Talamge's Pre-party

We celebrated Talamge's birthday with family while we were in Blanding for Christmas.


        

We also celebrated his cousin's birthday too.
I love Talmage's face, he thinks he got jipped!

 

 Talmage's penny train! With 365 pennies all in his birth year 2012.

Lost!

I got lost last week. I don’t mean way-laid, took-the-long-way-around stuff. I mean the kind of lost that rarely exists in a world filled with GPS turn-by-turn and smart phones. I mean I got LOST.

I was in Pittsburgh with a few hours to kill, so I thought I venture into the city to see a few sights and grab lunch at this well-known hot dog stand in downtown. After taking the long-way-around to see what I wanted to see, I headed toward the hot dog stand with my trusty hand-written directions, faithfully obtained from Google Maps before I left the hotel’s WiFi bubble. I found the stand. Fairly easily, actually. But I had left out one important step: parking. I drove past the stand, remembering that I had seen a sign for a parking garage a few lights back.

The only picture of Pittsburgh I managed to take, between a dead camera battery and
being hopelessly, hopelessly lost. This is taken from the West End Overlook.

This is where things began to slip. I had come in on a one-way road, so a U-turn would have been a bad idea. It seemed that two right turns would take me back toward the garage. I drove past another parking garage, thinking the first one would be a little closer. And then kept driving – now somewhat confused. I wound around downtown neighborhoods for awhile, having no idea why I could not find my way back to the garage, or even the street I had come in on. Finally, I did manage to make my way back to the freeway, but I was fairly sure I needed to go west, and I there was only an east-bound on-ramp. No problem, right? Make a U-turn at the next exit and head back west. Easy.

Now, I am still trying to process everything that happened next. I took the next exit. Just as I got off, I saw a swarm of red and blue lights coming toward me. Behind them, a seemingly endless line of diesel trucks, all blaring their horns. I rolled down my window, unsure how to proceed, and heard an announcement from somewhere saying something about a Big Rig Motorcade welcoming home athletes from the Special Olympics. I had pulled over by this point, but soon realized that one of the officers was shouting at me to keep moving, so I did. The road in front of me was clear, but I wanted to turn around. The trucks were still coming, so I kept driving. Somehow, I ended up in a neighborhood with narrow, U-turn-unfriendly streets, so again, I kept driving.

Finally, I found a spot to make a quick turn-around. Only things looked different on my way out. I came to an intersection that seemed familiar and attempted to head in what I thought was the correct direction – only to end up in the middle of a funeral procession.

I am not making this up.

I continued with the procession until I felt I could reasonably slip away, only to end up in another of those narrow-streeted neighborhoods. I tried my best to backtrack, finally finding my way back out to what seemed to be a major street. Still, it didn’t look very familiar.

It is here that I think I made my largest mistake. The winding, narrow streets, thick trees and rolling hills had all combined to force my natural sense of direction into something of a tailspin. You see, it seemed logical to head west, so I did. Or, I thought did. I drove along the banks of one of Pittsburgh’s many rivers for some time, winding in and out of railroad tracks along the way before coming to a bridge. I felt like I needed to cross the river, so I took the bridge and again headed in the direction I believed was west. I knew I would hit the freeway soon. Yep, anytime now. I am sure it is just around that next corner. Uh-huh, just over that hill.

Nope.

I did just what every man would do. I kept driving. At some point, I checked the rearview mirror in my rental car, noticing for the first time that it had a digital compass there in the lower right corner. It said SE, which I thought was strange, seeing how I was driving straight west.

Still no freeway. More yellow and orange trees. Occasional businesses, but not much else going on along this stretch of road. Mirror still said SE. And, then, there it was. No, not the freeway. A road sign. A road sign that said the road I was on was Southbound PA-885.

Southbound?

Next one said the same thing. Mirror display read S. The evidence had become overwhelming. I was lost. And, for maybe the first time in my adult life, I didn’t even have a hypothesis on what to do next. Should I try to back track? Find a McDonald’s and use WiFi (but then I’d have to find a McDonald’s)? Reorient myself using the rental car’s built-in compass and try to head west again?

