Fact|Fiction

Darren and I took in a cultural event at the Seattle Center today that involved three women dancing with fire. It was actually very impressive. The music that they danced to was kind of mysterious and seemed somewhat out of sync with their audience, a large percentage of which was under the age of 7. But they could do some very impressive things with torches and one of them had a hula hoop that was on fire. It was too bad it was not dark where we saw them, as I sure the fire is much more stunning with mood lighting.

A brief pregnancy-related scare landed me in labor and delivery for a few hours on Thursday. All is well now and I am being encouraged to rest, as though my habit of sleeping about 9 hours a night does not constitute sufficient rest. I actually went to clinic briefly on Friday, although most of the other clinic people thought it was crazy I came back. My medical assistant kept yelling at me for walking too fast, 'slow down, slow down' she says over and over. But everyone has been very supportive and concerned despite my fear that they will be angry or upset when my health needs make their lives and jobs harder. I find it difficult to strike a balance between pushing myself too hard for the sake of not seeming like a wimp, versus doing what is best for me and the progeny health-wise, versus not making my pregnancy a pain in the ass for those around me. There is definitely danger in knowing too much, as I am probably too objective about a lot of what happens to me as a patient. The flip side of that is being worried about the worst, such is what happened to Darren when he googled "28 weeks pregnant bleeding". I encouraged him not to do that in the future for the sake of his own sanity.

But all seems well, we are having a relaxing weekend, trying to determine if we should avail ourselves to an IKEA holiday tree. I am sure it would become a giant cat toy. But as we are hosting my whole family for the holidays it might be nice to have a tree. I am not sure I want to deal with the hassle of tree and told Darren yesterday that I wanted one only if it came with a pre-installed base. Seems unlikely they come this way though, so Darren suggested a fake one, but there is something about a plastic tree that just seems lame. I suppose that cruelly cutting down a happy tree for the sake of my aesthetics is also kind of lame. I imagine we will do what we did last year, which is to haul in the blue spruce we have in a planter from our first Christmas here back inside.

My Thanksgiving call totally kicked my ass. I think I am just now feeling recovered, despite 10+ hours of sleep last night and having Friday be so laid back the most exciting event was that I ate an omelet. Actually, I ate breakfast for all three meals on Friday - greasy hospital eggs for breakfast, omelet for lunch, pancakes for dinner. My computer also died a dramatic death on Friday, but Darren took a bunch of things out of it and swapped them around and suddenly it was alive again. My computer is a phoenix, although Darren calls it a "frankenputer".

My friend Lainie visited the previous weekend. Highlights from her visit included Aveda Training Salon Self-Renewel Experiences, during which I was denied the foot massage and subsequent wrapping with hot towels, lest they send me into labor. Apparently there is an acupressure point above your ankle that can cause contractions. It's named, for some mysterious reason, "spleen 6". If this point is so powerful, shouldn't we be telling women to avoid hiking boots and whatnot to prevent accidental pressing of the point. Anyway. We also went to a chocolate factory for a tour. It was very educational, although I am not a super big fan of their chocolate. A bunch of misfits were on our tour, including some guy who said there was a law coming out to change the definition of chocolate and so what was the company going to call their product when this happened. There was another guy who mumbled all his questions, and he must have asked five or six during the whole tour. Then there was an old guy claiming the place did not smell like chocolate, unlike the Hershey factory in Pennsylvania. And then there was a woman who did not have a question but marveled that someone who invest money in a company that made only fair trade, organic chocolate. The upside of the tour - it cost five dollars and they fed us so much chocolate we were sick when we left. Also we learned a lot of chocolate facts, which I have since forgotten.

I've been going to yoga over the past week, hoping to help my persistent right sided back and leg pain that I think stems from a tight iliotibial band. My back feels better, but I think today's yoga somehow stretched out the connection between my sacrum and my pelvis.

I don't think this joint should really be moving all that much. Yet I spent the day with the distinct feeling that I had somehow separated it. It seems okay now, but is one of the strangest sensations I've had, since I, like most people, assume their pelvis is, well, solid.

