Alone Together

Recently I worked what was supposed to be an easy weekend shift. I started off the day with one patient. A nice fellow who through a series of unfortunate events had ended up intubated several times. But here we were, well on the mend, and chipper. The kind of patient I enjoy. I was expecting to transfer him, but the order came though much earlier than planned, leaving me in a precarious position. By 11am I was patient-less and by virtue of the conditions of my contract, I could not be sent home. So I started helping with lunch breaks. Then with another, very complex patient. But the fact of the matter was that I had no patient, so a double admit was a very strong possibility. Not exactly my perfect scenario.

Mid-afternoon rolled around and I finally got the call. A 20 something year old female currently hallucinating in 4 point nylon restraints. Urine positive for opiates and cocaine.


Normally I would be pissed to get the news, but I was having a good day. Charge was nice and my co-workers were chill. For once, I didn’t get my feathers ruffled.

So I got my scant report and soon enough my new patient arrived. She was just as expected. I quickly lost my IV access because she was thrashing around so much. The restraints were helping but she was all over the bed. A security guard stayed in the room with her, which is not normal but I wasn’t going to turn down extra help!

My helpful co-workers were kind enough to place another IV (and another after that one started looking bad) and a quick page to the Doc earned me an order for more Ativan. Things were going rather smoothly.

Around 1700 it became obvious that we had too much staff and that we needed to slim down. Since I couldn’t be sent home, it was decided that I would absorb another patient. I picked up an 80 something year old woman who had coded earlier in the shift. A couple of compressions later she was back and earned a tube. After a phone family conference the decision had been made to make her comfort care. She was started on a Morphine drip and once comfortable, extubated.

So I had just picked up the easiest of patients.

There’s a fine line to walk when administering drugs in dying patient. Morphine can cause hypotension and depress the respiratory drive, two things that can hasten death. I suppose it requires some mental gymnastics when you make the decision to increase the amount of Morphine that you’re giving to your comfort patient. I must believe that I’m keeping them comfortable but not that I’m killing them. So when her respiratory effort increased and I could tell that she was struggling for air, I made the decision to turn up the rate.

Although I don’t necessarily agree with it, I understood it when the family (husband and son) said that they would not come in to be with her as she passed. They just wanted to be notified when it happened.
This lady had been hanging on for hours. I would watch as her oxygen levels plummeted and then, almost through pure force of will, she would take a deep breath and they would bounce right back. At just about 1900, as I was getting my report ready for the oncoming shift, I looked up at the monitor. I could tell by the way the rhythm was changing that the end was near. My other patient had settled down, probably because I had found the therapeutic dose of Ativan and Haldol for her, so I had a few moments.

I pulled up a chair and sat next to her. Taking her hand into mine I watched the monitor. Her hand was already cold and I’m pretty sure that she was not conscious enough to know I was there. She lay there, each breath coming more slowly than the last. I talked to her, letting her know that it was ok. That she was not alone. Her heart slowed, the rhythm changed and I was almost certain that she was in PEA when it started up again. For several minutes her heart struggled to perfuse before it finally stopped. There’s no way to tell the exact moment that she died, but somewhere during that span I went from holding the hand of a person to holding the hand of a corpse.

For 15 minutes or so, two people sat together, touching. Each alone with their own thoughts, oblivious to what the other was thinking and feeling.

Working in the ICU isn’t always about fighting your very hardest to keep somebody around. Sometimes it’s about helping them let go.


The human spirit can be a fragile thing.

There’s something that draws an explorer to a place that perfectly showcases the ruins of its glorious past. Last year I headed out to Vietnam, specifically seeking out Hanoi to walk the streets of its Old Quarter with the intention of experiencing the collision of new and old. To view with my own eyes the decay of the frivolity of days gone by and to see how things were changing.

A few weeks ago I boarded a plane headed to Havana with the exact same intentions. For a long time Cuba has enchanted me, a forbidden land locked in time. I landed with high expectations. Met my cabby at the airport and jumped into his Soviet Lada with high hopes, careening through Cuban traffic with a fresh Cuban cigarette hanging from my lips. How else are you expected to explore this new territory?

Freshly dropped off at the new apartment it as time to hit the streets, even though it was late and I was feeling tired. One can’t just fly to another country and be expected to go to bed. So I started off down the Prado until I ran into a nice gentleman who spoke English quite well. He informed me that this weekend was Carnival and extra specially, tonight was the one night a month that members of the cigar Colectivos were allowed to bring cigars home to sell themselves. A sort of bonus day.

