**************************

My daily stops became part of our routine.  I could tell she was having a hard time adapting to the reality of her new circumstances, though.  Her family visited regularly and she put on an optimistic face, but the permanence of “I may never walk again” is a hard pill to swallow for anyone.

We moved her from the ICU to the regular wards, to the rehab wing.  The team taught her how to use a wheelchair, how to transfer from bed to chair, how to take care of her skin to prevent bedsores and how to stretch muscles to prevent contractures.  Her part was the hardest, though– she learned how to accept help, how to express her anger and grief, and how to live her new life in completely alien circumstances.   Those lessons perpetuated long beyond her discharge from the hospital.

*********************

She regularly took wheelchair cruises around the wards, and met the boy’s family and friends on numerous occasions.   In the evenings I saw her visiting him– parked next to his bed, reading him the cards and well wishes out loud.  Sometimes she just sat.  She told him stories and brought in pictures of her family and friends, making up responses about the people in his pictures dotting the walls. Sometimes she talked about the future, what would happen after they both recovered.

The socioeconomic differences disappeared in the face of common challenges– but the parallels were obvious in all ways except the most important.

*********************

One morning after physical therapy, she asked, “Is he coming off the vent soon? Do you think he’ll go home too?”  Probably not.  And home may never happen. I don’t remember what I said to change the subject but she  didn’t ask again.

That week had been particularly challenging.  Organ failure and infection waged a campaign against his tenuous hold on life, despite multiple operations to clean out bone fragments and remove infected tissue, giving the body the best shot at making itself whole again.  Every time we went into the operating suite the risk increased, the opportunity for a good outcome edged just that much farther away until it was not clear that we could do any more good.

The care team had to present his family with the options: continue aggressive treatment that might not aid in recovery, or move to supportive care to make him as comfortable as possible.

No words will suffice at that point– the emotions come out in guttural screams and deep, soul-wrenching sobs.  It was in that conference that I first became acutely aware of the failings of the English language.  Unfortunately, it was not the last time I would recognize that fact.

*********************

Over the following months I ran into her around the hospital, heading to the clinic to see her therapist and working on the psychological scars that persisted long after her surgical incisions healed.

The last time I saw her, we chatted in one of the rooftop garden niches that offer patients a respite from the antiseptic hospital walls.

“How are you?” I inquired.  “I’m glad to see you smiling more.”

“Yeah, I’ve done a lot of growing up.  It’s tough, but getting better.”

We sat without talking for a while, as leaves rustled in the breeze and the sun warmed the tops of our heads.  She broke the silence.

“I should go, my mom is picking me up downstairs.  Thanks for sitting with me.”  I walked beside her to the elevator bank and watched the lights ascend numerically.

The doors chimed and slid open.  As she wheeled expertly into the elevator and pressed the button, she looked at me.  “I haven’t told anyone this, but I think about him every day– that’s what keeps me going.  I’m one of the lucky ones.  And I know it.”

I stood there, watching her eyes well in a reflection of mine.  We raised our hands in the age-old farewell gesture as the elevator doors closed, leaving me looking at my own standing, breathing image.  Lucky, indeed.

Progress is gauged by the level of music in the OR.  Routine procedure?  ipod blaring.  Tough cases have a soundtrack consisting of crisp orders and little else.

Both suites were vacuum-like and breathless.   After 8 hours in the OR, my residents sent me home even though the repairs weren’t close to being finished.  Even the senior guys were standing around observing since there was no room to assist the attendings crowded at the table like drunk bachelors bellied up to a Vegas bar.  The look of desperation was the same, too. You don’t know fear until you’ve seen the premiere surgical talent in the country get tense around the eyes. And then start shaking their heads.

I couldn’t believe it was the same city, same day, same life I’d woken up to.

**************

The following dawn I saw both of them.  In the ICU, he was suffering from acute renal failure, and all the blood products and iv fluids were being retained, distending a formerly athletic physique into an amorphous mass.  Down the hall, her neuro exam hadn’t improved although the vertebral fracture was repaired, and chances of her regaining function were slim.   Our rounds were a grim affair, led by surgeons who’d aged years overnight.