Thanksgiving in the hospital afforded me a rare opportunity - four different Thanksgiving meals. My first was in the hallway outside the postpartum unit and was given be a volunteer group for anyone in the hospital. The second was at a co-resident's house, where I managed to be for 1 hour prior to getting called back to the hospital. The third was dinner in the cafeteria. The fourth was around midnight on Labor and Delivery. Admittedly I bypassed the L+D dinner in lieu of ten more minutes of sleep.

At my co-resident's house we were supposed to say what we were thankful for. Darren said he was thankful that he got to see me for a few minutes. I got paged before it was my turn, but I am thankful the progeny continues to be an interuterine inhabitant. Earlier that day I had gone to look at a slide under the microscope on Labor and Delivery and managed to enter the room right as one of the nurses was tending to a stillborn baby. I do not know the circumstances of this baby's death, but it did not look all that much different in terms of size than some of the smaller babies I've seen in the NICU. I almost burst into tears right there, trying to stare into the microscope and avoid looking at the basin the baby was in. Friends with children have told me these weeks are the scariest during pregnancy because of the fear of pre-term birth. Funny as it may sound, I have tried to not get too hopeful about having a completely normal pregnancy, mainly because I know about how wrong everything can go. The progeny started kicking me right after I saw the dead baby. Intellectually, I know it was probably the jolt of adrenaline that went through my body at that moment that woke it up, but I like to think it was telling me not to worry, that for right now, everything is fine, and that each minute, day, and week longer it stays inside is one for which I should be grateful.

On Saturday, I was again post-call. This time however, the call gods had smiled on me and I had slept about 6 hours in my own bed. Unfreakingbelievable. Darren had made plans to play Halo 3 with Karl and Randy because he thought I would likely spend the day asleep. Although this turned out to not be the case, who I am to begrudge him a day of putting the smack down on 6 year olds across the country. Actually Randy did not have Xbox live, so the just played each other all day, Darren being the clearly more advanced party, offering advice to Karl like "Don't just stand there, keep moving around."

At first I was going to stay at home but Darren convinced me to leave the house. After dropping him off in Fremont for the above mentioned gaming bonanza, I headed straight to Chipolte. Because I am addicted to cheap, mass market Mexican food. They were out of iced tea. You may think this is not a problem, but trust me it is.

When you get pregnant, there are suddenly a lot of rules about what you can/should put in your body. Eat fish, but not too much, make sure it is not raw and not full of mercury. Eat calcium containing foods but not unpasteurized cheese items (which is actually more common than I imagined). Then there are a lot of things that fall under the "do this at your own risk" which translates to "do this if you hate your unborn and wish it to suffer". Some of this is obvious - alcohol, for one. But then there is caffeine. Now it is true that there is a dose response curve regarding caffeine consumption and early miscarriage. I now make only decaf at home but sometimes indulge in a caffeinated latte (which is good and bad, see above regarding calcium). And then we had a presentation at work about ADHD and one of the questions they asked about was maternal caffeine consumption. The scale was really terrifying as I think the options were A) 0 B) 1-5 C) 5-10 D) 10-20 E) more than 20. Yikes. I've definitely had that much. And then there is the artificial sweetener caveat. Basically, we don't know what it does so just don't consume it. Thus diet coke is a double whammy and ice tea looks good be comparison. I hate regular coke and am trying not to consume needless calories, especially in the form of high fructose corn syrup. I know, I should just be drinking water.

I ended up having water. Afterwards, I went to the Washington Park Arboretum and took lots of pictures.

The winter garden. Always looks way cooler than my winter garden.

A pond with fairly stagnate looking water. You can't tell because it's covered with leaves.

Duck bottom! This duck was very, very hungry.

I love how everything grows moss on it in the pacific northwest, including other plants.

These purple berries almost did not look real.

Many people were taking pictures of this heron. He is the avian equivalent of Britney Spears.

Cold koi in the foreground. Apparently, koi feeding season in over and they are left to fend for themselves.

I always want to go in the teahouse, but they keep people out, probably to keep it clean and you know, peaceful.