Cuba is an exercise in dispensing with predispositions. One walks down streets that would instigate near panic in the US without fear in Cuba, and one learns this quickly. And this is how I found myself in a random kitchen on my first night in Cuba. Surrounded my large men insisting that I purchase cigars of questionable provenience for an apparent discount.

I do wish I could tell you an anecdote here, like from my trip to Thailand where I threw money into the face of a bar manager who was attempting to cheat me. I do. But I don’t. No, I negotiated poorly figuring that whatever I got, it was still Cuban tobacco and got out of there with my shoddily crafted box filled with mystery cigars. Hours into the country it was Cuba: 1 and Me:0.

But travel isn’t about keeping score.

The next few days rolled by with me walking about the city, doing my best to get a feel for the place. I like nice things but I am also quite curious about what life is like for the average citizen, and so I set out to find out.

By the third day I was burdened by a weight. I did not understand this weight, I only knew that I was plagued my a feeling of claustrophobia and I was looking forward to changing locations to the laid back town of Trinidad.

Hanoi is an achingly beautiful city. It is full of crumbling 18th century architecture, harkening to days gone by. An homage, if you will, to its colonial past. It’s also a thriving city full of life and excitement. Vietnam is pulsing with life. With hope. With progress.

It wasn’t until several days later that I realized the difference. Havana is stunning city, almost impossible to take a bad picture of. But the average person, I could not detect much hope from them. Things were dire and they had been for awhile. As opposed to Hanoi, a beehive of a city. Everyone working towards something bigger. Havana felt more like every man for himself. Things were not going well and I could detect little hope for a better life in the near future. As an American, I couldn’t help but feel a bit responsible for this. Compounding this fact was that every single Cuban I met on the street would immediately upon finding out I was an American insist that the average Cuban loved America. That we were all welcome there, and that this diplomatic situation we found ourselves in was merely some misunderstanding between our countries.

I completely agree, but at the same time, I know that it is my country that is almost directly responsible for their current economic situation. I know it’s not be personally, but still, that kind of weight adds up.

It wasn’t until much later that I realized the dire situation that Cuba was in, and has been in for many years. It as the sort of realization that makes one take a step back and question everything that they have been told.


I’ve been back for exactly one week now. It’s astonishing how quickly one re acclimates to home. In less than 24 hours things were pretty much back to normal and within a week it was if I had never gone. That is except for the memories and the few things that I brought back with me. But the memories are exactly what I was going for. Travel is an addiction and before the trip was over I was already contemplating my next adventure. It seems that no matter what, trips are never long enough.

What is it about travel that I love so much?

When one immerses themselves into a foreign culture they make themselves vulnerable. The walls that we have erected in our normal lives come down. They must. The act of navigating this new world forces us to interact with people. With limited knowledge of the language we are forced to rethink how we communicate. We must find a common denominator. We often find ourselves at the mercy of strangers, and that’s exactly where the beauty is.

Travel challenges the notion that we are superior. So many times I have come across a situation that my instant reaction was to assume that our way was the best way. On second consideration though, their method seems to work just fine for them. Who am I to assume that our way is the best way? What works for one does not always work for another.

When we travel to new places we can’t help but be amazed at the differences. The language, the etiquette, customs, personal space, writing. The list could go on ad infinitum. What we often miss is how similar we all are. Love, agony, hunger, hope, lust. These are all universal emotions. We work hard so that we and the generations to follow us can have better lives. We worry about that future. We feel love, we suffer loss.

And that is, I think, the most important lesson of travel. That with all these differences, at the core, we are the same.

So many times during my travels I have found myself depending on the kindness of strangers. I was not asking much but I often needed help. What I have found is that overwhelmingly the people of the world are kind and helpful. We often forget this. So often we are told that the world is a scary and dangerous place. Most people chose to hunker down at home, surrounded by the familiar. Living in an echo chamber of fears. Never having their assumptions challenged. That is a shame. Everyone should take the time to leave their comfort zones and be a quest in someone else’s country. Challenge yourself. Remark on the differences and look closely for all of the similarities. I don’t think you’ll be disappointed.

Wish I Was Here

Today I was eating one of my cheat meals, struggling to savor every bite when I realized that life seems to be a lot like eating.


I like eating. A lot. I think about food quite a bit. I love planning meals. I love preparing meals. I get a lot of pleasure from cutting something precisely or cooking a piece of meat just right. But mostly I love eating it.