Then, randomly, I remembered that the rental car agent had stuck a paper map of the Pittsburgh area with my receipt. Did you know they still print paper maps?

I stopped in the next parking lot – a Taco Bell. I found PA-885 on the map. I was not even close to… well, anything. I managed to plan a new route using the map. It was late enough now that I knew it was straight back to the airport – without lunch. I had seen the sights of Pittsburgh, though certainly not the ones I had planned to see!

There are many, many analogies to draw from this experience. I cannot ever remember being so physically lost, but I haven’t always been able to clearly see the path temporally or spiritually. There have been many maps in my life, most of which, like the paper map from this experience, have been in my possession for the entire time, but certainly not remembered or used correctly.

You may, if you like, insert your own parable here. 

I included this map for your viewing pleasure. "A" is the restaurant I was trying to find. "B" is the Taco Bell parking lot where I finally stopped to grab the map. Please note, the "Suggested Route" highlighted in blue IS NOT the route I took between the two locations. I'm not sure I could even figure out my actual route. 

This Week's Lesson: Be Prepared for Anything!

     This is mostly for my own selfish journaling. You are all welcome to read, though I don’t know if everyone will find it interesting. It may not be great reading for the faint of heart. And forgive me for committing the blog-o-sphere faux pas of publishing a post this long without a single picture. Nothing seemed appropriate.

     If you ever want to remember how small and inadequate you are, stand in a room where someone’s life is on shaky ground, and realize you have absolutely no idea what to do. This happened to me TWICE in the last week.

     The first time was early Tuesday morning, in the final few hours of a 24 hours shift. I happened to be standing next to the intern when his phone rang. “Yes, I’ll be right there. … I ‘ll call her immediately.” I followed as he headed down the hall as a brisk pace, while calling the senior resident, who happened to meet us on the way, so that we all entered the room together. There lay a woman. Well, she was lying, technically speaking, but there was nothing still or relaxing about the scene. The woman was writhing in the bed, screaming out frequently while her mother tried to comfort her.

     The senior resident approached the bed to attempt to question the patient, but almost immediately the woman called out “My water! I think my water broke!” It was clear she was right, as there was now a puddle of fluid joining her on the bed. The senior resident grabbed a glove and assumed the position for a cervical check. The woman nearly came off the bed and slung some colorful language toward the resident, who simply said: “That is not a head. That is not a head!  We are going to the OR!”

     She stood up, but before she could remove her gloves, the woman called out that she had to push, and it was clear that despite everyone’s protests, she was going to do so. The resident went right back to work, and soon we could all see two little feet. Then hips and pelvis. Then abdomen and torso. And then it was as if time stopped, and the baby did, too. The body stayed there, supported by the resident, but the head did not want to descend. We all waited in silence while the resident continued to work, verbally trying to remember how to help a “footling breech” finish the delivery process. After what seemed like an eternity, she cleared a posterior arm and was able to guide the head through the remainder of the journey.

     The Intensive Care Nursery team was standing by, going immediately to work on this poor little body, born six weeks too soon. The room remained quiet, save the woman’s cries, until the baby followed his mother’s example and made a few sputtering cries of his own. After a brief stop to see his mother, he was whisked away to the ICN (known more commonly as the NICU) where he began his recovery.

     Throughout the experience, I stood with empty hands at the end of the bed. Nurses rushed in and rushed out, each seemingly knowing exactly what they could do to help. I knew nothing. The world seemed to be spinning without me – independently of me. A thick frustration assailed me, as I felt myself a powerless observer. I wanted to help. I couldn’t help.

     We compared times following the experience, and found the call was placed to the resident’s phone at 5:25 a.m. and the time of delivery was 5:35 a.m. Ten minutes. It all happened in ten minutes. Ten very long minutes that I will not soon forget. Mom has been released from the hospital, and baby has done well as well.