I figured out the macro function on the camera! Go me!

Wikipedia (my source of knowledge for all things I cannot look up in my Health Care Provider Toolkit given to me by UW) tells me this is the superorder for sharks.

While driving on the I-90 floating bridge to my Eastside ENT rotation, I became trapped behind a red Mazda Miata with a vanity place that simply said "SHARC"

Somehow, it is not so impressive when not spelled with a "K".

All week I had a premonition that my Friday night call would involve being awake the entire night. And of course, it did. It was not as busy as I’ve been in the past, running around with an ever-growing list of tasks that it seems impossible to complete before the handoff to the next resident, but it was steady with lots of weird phone calls about random labs being too high and a laboring lady whose birth not exactly uneventful. And all night long, the progeny kicked me. Thanks, I know we’re both awake. I’m having fun, hope you are too.

I had finally crawled into bed for a 25 minute power nap prior to signing out to the next team when Darren called announcing he had arrived. He forgot that we sign out at 8:00 AM instead of 7:30 on the weekends. He finally located a parking spot and met me in the cafeteria where I treated him, courtesy of the on call meal plan, to 2 eggs, 2 hashbrowns, and tea. He later asked me how much breakfast cost (about 4 dollars, which included yogurt and OJ for me) to determine if it was a good value for the money. My guess is probably not, as the food is a best lukewarm and the eggs always have a mysterious consistency.

My call night also racaped a vaguely familiar experience I had earlier at the VA hospital. Over the past month, I’ve had at least two encounters where I feel I keep repeating the same thing to people because they A) are not listening or B) think I’m holding something out on them. The first time when I needed to get a security badge and computer codes to do my outpatient surgery rotation at the VA. This rotation consists of 6 half days of clinic, only on Thursday mornings. You would think I could just show up, examine some people for hernias and leave, but no, The Government is involved. My first adventure involved getting my ID badge. I was led through a maze of hospital buildings to human resources, where a women in a basement office demanded to see my 11-7 form.

Me: My what?
HR person: Your 11-7 form.
(Right, that form.)
Me: I don’t have that form.
HR person: Who is your supply supervisor.
Me: My what?
HR person: Your supply supervisor.
Me: I don’t have one
HR person: What department are you in?
Me: Family medicine, no wait, I guess general surgery.
HR person: You need to contact the general surgery supply supervisor.
Me: Okay.
HR person: Silence.
Me: Who is the general surgery supply supervisor?
HR person: Writes down several phone numbers.
Me: Okay.

I call these people and procure an 11-7 form. I return to human resources to get my badge.

You need to make a badge appointment. We are very backed up and there is a waiting list for badges.
Me: Okay.
HR person: When do you want to come?
Me: I’m only here on Thursdays.
HR person: We have a Monday afternoon slot.
Me: I’m only here on Thursdays.
HR person: How about Tuesday morning?
Me: I’m only here on Thursdays.
HR person: There are no options for Wednesday because there is a HR meeting.
Me: I’m only here on Thursdays.
HR person: So you want to come Thursday.
Me: Yes

My second experience happened this morning. I was telling the day team about what the GI consult doctor recommended for one of our patients.

Me: Apparently, she has some labs a Virginia Mason we need to get in order to decide what treatment to give her. I tried to call them last night but the lab said they did not have the results because if it is been over a month the labs go to medical records. You will need to call them during business hours today to get the labs.

(Seems pretty straightforward right? Our attending doctor had tons of questions, I had no answers)

Attending doctor: How does GI know she had these labs drawn?
Me: I don’t know. Maybe she told them.
Attending doctor: Will we have to sign a release of records to get labs?
Me: I don’t know.
Attending doctor: Can’t we just order these labs again, why do they want the ones from the other hospital?
Me: I don’t know.
Attending doctor: But Virginia Mason has an electronic record, why are the labs not still in the computer?
Me: I don’t know.

There were other parts to this conversation, which I have forgotten since I was so tired, but I feel like I said the words “I don’t know” at least ten times.

The moral of these stories? Don’t come to me looking for answers, especially if it’s not a Thursday.