There’s something about eating a delicious bite that brings me joy. Like most people, I used to just shove more and more into my mouth. I always wanted more. But the problem with that strategy is that you’re always focusing on the next bite, and never savoring the one that you have. Before you know it, the meal is over and there won’t be another for quite some time.


Learning to savor every bite isn’t easy, and I’m not very good at it. Right now, focusing on the bite that I’m eating has had the unfortunate side effect of reminding me that soon this meal will be over, that my mouth will once again be empty. It will be hours until my next meal and the vast majority of my meals aren’t particularly good.


How does one savor an extraordinary meal without being acutely aware that it will be over soon?


And so it is with life. Extraordinary moments are fleeting. When I’m in them I’m always reminded that they will be over soon, and my life will return to it’s normal, mundane state. It is impossible to fully appreciate a moment with this thought hanging around in the back of your head. Right now, I have no idea how to get past this stumbling block.


For now, I simply close my eyes and chew, reminding myself that no matter what is to come that I am here, now, enjoying this delicious bite.

The slow or the dead

For the past several months I have been noticing the increasing feeling of dissatisfaction. Initially I think it was masked by the fact that I had started traveling again but it soon reared it’s ugly head. I thought that if I just kept on the move, always off having an adventure when I wasn’t working that it would pass, but that hasn’t been the case. It’s always there, in the background, and when things are silent and still, I can feel it.


I’m more emotional lately as well, or perhaps moody is a more appropriate word. I rarely feel happiness and never feel contentment. Instead there’s always a lurking disgruntlement. I seem to have a beef with most of the aspects of my current life and am only hopeful when I think of a life that is almost totally different than the one I have now.


I can’t seem to stop dwelling on things that annoy me and have problems focusing on positive aspects of my life. I’ve been making an effort to meditate but when I close my eyes my mind goes crazy, jumping from thought to thought and when I’m done, I don’t feel contentment like I used to, only frustration that I can’t even meditate anymore.


At work things are particularly bad. I’m even more detached from my patient’s than usual. I’m having problems feeling compassionate. I feel weary from taking care of people who leech from the system and don’t both to do the minimum for themselves. The hospital itself doesn’t make it any easier. It’s the most poorly run facility that I’ve ever worked in. Physician owned seems to mean that there are no repercussions for physician mismanagement. It’s often over an hour before someone will call me back at night which doesn’t help the distinct impression I get that most of them are only concerned with how much money they can make more than patient outcomes.


I used to have a deep, unshakeable feeling that I was supposed to do something great. I didn’t know what it was, only that it would touch many lives and somehow make the world slightly better. I don’t believe in predestination, but I held fast to my belief in myself. I knew that if I just kept on moving forward that someday a situation would present itself for me to fulfill that belief. Now, I’m not so sure. I feel mediocre and for the most part, useless. It’s not pleasant to feel this way, especially because I started nursing because I was tired of feeling useless all of the time.


The one thing that gives me hope is that I hate feeling this way. I may move slowly, but I’m looking for something that will get rid of these feelings. I think I’m starting to get pointed in the right direction and I’ m going to keep going that way until I figure it out, or I’m dead.


Lets hope it’s the former.

Wedding bells and lonely hearts

Well, over the long weekend G got married off. I probably shouldn’t have been surprised, but it was a nice, unpretentious ceremony outside. There weren’t too many people invited and all in all I think that it went very well.


D and M flew in from Philly and we all stayed in a room together at the local hotel. It was good to catch up with them. I picked them up at the airport around midnight and we stopped off at a taco truck on our way back to the hotel, which I think is a pretty good welcome to LA. The next evening was the wedding, but we used the day of to do a little exploring. We drove to DTLA and walk around the theater district on our way to Grand Central Market. We managed to get some tasty treats before we had to get back to the hotel and get ready.


I had made a huge Google document and shared it with them full of possible restaurants to eat at, which seems a bit silly in retrospect. We only had one real meal to eat. They flew out Sunday afternoon to go house hunting in Washington. Hopefully they found something that they like.


I was sad to see them go. Sometimes I forget how good it feels to have true friends around you. It re-enforces how lonely I feel the majority of the time. I like to think that by forcing myself to be alone I’m creating a strong and independent person, but what if all I’m doing is just making myself lonely?


I often think about what my life could be like if I just chose to work a normal job, stop moving, and maybe buy a house. I know that I could still have cool vacations. I’d have the opportunity to make good, stable friendships. Have people to spend time with. Actually take trips or even eat out with other people. If I didn’t have to pack everything I have in my car I could but another motorcycle. I could have a TV room. I could have a dog. I could have, I could have, I could have.