     The second experience developed more slowly, but ended nearly as quickly. This baby was at term, but was also known to be lined up “breech.” Mother was scheduled to report to the labor and delivery unit for an “external version.” This is where the doctor attempts to push the baby into the proper position in order to allow the mother to deliver normally.

     Unfortunately, on the morning of the scheduled version, she, too, felt a gush of fluid. A visit to “OB Triage” confirmed that she had lost her amniotic fluid. A quick ultrasound showed the baby was still breech. This complicated things. External version is less successful without fluid. The mother expressed a desire to avoid cesarean delivery if possible, and we conferred with the attending physician. After some lengthy discussion, he decided to try attempt the version despite the loss of fluid, but encouraged her to get an epidural prior to the procedure, because it could be quite painful.

     After the epidural took effect, we entered her room (which happened to be the same room as the previous story) to attempt the version. I don’t think anyone had high expectations, though the attending said “50/50.” After 10 or 20 minutes of pushing on her stomach, he did succeed in getting the baby head down, though he could not quite get the baby to line up in the pelvis just right. After more discussion, we decided to get a small dose, what is slangly referred to as a “whiff”, of pitocin to firm up the uterus in the hope of helping the little one finish his descent onto the cervix and prepare for delivery.

     We took leave from the room and went to watch the monitor for contraction pattern and to monitor the baby’s heart rate. It took some time before the contraction pattern seemed acceptable, and the attending returned to the room to assess the situation. He came out grinning, saying he had checked by ultrasound and the baby was now properly positioned. The resident, somewhat unbelieving, and I then went into the room, assigned with the task of verifying fetal position and performing a cervical exam to assess dilation as we prepared for her labor stage. Turned out the baby seemed to be in the proper position. The resident gloved up and began to perform the cervical check, and as he did so, the baby’s heart rate took a nauseating dive. The nurse, standing in front of the monitor, said, somewhat lightheartedly, “There is no cord, right?” To which the resident responded: “No, there is no cord. Oh, wait. I have cord.”

     Once again, I found myself at the foot of the bed, moving in slow motion while the rest of the world seemed to be in fast forward. “Having cord” as he had stated meant that the umbilical cord has prolapsed, or beaten the head to the cervix. This is an emergency. If the baby’s head descends and compresses the cord, the baby will not get the blood and oxygen it needs. In a body so small, even relatively short periods without oxygen can cause very serious consequences, and mortality rates from this condition are very high. I had been taught previously, more than once, that “if you feel cord, do not move your hand.” It then becomes your job to try to hold back the head and protect the cord while the mother is prepared for cesarean delivery.

     So there we were, the resident awkwardly half sitting, half lying at the end of the bed, trying desperately to “protect the cord” while we rolled the patient straight back to the OR. It takes time for the level of epidural to reach “surgical levels” and time was not in our favor. The baby’s heart rate fell to critical levels when we entered the OR, and the doctor prepped the patient and made his first incision before the anesthesia was sufficient. She cried out, and the anesthesiologist made the decision to put her completely to sleep. In minutes, the baby was out, a girl, looking relatively pink (which is good) and with a heart rate, but making no efforts to breathe on her own. She was intubated and taken to the ICN (NICU), where she stabilized and began supporting her own respiration. Mother did well, as good as could be expected post-operatively.

     That same, overwhelming feeling of helplessness accompanied me through this experience as well. Both have served to motivate me to avoid a similar feeling in the future, which will require diligence in studying and in training – though I hope to not face many similar situations in the future!

    For this rotation, I am on the labor and delivery unit full time. There have been many lessons, like those mentioned here already. But one stands in stunning clarity, above all others. When working with obstetric patients, those pregnant and nearing delivery, you cannot expect anything. Complications arise in the most routine deliveries, and others that seem to be headed in the wrong direction work themselves out regardless of what you do. The best you can do is be prepared for anything. Literally, anything.

Miracles are everywhere to be found

     It has now been 22 days since I hugged my children, kissed my wife and boarded an airplane to Indiana. This is the fourth Sunday I have not had to carry a child out of Sacrament Meeting or whisper threatenings about not going to “nursery class.” And, it is incredibly hard to describe how badly I miss it. Yes. That is right. I miss carrying my children out of Sacrament Meeting. Of course, I just miss carrying my children in general.