My sister came for a visit over the weekend. She has recently emerged back onto the dating scene but was attempting to use Craiglist, which seems to me the most likely place to meet a married man looking for discreet company. She had also looked at Match.com but had not registered, claiming that the 35 dollars was a weeks worth of groceries. Nor had she put up a profile. She was basically a Match lurker.

It's too bad I got married so young, because I would have made a kick-ass single person. However, perhaps, in the warmth and stability of my relationship, it is easier to encourage others to let it all hang out in cyberspace in efforts to attract the attention of the opposite (or same) sex. It's hard to say if I would be quite so ballsy with my own internet dating site profiles, but the ones I have written/helped write for other people certainly seem to be successful. And this weekend, my sister and I did just that. We composed an irreverent and self-deprecating profile that has earned Susan the attention of many men on Match in the greater Nashville area.

The online profile is frequently formulaic and boring, full of things you are and things you want. I say it is best to make fun or yourself, other dating hopefuls and if possible, the profile questions to create a truly outstanding profile. Otherwise you run the risk of being a "fun-loving, easy-going person who enjoys dinners out AND movies at home, looking for honesty and respect in a relationship". I say it is better to be a "bitter curmudgeon, who believes if you haven't found the bad in a situation you haven't looked hard enough". The questions for the profile tend to lead you to the former, resulting in a veritable McDonald's/Burger King/Wendy's experience in the online dating world - all the profiles are the same, they all pretty much suck, and most of what they have to offer is bad for you.

Meanwhile, what Susan says she does for fun is "Usually wallow in self pity, but sometimes, between downing my happy pill and reruns of Forensic Files on Court TV, manages an emergency phone call to her therapist"

Susan is now basking in the glory of her quirky profile. Everyday new people email or wink at her. This is a tremendous boost to one's self-esteem; after all, who doesn't want to be wanted, even if it is by men twice your age 75 miles away.

And maybe, I have found a way to supplement my resident's salary.

Yesterday Darren and I were having a perfectly agreeable conversation when the subject turned to my many years of schooling. He then proceeded to tell me I my medical education consisted of nothing more than "glorified vocation school". Ouch. I think he is just bitter because we both know he is wasting his potential.

I had an unpleasant day at work yesterday because not one but two patients yelled at me and were angry I did not prescribe them their desired Schedule II drugs. I should just let this roll off my back because I truly do believe I am acting in their best interest. But getting yelled at is not fun.

However, I am super excited about the upcoming weekend because for us it will feature a FARM adventure. King County is hosting a harvest festival with local farms, inviting you to go and see where local fruits and veggies, cheese, wine and other goodies are produced. Additionally, there are not one but two alpaca farms where you can visit and pet the alpacas and the babies (called crias). I love me some alpacas. When I discovered the farm tour I clapped my hands in glee and demanded Darren take me to all the stops, even if it took the whole weekend. I have since revised my original desire to see every stop, but I think I am so excited about the farms because I sometimes miss my rural homeland, complete with cows and fields of corn. I like living in the city, but sometimes it is just too loud with too much traffic and too many fancy stores with 1200 dollar purses I will never get up the courage to walk into. But then when I visit rural places I remember the crushing boredom of my youth, longing to get to something bigger or at least different.

I asked Darren if we could name the progeny Cria but he said no.

I finished my last shifts on night float Friday and over the weekend have averaged about 11 hours of sleep a night. I feel like a whole new person. Previously I was just feeling very worn out and grumpy. And tired in a way that sleep coming in 4 or 5 hour blocks was not going to make better.

Darren has been bugging me to write more than my every season entry. I'm unclear on my my blog disintegrated but I think it had a lot to do with starting residency and thus having less time, and also the resolution of what started the blog in the first place - Darren and I being apart for medical school. And for some reason, I felt more private about writing about my work as an actual doctor; like I was somehow betraying the trust of those I was caring for.