I could have all kinds of things.


By continuing with this lifestyle maybe I’m making a choice to not be happy.


But the last time I stopped all I could think about was getting back out there and exploring. Maybe these are just all my fears and insecurities talking. After all, choosing to live like this is a pretty scary thing. I have no idea what the future holds.
Thinking that having things could make me happier is a trap that so many people fall into.


No, I think that this is what I have to do. At least for the foreseeable future. I should quiet my fears and trust in myself. I need to believe that there is a wonderful, exciting and fulfilling future just waiting for me out there and then I need to put one foot in front of another and go find it.


I’ve been up to quite a bit lately. I’ve been to LA (taco truck tour), several trips to San Diego, Las Vegas and even Tijuana. Yet I can’t seem to bring myself to write. I’m not really sure what the problem is. I’m not sure if when I get lots of days off I end up going somewhere and when I only have one or two days off, I want to not do anything. Or perhaps there’s something much deeper going on.

I suspect it’s the latter, as I find myself avoiding the question.


What is hidden so deep that it keeps me from writing? What am I afraid of finding?


I want to travel the world so badly. Right now I get paid to travel around the US, which is awesome, but I long for faraway shores. I’m hoping to be able to make it a reality this fall, after the end of this contract. I think I’ve finally settled on Thailand, it seems the most accessible. But already I’m finding myself second guessing. Wondering if I’m choosing the right place. Thinking of alternatives. Searching for the perfect experience. In addition, I’m already worrying about things that could make the trip not happen. Wondering if the amount of time I’ve decided to go for is too long. Worrying if the trip will cost too much. Most of all, scared that I won’t have another job lined up for when I get back.


On top of all of that, my car started acting up. Puffs of white smoke during start. Maybe I broke it when I went stage 2, but I knew that was a risk.


The point is, for a person who considers themselves laid back, I seem to worry quite a bit. I’m so focused on the things that could go wrong that it’s getting in the way of the present and probably hindering my ability to actually realize my future.


What to do? How to delve down into myself and figure out how to quiet it. Quiet myself, I suppose.


In other news, G is getting married in less than a week. D is flying in and we’ll have a couple of days in LA to hang out. Should be a good time. I actually have 8 days off in a row. A few of them are occupied with the wedding and such, but the rest are wide open. For the first time, I have a stretch of days off with nothing planned. It should be interesting.

Pacific Coast Highway

A few weeks ago, I loaded up the car and took the trip that I’ve been wanting to take since I first found out I would be in California. A trip up the Pacific Coast Highway.


After a couple nights of reading and planning, I felt like I was ready. I didn’t want to do too much planning as I wanted the trip to still feel spontaneous and flexible. My rough plan was to hit up the PCH in Santa Monica and head north. I wanted to see Solvang, Hearst Castle, Elephant seals of San Simeon, and the Monterey Aquarium as well as a restaurant or two. The main attraction would be the road and I had four days with it.


I woke up on day one ready to go. It’s a bit of a drive to LA for me and wanting to avoid rush hour, I didn’t leave until almost 9am. There wasn’t too much traffic until I got to Santa Monica, where it really picked up. It continued to get worse once I hooked onto the PCH and really started to frustrate me. I started to feel like I should have connected to the PCH further north. Being surrounded by traffic was making me feel irritable and hurried. I headed north through start/stop traffic.


I wanted to keep this trip fairly simple, so I had decided not to use my GPS. I was going to rely on road signs until I needed to navigate through a city to a specific location. The basic plan was to head north past Santa Barbara and then head inland for a bit towards Solvang, a Danish looking town complete with windmills. After Solvang I was going to continue north towards Cayucos where I had heard about a small smoke shack on the beach that sells smoked fish tacos.


My trip was taking longer than expected and I was getting hungry, so I stopped in Guadalupe, a small farming town, for some tacos. It was while I was there that I consulted my phone and realized that I had missed Solvang by quite a bit. Further irritated, I continued north for fish taco’s that I was no longer hungry for.


The PCH follows the coast again at Morro Bay. When I was a kid, we lived in Bakersfield briefly. Wavelengths was a store that I wanted to buy all my clothes at. It specialized in Skate/Surf apparel, and wanting to fit in with Cali culture that’s what I wanted. I distinctly recall that the original store was in Morro Bay. So out of curiosity, I stopped to check it out.