President Thomas S. Monson

     Today in our priesthood meeting, we discussed President Monson’s talk from the priesthood session of April’s conference. The talk generally is about being worthy and prepared to serve as opportunities arise. In the talk, President Monson shares a brief story about two soldiers from World War 2. One soldier uses the priesthood to command the second to “remain alive until I can get medical help.” Both soldiers survive to get medical attention. President Monson then states: “Miracles are everywhere to be found…”

     That phrase served to prick me in the heart. It replayed over and over again in my head. You see, this has been a summer of miracles for me. Truly. I immediately had the desire to write down some of the great blessings that had been afforded to my family and me. I just don't want to forget.

     First: Recently, an orange “AT” light appeared on the console of our Mazda5. I tried to ignore it for a while. Then I checked the transmission fluid level and topped it off, hoping that would be significant. No change. The longer it went, the more “symptomatic” the van became, shifting hard or at inappropriate times, and just generally not performing well. I finally gave in, found the time and took it to the dealership. I was told the transmission had failed, completely. The van was not even safe enough for me to drive home.

A Mazda5 very similar to ours.

     When all was said and done, it took 8 days to complete the repairs, with the total bill coming to more than $3,100. Where is the miracle? When we bought the van almost three years ago, I struggled within myself before deciding to buy a $1,200 after-market extended warranty. Our total out-of-pocket expense at the time of repair? $256. And that INCLUDED the cost of a rental car we used while the repairs were completed.
     I think this story will really stick with me for a while, but for an entirely different reason. At the time, I was rotating at the VA hospital in Phoenix. My attending physician was a self-described atheist who explained his views in this way: “Go as far left as you can, then go a little further, then turn to your left, and you may see me off in the distance.” I related the story about our van to him one day. He, knowing my religious background, responded, “Don’t you dare say it. Don’t you dare say God let the Nazis kill Jews and allowed slavery, but he reached down and fixed your van."

     I didn't say it. But I thought it. I can’t explain why there are so many tragedies in our world. I don’t know why people suffer. I still don’t know why our second son left this life before we got to look into his eyes. But I still know that God knows us personally, and he has never stopped caring. Even about the little things.

     Second: I took my Level 2 Comlex this summer. That is second of three tests I have to pass before becoming a fully licensed doctor. I have to pass this test in order to graduate from medical school, and my score is an important part of my residency application, which will determine where I continue my training after I graduate. I put forth a diligent study effort, but I was not feeling very confident the night before the exam. We were staying with Christina’s family and I was trying to ward off a full-fledged panic attack when Christina’s mom, Larna, sat down next to me. “This is an important test for you, isn’t it?” she said, somewhat more timidly than I expect from her. I assured her it was. She then bore something of a simple testimony, and told me that there were tools available to help me and that Rob, Christina’s dad, was willing to give me a priesthood blessing. I accepted.

Rob and Larna Meier

     Rob, who is the bishop of his ward, laid his hands on my head, and I still remember very clearly some of things he said. He said the Lord was aware of the efforts I had made, and that I had fulfilled my obligations both related to school and outside of school. Then he said something that I don’t expect to ever forget. “You have done your part, but you need to quit trying to rely on yourself and allow the Lord to help you.” In some ways, this was a mild rebuke, but mostly, it was a very important lesson that I do not think could have come from information Rob had, but that the Lord clearly did. I slept well that night.

     The test turned into a month-long ordeal, as my 8-hour test crashed just over 4 hours in, and I was forced to reschedule the second half in mid-July. I have absolutely no idea why the test crashed immediately following the lesson I had learned. It was a surprisingly emotional experience. But whether the crash was part of the plan or just coincidence matters little to me. What I do know is that during both of the test sessions, the words from that blessing resonated within me, and I tried to relinquish control and allow the Lord to help me. I received my score last week. It was an eye-popping number that significantly trumped my Level 1 and is undoubtedly higher than I could have accomplished on my own.