And now of course, there is my pregnancy, which I could, like many other bloggers, write about in nauseating detail. But I don't really want to be a Mommyblogger, because I don't really feel defined by this pregnancy. It's a part of my life, like everything else, and certainly Darren I talk about our future progeny a lot more now then we did before I was gestating it, but it is clearly not defining my existence. I still get up and go to work and do the same job I was doing before and still have the same friends and projects that are important to me and still have the same worries about what to do after residency.

I guess part of the reason I do not feel it consumes me is because I know 6 weeks after it is born, I will go back to work and do what I am doing now. Darren will be doing a large chunk of progeny care and there has never been any talk about me taking a break from my job because it's not really financially possible and more importantly, it's not at all what I want to do. In 6 months, I will be a parent, but I will still be a wife, a doctor, a friend, and someone who wants to help make the world a better place, independent of all the good deeds the progeny might one day do.

So enough about the pregnancy. The nausea and bone crushing fatigue is gone and I am still capable of hiding it until a thick layer of fat.

Instead, how about a Danskin recap.

My family arrived Wednesday before the Danskin to hang out and prepare. My mom continued to one-up me by going on several runs before the event as part of her training. We went on a brief and frigid practice swim in Lake Washington. I should have realized at the time that during that swim the universe was using Foreshadowing. My mom and I went shopping at REI for a last minute triathlon outfit, which I later traded in for some new Danskin shorts and the event-provided tank top. After registering on Saturday, my mom, sister and I went for facial/massages at the Aveda training institute where my race number arm marking was promptly rubbed into my entire upper body. We racked our bikes and then had a pasta dinner at Sharon's (she's an attending who does the race every year and helped me learn how to swim). We came back to get all our things ready and settled down for an early sleep.

I awoke in the morning to the sound of rain hitting the pavement. I then entered the bargaining stage of grief - maybe the cloud will blow over and the sun will shine when we start the race 2 hours later. Or not. My mom and I had a banana and some English muffin for breakfast and then headed off into the drizzle, having generously decided that the rest of the family could come later to avoid them getting completely soaked (note the use of Foreshadowing).

We arrived and set up our gear under out bikes, covering it with my rain jacket, a move when would prove to be the smartest thing we had every done. It was cold, but we stripped down, popped on our swim caps and made it to the swim start. We had purple caps, denoting the Mixed age group wave, and soon found ourselves in a sea of purple capped women. I almost lost my Mom when she went to pee but we found each other and began to be funneled towards the start line. It was nice and warm in the mass of people and not really raining all that hard.

Several purple waves went in ahead of us. I thought we had several more waves to go but all of the sudden we passed the gatekeepers and were herded towards the water. Now it was COLD without all the other bodies. Could we go back with them? Um, no, as we were beckoned into the water by race staff. The water was cold, but the adrenaline made up for it. After a pep talk, during which we were christened "totally radical" the swim noodles blocking our path went up and we were released.

My mom and I started swimming and managed not to get kicked too much as we made it to the first buoy. Then we got into a rhythm and were able to stay together. My mom was actually passing a lot of people, so we had to swim in a line for those parts. It was cold, but you warmed up fast in the water. We made it to the second buoy and started back to shore. That last leg was a killer as it seemed we would never make it to the exit, but soon I saw seaweed and then we were being help up and out of the water. Susan and Darren screamed hi and snapped out pictures. We had completed the swim!

Unfortunately during the swim, it had really started raining. We ran back to the transition area and then the downpour began. We slurped down some zucchini bread and started changing into our bike clothes. I made a feeble attempt at drying off; "Don't even dry me" my mom cried "it's no use!" We wedged our feet into our shoes and took out bikes off the rack. We ran towards the bike start and mounted our bikes, waving to my family as they snapped pictures of us riding away.