Morro Bay is a small beach town, home to Morro Rock. It’s actually quite beautiful and I’m sure relaxing if you have time to spend there, but I was still feeling rushed from being stuck in traffic for so long and irritated for missing my first point of interest. For a vacation, I was not in the right mindset.





Just north of Morro Bay is Cayucos, home of Ruddell’s Smokehouse. I was still full of mexican food from my stop in Guadalupe, but I couldn’t drive by without trying at least a taco. If I’m good at anything, it’s gluttony, so I stopped in. After a discussion with the man behind the counter I settled on a smoked Ahi taco. I wasn’t sure of what to expect.


The taco was quite good. It was served with crunchy fresh lettuce, a mayo based sauce, and apples, all which played very well with the smoky flavor of the fish. I was just wishing that I hadn’t filled up on mediocre mexican food an hour earlier.


Thirty minutes north and I was in San Simeon, home of the Hearst Castle. From here there’s not a lot of population until Monterey. There are only a few hotel options, but using my trusty phone I was able to find on with a reasonable rate and book a night last minute. I checked in, dropped my bag off and decided to drive a bit up the road to see what kinds of pictures I could take. As the sun was setting, I found a small beach with a pier and managed to take a few shots. The next morning would be Hearst Castle.






I awoke the next day not feeling quite 100% yet. I had been planning on making it to the visitors center in time for the first tour, but ended up lying around for a couple of hours until I felt a little bit better.


There are several tour options, each starting around $25. I opted for the “Grand Rooms” tour as it’s recommended for first time visitors. I climbed aboard the bus that took us on a 15 minute ride up the hill to the home. I was surrounded by annoying idiots. When we disembarked and met our guide I realized that she was also an idiot. The tour was rather short and I felt claustrophobic, surrounded by amateur photographers shuffling about in your personal space with no regard for social convention. I was happy when the tour was over having gleaned the impression that while quite rich, W.R. Hearst was probably a huge douchebag and asshole to boot.





I was ready to hit the road again.


Not far from the castle is a beach where Elephant Seals come to mate. It’s unmistakeable from the signs and huge crowds of people. But I had to stop. How often does one get to see Elephant Seals in the wild?



Back on the road I headed north towards Monterey with the intent of stopping at Julia Pfeffer Burns park, home to a secluded beach with waterfall. However, for this section, the road was the main attraction. Driving gloves on and tunes cranked I started on a pace that just slightly exceeded the posted limit, only stopping to take pictures as warranted.



Pulling into the State Park I happened upon a nice park ranger. He recommended that after I check out the beach view that I also head back into the woods, as there was another trail ending in a waterfall. We talked for a moment and then I headed off towards the beach. The view was amazing but people were everywhere. For a trip with the intent of getting away, I sure was surrounded by lots of people.

Taking the rangers advice, I headed into the woods. After walking for about 15 minutes or so I noticed that I was whistling to myself. I had finally started to relax.


These are the moments that I need to pay attention to more in my life. Too often I’m doing what I think I’m “supposed” to be doing and not what actually makes me feel peaceful or happy. I think I need to be outside more.




Continuing up the PCH, I headed towards Monterey. There was an aquarium to see. Using my phone I found a few budget hotels, but upon further inspection they all looked pretty sketchy. I decided to up the room budget for one night and booked a nice room using Hotel Tonight. It was worth it. Since I was splurging I found a nice French restaurant and had a Cassoulet for dinner. I probably should have stuck to my first instinct, which was to have the Duck Confit, but the Cassoulet was ok, if not a bit salty. I picked up some Duvel on the way back to the room and settled in for a little relaxation and TV.


The next day I knew I had to make it to the aquarium for the feeding at the Open Sea exhibit. Evidently 300 elementary school children had the same idea. Never the less, it was still pretty cool. The tank had Sun fish, turtles, sharks, tuna, bonito, and a school of sardines. Who would have expected that the sardines were the stars of the show? Watching them school was mesmerizing, but when a few poor individuals were separated from the group, it got really interesting. A Bonito, smelling dinner, hunted down and ate a few poor individuals much to the horror of the little children and to my, sadistic delight.



After the aquarium I once again headed north to meet a friend in San Mateo. I hadn’t seen her since high school, but now she came armed with a brand new baby. It was good to catch up. We spent a few hours at a nice seafood restaurant until it was time for me to go. Stepping out, I was greeted by rain, something California needs very much. My mission tonight was to see how close to Solvang I could get, with the plan of trying to see it on my last day. About two hours out I started looking for a hotel. Finding one, I called and verified that they had rooms available. I was no longer on the PCH. It’s a lovely road and I would have liked to drive it again, but at night, during the rain, and while trying to make time, it wasn’t a good idea. Instead I bombed down the 101 in the rain, reaching the outskirts of Solvang just before midnight. After getting a bit lost, I finally located my hotel by it’s large, fake windmill out front. The room was old but it would have to do. I was missing my comfortable bed from the night before.