     Third: I flew into Indiana without any transportation. I did not know how I would get from home to hospital to hospital and back. My initial plan was to get a bike, and mix that with bus transport as needed. However, it was clear the first day that the roads I needed to travel to the hospitals were far too busy for me to feel comfortable on a bike. There were no sidewalks or bike lanes, and through large portions of road, there was not even a shoulder. I would have to walk over a busy freeway on/off ramp with no sidewalks to even get to a bus stop, which made the bus stop feel like it was a million miles away. I rented a car when I first arrived, to help me get settled in, but it was clear I could not afford to keep the car a week, let alone a month. I felt somewhat trapped, and spent some time on my knees, praying for a solution.

 The 2003 Dodge Dakota that
Dr. Pepple graciously let me borrow. 

     During my first day, I was questioning some of the residents about travel options. One of the attending physicians overheard. He asked me to speak with him before I left that day. It turned out that he had an extra car sitting at home, and he didn't like it to sit too long in his driveway (because the squirrels think it makes a nice home). He asked if I would be interested in driving during my time in Fort Wayne. Of course I was interested. I had known this man for less than three hours at this point. There was no contract. No negotiation. He looked me in the eyes and told me to use it for whatever I needed it for, for however long I needed it, and then to bring it back. I shook his hand and knew in my heart, again, that the Lord watched over me. He knows my needs, even the little ones, and he had directly and distinctly answered my prayers (and those of my family).

     If you are still with me, congratulations!  You have read more than three pages and 1,300 words. I hope you found it worth your time. I did. I am grateful for the innumerable blessings I have received. I am grateful for the power of prayer, and the power of the priesthood. I know that this summer is probably no more special than any other, but right now all I can think about is the blessings that have fallen like rain in the past few months.

     Well, all the blessings I have been given, and the fact that I will be back with my beautiful wife and amazing children in four days. I may even be able to carry one of them out of Sacrament Meeting next week. Thursday can’t get here fast enough!

Rambo

Talmage's surgery

Talmage had to have a dermoid cyst removed from his right eyebrow.
Nothing left now except for a little bitty cut. He has been really good all day.

Talmage before surgery in his purple hospital gown.

Talmage was pretty good, he didn't cry much. He looks like a girl.

Chalkboard Suitcase

Need I say more..

I think Talmage's face says it all. "What are you doing in my bed?" Yes, McKay what are you doing?

McKay's Pirate Party May 14

We celebrated McKay's birthday a few months early. Mainly because come July  most of his friends he has  made over his 2 1/2 year of life are moving.

We had pirate stew,  pirate bread, sea weed salad, dried apples, beef jerky, Sauerkraut,  olives, and  oranges ( to prevent scurvy of course.)

Root beer

Captain Hook came.

We made pirate swords and pirate hats.

By the end of the night McKay was dubbed Captain Grumpy. He was one tired boy, he really shouldn't have because he took a 3 hour nap that day. He has never done that!

The Cake. So my cake didn't turn out. My frosting melted, I guess that is what happens when you can't get your house cooler then 81 degrees. Also I was trying to frost a cake with one hand. Holding a baby while defending the cake from a toddler. Michael did finally make it home for work to help me, I was very grateful for his help!

 We opened gifts. McKay got some great toys and cute summer clothes!

Sariah, Ethan, Eli, Eve, and McKay

 We tried taking pictures of everyone. Most of the pictures didn't turn out, so sad. I can only blame myself. I forgot to charge my Nikon. So I was left with just my point-n-shoot.

The littlest pirate at 4 weeks old.

The most confused pirate at 3 months old.

Ethan Sporting the pirate look. His picture was the only one that really came out. :(

Mother's day breakfast

Michael made me a lovely breakfast with blueberry muffins, blackberries, strawberries and a hard boiled egg. He really surprised me, I didn't think he had gotten me anything and I wasn't really expecting anything. He got a me a really nice framed picture of Christ and a board book from the boys.