When we were done checking in on everyone, I went back to check on them.  He would be out for a long time, but she was up, with completely bloodshot eyes and crumpled tissues scattered across the floor.  I peeked in, not wanting to disturb her, and was greeted with a weak, “Hey.”

Three steps to her bedside closed the distance and simultaneously opened up an undeniable chasm between us.  As I started, “Can I do anything for you–” her eyes welled with tears.  And so I sat there, passing her tissues and trying to ignore the aching in my chest that gave me the answer to the unasked question: “How would you feel if it was you?”

**************************

“Visitors aren’t allowed for another two hours.” The nurse’s face softened with recognition as I turned back towards the door at her announcement.  “I thought you were one of her classmates, sweetie.  Never mind.”

**Certain elements of this story have been changed to protect patient privacy.**

I was 17 when I met them.

She was the quintessential blond, blue-eyed all-American girl next door, captain of the cheer squad with doting parents and 3 little brothers who hung on her every word.  He was a Hispanic kid from South Central with a quick wit, soulful brown eyes, and an enormous extended family, including abuelas who could fix anything with their legendary cooking.

In the land of the silver screen and dreams come true, it wasn’t such a stretch to imagine that they would cross paths eventually.  A bystander at the intersection, I was privy to a remarkable scene that encompassed those  themes explored in the great novels of our time– love, life, and loss.  This is their story, as I witnessed it.

*****

I was there when they collided, literally, in the ED (emergency dept).  She was airlifted in and arrived on a backboard, her dilated pupils causing her blue eyes to appear black, but somehow she remained calm– from fear? from disbelief?– as we sliced through her drenched summer clothes and placed lines to bolus fluids and meds through her vessels.  The abrupt halt of sirens punctuated by a crashing door gave only seconds notice before another gurney careened into the trauma bay and into the middle of our team, demanding attention.

The newcomer was drenched too, but in crimson fluid unstaunched by a Matterhorn of blankets.  Sheets maybe?  As the group divided into two complete but smaller entities, amoeba-like, to attend to both casualties, I couldn’t distinguish the beginnings and ends of the wrappings, but it didn’t matter.  Trauma shears made short work of the macabre paper mache while the histories came through in patches, like a TV with bad reception between channels.

18-year-old caucasian female, no known drug allergies…

…he was just coming home from summer school and playing with his siblings….

…She has lower limb sensory and motor deficits…likely vertebral fracture…

16-year-old hispanic male, no known drug allergies, presents with severe crush injury…

…Jumped into a lake and she barely touched the bottom… Estimated 40-ft height…

…The hammock was supported by a concrete pillar, which toppled…took an hour to get it off him…

And the hushed words continued to swirl, mingling with the sobs and plaintive questions from the waiting room.  We hung units of blood, confirmed OR prep, and readied for the mad dash through the corridors.  I tucked myself out of the way, taking care not to stand in the path to the doors, and in one small space between the alarms, she looked at me and asked, “it’s bad, huh?”

Confronted in my spattered scrubs and filthy shoe covers, I could only manage, “I’m not a doctor, but they’ll do their very best for you,” before the gurneys swept off in a parting sea of surgeons.

In the voided trauma bay I picked my way to the sink over the Jackson Pollock floor.  My exhalation echoed the whoosh of water from the faucet, incongruous in a space that had just witnessed its umpteenth episode of controlled chaos.  It felt as if I’d forgotten to breathe for the entire time.  The meant-to-be-comforting squeeze from the charge nurse and my few deep breaths only provided marginal relief, but like a shark, you have to keep moving.  The unspoken rule was, if you stop someone else dies.

As I headed blurrily towards the operating suite, even the running litany of to-dos couldn’t shut myself out of my head.

Head to OR, pull gloves for the residents, look up old charts–

you know, that could be you–

find films, check labs–

or your brother or cousins–

get the other teams up to speed, run the new blood upstairs–

there but for the grace of god….go I.

Yes.  Yes, I know.  But this is not the time for that, not when they’re on the table and in for the fight of their lives. This comes later.  Keep moving.

So I pulled on a mask, drew another breath (such a simple thing I took for granted) and stepped through the doors to the OR.

