in moving here?" "Why didn't we move somewhere where we have friends?" </i></span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">We are certainly enjoying the beauty of our new home...and the amazing food...and the outdoor activities...and the adventure of being somewhere different...and the fact that we get to experience this together! But...I can't help but wonder!</span><br />
<br />Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0South Burlington, VT, USA44.4669941 -73.17096040000001344.285681600000004 -73.493683900000008 44.6483066 -72.848236900000018tag:blogger.com,1999:blog-3798690260169589326.post-8335706430880589192013-08-11T16:55:00.000-07:002013-08-11T16:55:05.746-07:00Golden weekend<span style="font-family: Trebuchet MS, sans-serif;">I've had two "golden" weekends in a row (i.e. both Saturday and Sunday off), and it's been really lovely. Labor and delivery is fun, but it can be stressful too...so it's nice to have the weekend to relax and regroup. Yesterday, we went to the <a href="http://www.burlingtonfarmersmarket.org/" target="_blank">Burlington Farmers' Market</a> and bought some <a href="http://www.todayifoundout.com/index.php/2010/04/carrots-used-to-be-purple-before-the-17th-century/" target="_blank">purple carrots</a>, stopped by a cute <a href="http://augustfirstvt.com/blog/" target="_blank">garage-turned-coffee shop</a> for cappuccino and a delicious "<a href="http://augustfirstvt.com/blog/" target="_blank">coffee toffee bar</a>," then picked up a baguette at a <a href="http://www.klingersbread.com/" target="_blank">local bakery</a> before heading home to read my new <a href="http://www.vanityfair.com/" target="_blank">Vanity Fair</a> and watch a few episodes of the extremely addictive <a href="http://www.buzzfeed.com/lyapalater/surprising-facts-about-orange-is-the-new-black" target="_blank">Orange is the New Black</a> on Netflix before dinner.</span><div>
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<span style="font-family: Trebuchet MS, sans-serif;">Today, we hiked <a href="http://www.vtstateparks.com/htm/camelshump.htm" target="_blank">Camel's Hump Mountain</a>--Tessie's first real mountain hike! </span></div>
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<span style="font-family: Trebuchet MS, sans-serif;">Tomorrow morning, I'll be back on L&D...I've been getting a bit more confident with my cervical checks, which makes life a lot easier! Chris is still on the hunt for a teaching job...we've been very surprised by the difficult job market for teachers in Vermont. In the meantime, we will keep enjoying life in this beautiful part of the country and hoping for the best!</span></div>
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{it gets chilly at night, even in August...so we had mini <br />hot chocolates after one of our nightly walks this week}</span></td></tr>
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Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0Vermont, USA44.5588028 -72.57784149999997741.6285143 -77.741415499999974 47.489091300000005 -67.41426749999998tag:blogger.com,1999:blog-3798690260169589326.post-54106310918557444132013-08-08T19:05:00.001-07:002013-08-08T19:05:45.959-07:00Throwback Thursday<span style="font-family: Trebuchet MS, sans-serif;">Five years ago today, two of my dearest friends got married! It's hard to believe how much can happen in five years! Vickie got a PhD in biochemistry from the University of California-Irvine, she and Dan had a baby (who is now one!), and they moved back to the middle of the country for Dan to get a PhD at KU in Lawrence, Kansas. I got an MD and MPH, got a puppy, got married, moved from Chicago to Omaha to Baltimore to Burlington, and started residency.</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">Even crazier is that last weekend was my 10 year high school reunion! I wasn't able to make it home for the celebration, and I both can't and <i>can </i>believe that it has been 10 years. I have changed so much since 2003--and I can't say I'm especially sad that I wasn't able to see the temporary posting of the class of 2003 slideshow on the <a href="http://www.sidneyraiders.org/education/school/school.php?sectiondetailid=113&" target="_blank">Sidney High School website</a>! </span>Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0United States37.09024 -95.712891000000013-36.4181565 99.052733999999987 90 69.521483999999987tag:blogger.com,1999:blog-3798690260169589326.post-71178942474362825932013-08-04T08:36:00.000-07:002013-08-04T17:51:16.905-07:00A Prairie Home Companion<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: Trebuchet MS, sans-serif;">Most Saturday nights, we turn on the <a