It was cold! And raining! And cold! But we soon got into a rhythm and were headed towards I-90. As we went up the hill to get on the bridge there was a chain reaction of badness, forcing my mom and I to hop off our bikes which in turn made the woman behind me hit me and fall over clipped in. Oops. She was okay, though. We sped across the bridge and into the tunnel, which was like heaven. It was warm and dry. I stopped shivering. Then we exited the tunnel and were hit with a cold blast of rain and wind. "Can we go back in" I asked. We kept going and towards the turnaround point, my mom made friends with another cyclist. I believe most of their conversation centered around the crappy weather. We made it to the turnaround point and started back up the hill, eagerly approaching the tunnel for a respite. We passed many cold, wet cyclists with bike problems, being helped by colder, wetter repair people. We made it back to the tunnel, leisurely biking through to warm and dry ourselves as much as possible. Then we were back out in the rain, traveling across the bridge. The wind was stronger this time and the cross wind was making our bikes shake and vibrate. We slowed down to avoid being flipped over. It was the only time I was really scared we could be hurt in the race. Luckily we crossed without incidence and made it to the part where you get back down to the road. The on-off ramp to I-90 is very narrow and people were shouting about going single file, one for those walking and one for those still riding. A very bitchy, evil woman shouted "on your left" and then passsed my going down, right after four people had reviewed the single-file instructions. "Don't do that" I yelled, hoping to save my mom from the same fate, as being passed almost toppled me over., "It's not nice." was the only thing I could think to add. She stayed put, between me and my mom. After we were back on the main road, I caught up with my mom and we complained about total lack of sportsmanship. We made it safely back to the transition point, waving again to my family. I almost rear-ended my mom because I was paying more attention waving and got yelled at. Oops.

Back at the transition zone, we racked the bikes and limped towards the start of the run. We overheard a woman exclaim "Not only am I doing a triathlon, I am doing it in the POURING RAIN!" We thought about using the bathroom, but we did not feel like we had to go so we headed out, barely jogging. We got free yummy electrolyte jellybean snacks, the packaging of which was beyond my mom's comprehension at that time. I opened the snacks and we shared the red ones, which tasted the best. We walked briefly, but then started jogging slowly. It was then I began to experience severe nipple pain. I'd had this problem after a cold practice swim once but had been able to go home and take a warm shower, which had really helped. Now there were three miles ahead of me. I was almost crying and trying to hold my breast to prevent them from bouncing with each step, but it did not help. Walking did not help either, so I elected to run to get it over with faster. Eventually it subsided into a dull ache. It was then that I noted my bladder was about to explode. We thought about using a bush, which some other racers were doing but then heard there was a portapotty at mile 1. We limped along and finally made it to the singular bathroom. There was a line of three people. The first went in and was there for a long time. Like five minutes. Then the potty started the shake and a bad smell came out of it. We looked at the woman in front of us and came to the immediate conclusion to cut our losses and keep going. This did not solve the full bladder problem, so a few hundred yards down the road I crouched behind a yard waste bin and peed into a storm drain (Think of the poor salmon, Darren said later.) I was a new woman, but my mom was still going faster than me. I must have looked pathetic because one of the race volunteers shouted out "Looking good 4281" Right. We ran/walked up the Genesee hill into the home stretch. The woman behind us was coughing up a lung, but refused out offers of assistance. Finally we made it to the park. I got a brief second wind and was able to do more than limp across the finish line with my mom. We had made it! They called out our names, as a "mother-daughter" pair. Darren snapped pictures and we hugged.

Then we got very cold. We grabbed our soaked stuff and bikes and walked home to warm showers and clothes and eventually a brunch and Cafe Flora. I'm so proud of my mom, who trained for 9 months, and braved some of the worst Seattle weather, gave me words of encouragement and last, but not least, acted as a human shield while I peed in some poor person's storm drain. She rocks.