There’s still a recurring series of vignettes that play back in my head, stories both heartbreaking and hopeful that are indelibly imprinted on my consciousness.  All it takes is some quiet space, maybe a line in a news article, or an ad campaign to bring the faces of my patients and their families back to the forefront of my attention.  I’m grateful for all I’ve learned, but also grateful not to be going through such emotional turmoil on a daily basis.

And so whenever I’m confronted with a particularly contrary client, an obnoxious customer service rep, or a frustrating negotiation, I take a deep breath and envision how I’d feel if I knew the whole picture.  What if they’re a patient?  Or dealing with the illness of someone close to them?  I’ve seen how bad it can get, and how close some can get to the breaking point.  Giving people the benefit of the doubt goes a long way in helping me diffuse my frustration and respond in a calm, collected manner.  However much posturing and yelling may occur during the day, it’s not a life and death situation.

Looking ahead to the next milestones in my adulthood– marriage, advancing my career, having kids– I know that there will be both joy and sadness.  The lessons I learned in my early 20s will help me address challenges in a constructive manner, take pleasure in successes, and grow into a role model for my future children.  But most of all, I want to embrace all those moments fully, taste them on the back of my tongue and absorb them into my skin, celebrate the fact that no matter when the story comes to an end, I can still write the adventure within.  And that, as Jon Stewart would say, is my moment of zen.

I love these simple but elegant options for a rehearsal dinner dress:

And these would look fab on my bridesmaids.  I kinda want one for myself, and they’d be super rewearable, too.  I don’t think it comes out on the far right dress, but there are sweet rosettes on the front.  So pretty!

That’s not the best part– they’re all <$70!  No, I didn’t leave off a zero. And there are dozens of other cute cocktail dresses to boot.

What do you think?  Which one would you prefer to wear as a bridesmaid?  I might just bite the bullet…

Click here for an invitation to the site.

(All photos courtesy of ideeli.)

In the depths of a chilly winter, I wanted a contrast to all the squash-focused and root vegetable dishes, and hearty meals that mark the season until the groundhog sees his shadow.  Since it’s crab season, I decided to take on a different kind of work this weekend– shelling my own fresh crab.  Yum!

I picked up 3 smallish crabs, planning at first to make crab cakes with cucumber-mango salsa, but then decided to go with a less work-intensive version.  The crunch of cucumber goes so well with the softer mango and the sweetness of the crab.  And I love a kick of pepper to spice things up– just the thing to satisfy a warm weather craving!

Summer Crab Salad

All the proportions here are approximate and can be adjusted to taste.

1/2 large English cucumber, peeled and diced

2 mangoes, peeled, pitted and diced

1/2 lb crab meat (Approximately 1.5lbs whole crab)

1/2 tsp cayenne powder

1/2 tsp paprika

juice of 2 limes

sea salt and pepper to taste

Prepare the cucumber and mangoes first, and toss with salt, cayenne, and paprika before letting it rest in the fridge.  The cucumber will release water while you shell the crab; drain the excess liquid when you are ready to add the crab.  Fold in the crab, dress with lime juice, adjust seasonings.  Serve on a bed of lettuce with fresh French bread on the side.

Thanks to the $1 bin at Target, I’ve had a cheap, easy way to keep my pants snugly tucked inside my boots for the entire winter.  Mitten holders to the rescue!  Turn up the cuff of your jeans, attach these like a stirrup, and you’re set.

Hm, these look suspiciously like the stirrups sold at Stirrupz.com ($25) or JeanStraps.com ($10) but are a fraction of the price.  Target for the win!

Anyways, looks like we’re in for some more cold weather, but at least my toes will be toasty inside my boots– and I know my jeans will stay put.  If/when these wear out they could be replicated pretty easily, too.

Any bargain finds prove surprisingly useful this winter?  Share your faves!

There are some seriously inspiring creations out there!  I mean, check out the work of these artists:

AnnaTheRed's farm bento

AIBento's decorated sandwiches

However, I’ve decided that given my cooking habits and the way we eat, bento making is probably not in my near future.  Over the weekend I do the bulk of my cooking consisting of the protein and a large portion of veggies.  During the first part of the week we eat these two basic dishes in a number of variations with some sort of carbs, scrambled in eggs, in soup or chili form, or on top of salad…  Basically anything that doesn’t require more than 5 min of prep when I get home.  Because I’m lazy like that. (Of course, the best is when he cooks and there’s NO prep whatsoever. )

I also bring food to work in tupperware, hence the bento idea– it’s just a different container, right? And then although my guy comes home for lunch, I thought I could make 2 every day.  One for me, and one for him.  That illusion was dispelled fast!