href="http://www.crosleyradio.com/Radios/CR3009A_iSolo" target="_blank">radio</a> (one of our favorite wedding gifts) at 6 pm to listen to Garrison Keillor tell the <a href="https://itunes.apple.com/us/podcast/apm-prairie-home-companions/id215352157" target="_blank">News from Lake Wobegone</a> and to hear soothing music (Garr-Bear, as we call him, with <a href="http://www.chicgamine.com/" target="_blank">Chic Gamine</a>, <a href="http://prairiehome.publicradio.org/programs/2009/12/19/" target="_blank">Norah Jones</a>, <a href="http://www.madeleinepeyroux.org/" target="_blank">Madeleine Peyroux</a>, and others...) while Chris makes a delicious dinner. So when we found out that GK and friends were going to be at <a href="http://shelburnemuseum.org/visit/planning-your-visit/ben-jerrys-concerts-on-the-green/" target="_blank">Shelburne Museum</a> (10 minutes from our house) for his summer <a href="http://prairiehome.publicradio.org/tickets/2013/radio-romance/journal.shtml" target="_blank">Radio Romance Tour</a>, we knew we had to go.</span><br />
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<span style="font-family: Trebuchet MS, sans-serif;">After a day in clinic on Wednesday, I picked up Chris and the picnic he had prepared, and we headed to Shelburne to set up our lawn chairs along with all of the other elderly white people (to be fair, there were some kids, some people our age, and probably some nonwhite people). We had an awesome time! </span><br />
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<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">{He started the night by saying, "It's always shocking to see in <br />person someone you've heard on the radio, <br />so we may as well get this out of the way first," as he<br />proceeded to stroll through the audience while singing.}</span></td></tr>
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<br /><br />Michelle Dorwarthttp://www.blogger.com/profile/09650209937712274213noreply@blogger.com0Shelburne Museum, 6000 Shelburne Road, Shelburne, VT 05482, USA44.3732069 -73.232179118.8511724 -114.5407731 69.8952414 -31.923585099999997tag:blogger.com,1999:blog-3798690260169589326.post-60117789040882668072013-07-29T19:22:00.000-07:002013-07-29T19:22:27.228-07:00Lessons in humilityI started on my labor and delivery (L&D) rotation last Thursday--and it has been challenging, to say the least. The most difficult part of L&D also happens to be the part on which everything else hinges: the cervical check. Deciding whether to admit a patient? Do a cervical check! Wondering if it's time to call the anesthesiologist for an epidural? Check the cervix! Questioning the progress of labor? Cervix!<br />
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Why is this such a problem? Imagine introducing yourself for the first time to a woman who (at worst) is screaming and writhing in pain and (at best) is extremely uncomfortable, then saying, "I'll need to check your cervix." Translation: <i>We just met, and you have a human being trying to escape from your body...but can you please get in a frog-leg position so that I can stick my hand in your vagina?</i> Not only is it painful for the soon-to-be mom, but given my lack of experience with palpating squishy objects that are hidden from my vision in narrow spaces, the resulting pronouncement is essentially meaningless: "Umm...so I think that the cervix is about 3-4 cm dilated, 80% effaced, and baby's head is at -1 station." Recheck by chief resident: "So...she's actually 9 cm, 100%, and +1 station."<br />
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Fortunately, all of the attendings and upper level residents are unbelievably supportive and patient. After the scenario I just described, I apologized to the attending for my <i>faux pas</i>, and she said, "Don't apologize! This is for your learning. You got to have the experience of doing an exam that was a 9 but felt like a 3!"Is there such a thing as a 9 that feels like a 3? Probably not...but I appreciated her kindness. <br />
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The past few days on L&D have been busy/crazy/challenging, especially the daily (hourly!) lessons in humility that come from being an M.D. but having no idea what to do. On the bright side: I'm getting paid for it! (And I have back-up, so moms and babies are still getting good care.) Hopefully the embarrassment will pay off and I'll become an expert at <a href="http://en.wikipedia.org/wiki/Stereognosis" target="_blank">sterognosis</a>!<br />
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In other news: we had our first visitors last week, and it was great! Here are some pictures.<br />
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