I was driving to the clinic that constituted my third year outpatient medicine rotation. It was far away, past Amherst. The road had many stop lights, untimed, and the third year schedule was overbooked, requiring you to be in at least three places throughout the day. I did not mind the lights delaying my progress, I hated my preceptor. I can't remember who called who, but suddenly there was my mother's voice, telling me my grandmother had cancer. Is it bad? How long? We don't know. I cried in the car. Then I went to clinic. I did not say anything because you are supposed to be strong and fearless. Later that day or that night or at some point, I can't remember, we found out it was bad. The family needed to gather in Texas. I bought a plane ticket from Cleveland, so I could fly with my mom. I was so tired and there were four hours between me and Wooster. Darren knew I would not make it. He drove those four hours, slept for 3 and drove back to Buffalo an hour after my mother and I got on the plane. I don't remember the flight there. But we landed and Houston was simmering. It is the humidity I was born into, but despise now I am an adult. We picked up the rental car and drove to a diner to wait for Susan's flight. I think I had eggs for breakfast, maybe with home fries and toast. Susan arrived and we headed southeast, first past the gated communities of the beltway of Houston, then past the refineries, then to a hospital. It took forever for my grandmother to be discharged. She wanted to pull her own IV. Her platelets were low, blood could have gone everywhere, so she waited. I was too scared to do it myself, I do not know if I could do it now. We drove back to the house where my mother grew up, past the rice fields and a meadow with cows. Each cow had its own bird to clean it. I looked at the cows and the birds, felt the icy child of the air conditioning and knew I would remember this forever. This stupid moment with cows and birds and blistering sky and man's triumph over nature with Freon. The house looked the same. We settled into routine as people came and went that weekend. My uncle cried when he told my grandmother he would build her the gazebo she had always wanted. My cousin spoke words of hatred to my sister and me. They were words of pain and of the dichotomy of opportunity our lives represented. I would like to think I forgive him now, but I don't. Time passed, we ate breakfast my mother cooked. I helped my grandmother out of her bath, her body bruised and wheezing. I smelled the flower of the same type of tree I used to play on in Illinois. I left three days later and cried on the plane. No one noticed. I would visit for one more weekend. My mother would stay. In early July she called me again. My grandmother had died. Darren took me to Dairy Queen and bought me a chocolate sundae. I would cry on the floor later, mourning a relationship my sister and I had never had with our grandmother.

Two years and ten months later, I have stepped off the bus to walk the three blocks to my clinic. I am talking with a friend, we are talking about nothing, the morning is beautiful and bright, and my life is together. My call waiting beeps, the call waiting I can never figure out. It is my father and something must be very wrong for him to call me so early. And it is, my grandmother has died in the night, alone in her apartment, suddenly but not entirely unexpectedly. I feel blind, tears well up and I scream no again and again. I am barely crossing the road, jay-walking, confusing the cars and pedestrians around me. I will never walk past this intersection again and not remember this moment. Five days later I am back in Seattle, opening my newly inherited luggage to remove my newly inherited quilt. I absently open the other compartments to remove stray contents, believing for a moment that this is my suitcase, that maybe I have left a postcard or a newspaper or something in one of the pockets. My hand finds an envelope, it contains the cards my grandmother received for her 80th birthday. I cry on the floor. Darren sits with me until it is over and then I place these cards in box filled with cards my grandmother has sent me, for Halloween and my birthday and to say thank you and letters just because. There will never be another envelope in my mailbox with her writing, or a card with five dollars in it that I use to buy ice cream.

If my family is an atom, and I am at the center, and my mother and sister and father are the first layer of electrons, then my grandparents were the second, orbiting and protecting the first layer. And now they are all gone, the shell has evaporated and the cold harsh world can nip at my mother and father and sister. I feel naked. I feel exposed.

There is a mysterious tree not too far north from the intersection of 15th and Cherry. It has a scarred trunk but from this issues branches with two colors of flowers. Most of the tree has white flowers but a small streak is pink flowered. Examination of the trunk reveals a different kind of tree was grafted on the trunk many years ago. The white tree now feeds this interloper, but the pink tree probably provides some sort of food from its own photosynthetic activities. One has to wonder though, if maybe the host tree does not quite like what the parasitic tree produces. One can speculate that over many years, the host tree might reject the graft like a human slowly rejects a foreign kidney. Yet today they bloom together happily.

In some ways I feel like this tree, grafted onto a new city that accepts me, but makes me wonder if I am doing the wrong kind of photosynthesis and the city is just too polite to say anything.

Who put these trees together? What it a joke, an experiment. Where is this person now. And how many people actually notice this mysterious tree. Or do we just park on the convenient street and charge towards the hospital with our heads down, ignoring all that around us except for what lies immediately ahead.