Have you ever tried to portion out a chunk of pork shoulder or pot roast into a bento box?  Even turkey sliders gave me trouble.  Veggies and rice are easier, but a man-sized meal doesn’t fit easily or prettily into a bento.  I tried this once, dividers and all, foregoing any of the cute decorative elements.   It looked, shall we say, less than appetizing.  No amount of cherry tomatoes or apple bunnies or cute toothpicks could have saved that thing from its ugly (although nutritionally balanced) demise.

Nothing like the cute bentos from Lunchinabox…  how disappointing.

After that, I told my boyfriend, “Think of the fridge like one big bento.  It contains food with diverse colors/textures and good nutritional value, you just have to portion it out accordingly.”  Tiny Japanese bento box not necessary.  I guess we all have to have something to aspire to, right?

Yeah.  Maybe when we have kids I’ll start making cutesy lunches to encourage them to try new foods, but I think the fridge-as-bento concept works for now.

Anyone else get overambitious in the kitchen?  Oh, the stories I could tell…

The end of 2009 was ridiculous with deals closing, the holidays, a computer meltdown, and a little surprise.

My resolutions?  Well, for one, to blog more consistently.  Now that I’ve got a sweet little netbook to replace my old computer, I will be much more diligent!   Here’s to a rocking 2010.

xoxo,

RTW

What better time to take advantage of a clean kitchen and stocked fridge?

Here’s what I made:

Sat evening:

• Homemade turkey meatballs with freshly chopped herbs – I made meatballs instead of patties so they could be packed easily as part of a bento lunch.  We ate quite a few of them as finger food hot off the stove– oops!
• Teriyaki chicken tenders – These aren’t McNuggets; they’re the small piece of chicken that usually comes attached to the breast.  I like buying packages of the tenders at Trader Joe’s since the greater surface area to volume ratio allows max flavor penetration from the marinade.  Plus, the tenders cook more evenly and are perfectly sized for incorporating into sandwiches or salads.
• Steamed broccoli and cauliflower – 1 head each.  I peeled the broccoli stems and sliced them thinly on the diagonal, and steamed them as well.  They add a great crunch to salads!

Sun evening:

• Homemade pizza – dough from scratch using Mark Bittman’s recipe from How to Cook Everything.  Yum!  Toppings included meatballs (from Sat), mushrooms, veggies, and some light mozzarella.

All ready for the oven!

• Tzatziki – a Greek cucumber and yogurt dip that is fantastic on its own or with pita bread.  Super easy to make: peel and slice cucumber using a mandoline.  Add salt to cucumber, wait an hour, press out excess water.  Add greek yogurt to cucumber mixture.  Eat and enjoy.
• Oh yeah, and I made eggs benedict as breakfast-for-dinner as well, per the bf’s request.

It seems like a lot of food when I list it out like this, but really it was all very simple and took minimal time– maybe an hour total each night?  And now I have a ton of healthy, prepared food in my fridge all ready for work lunches.

Seriously, a few years ago I’d have laughed my ass off at the idea of me cooking for any reason other than a party or special event.  But now I look at prepared items in the grocery store and think, “I could make that at home, for less money and with healthier/organic ingredients.”  So I do– and it’s immensely gratifying, even for simple meals.  Ok, ok, I know I’m kinda behind the curve when it comes to the domestic arts, but we’ve all got to learn sometime.  And the stuff I used to have to plan is now second nature.

What next?  I’ve also been entertaining the idea of making bento boxes for the bf and myself, but I’m not so sure it fits our eating habits well.  (FYI: a bento is basically a boxed lunch that is supposed to be nutritionally balanced, with a diversity of colors, textures, and flavors.)  More on my attempts at this later…

Anyone else end up cooking (and eating) more during the winter?  Guess the hibernation urge is strong even in California.