Waking up the next day I found that it was still raining. Undeterred I headed into Solvang for a bite to eat. Figuring that the Danish probably had breakfast sorted out, I ordered some Danish pancakes. Flatter and larger than the pancakes I’m used to, they tasted fine, but not extraordinary. The rain was still coming down, but after making it this far, it seemed a waste to not walk around a bit. The weather had other plans. About a block from my car it really started to come down and by the time I made it back, I was thoroughly soaked. Clearly I wasn’t going to see Solvang today, but what to do?



It wasn’t too much further to LA, so I decided to go ahead and drive to the Getty. Rain and LA is not an optimal combination for traffic in Southern California and by the time I made it to the Getty, I was feeling irritable again.


The Getty is a massive complex with all kinds of art to see. I can imagine that it’s quite easy to spend and entire afternoon there, and as it was, I was there for several hours. Why do people think it’s totally fine to have normal volumed conversations in an art museum? It’s not and it makes me want to spin kick you into a priceless chest of drawers. Or perhaps a tapestry if you prefer?






I finished up with the museum around 5 pm and it was still raining, not exactly the best conditions to attempt to drive home in. Pulling out my phone, I fired up Yelp and looked for ramen close by. It turns out that the Getty is very close to an area chock full of Japanese restaurants. I settled on Daikokuya on Sawtelle Boulevard. Traffic was a pain, but it was close by so I could tolerate it. After parking my car in the provided structure, I accidentally walked by the place and had to turn around. I was pleasantly surprised when I finally made it in. It was decorated to feel like you’re eating outside in a crowded Japanese alley. I liked it immediately and the ramen was delicious.


ramen II

After eating it was still much too early to leave for home. I had to work the next day and my usual approach is to stay up the night before so that I can sleep all day before work. Moving my car from the second floor of the garage to the top floor, I climbed into the passenger seat, reclined and took a short nap until it was time to make the drive home.


All in all, it was a good trip. If I were to do it again, I will probably connect to the PCH more around Morrow bay and avoid the traffic of LA. I would plan on doing more activities outside and away from annoying people. If I could, I would allocate more days to feel less hurried, but I’m still glad I did it.

San Diego Scheming

Last week I came down with some sort of nastiness. A cough that still won’t go away and a fever that peaked at 101.


I had been planning on driving to San Diego for a few days and then heading north up the Pacific Coast Highway during my days off, but I was afraid that I wasn’t going to have the energy to do all of that, so I decided to just go to San Diego and hang out with G. Unfortunately G had to work every day that I was there, but since they were just 8 hour shifts, we found plenty of time to hang out.


Day 1 we grabbed some lunch and a few beers at The Belching Beaver, a bar not to far from where G lives. Beer selection was good and food came from a food truck out front. I had a Bison Burger. It was quite delicious. Later we had to run a few errands and drop G’s fiance off at the airport. She left Patton, her epileptic cat with us. He’s kind of cute.



We ended up going out that night with a few of G’s friends. Not sure about what to do for day two I started asking. The general consensus was that I should grab breakfast at The Mission and then try to go hiking at Torrey Pines. Sounded like a good plan to me.


I was feeling Mexican, so I had Ranchero Verde. Pretty yummy. I then set off to find Torrey Pines. I’m pretty sure I parked in the wrong area because my walk to the hiking area was a bit longer than expected, but it was along the beach, so there’s nothing wrong with that.
I walked down the beach until I saw stairs going up into the bluff, just the landmark I was told to look for. Once up, the environment changes quite a bit and becomes almost desert like. It was very pretty. I’m glad that I went on a weekday though. It was busy and I can’t imagine what it would be like on a weekend.






After the hike, as I headed back to G’s house, I decided to stop at a recommend food truck for some fish taco’s. I had noticed Kiko’s place before, but hadn’t given it much mind until it came highly recommended. I’ve been in California for almost 3 months now and I hadn’t had a fish taco yet. I ordered a classic fish taco and a shrimp taco. I wanted to try octopus, but they were out that day. I went back later on another day just for octopus, and they were out again, so it must be really good. I’ll have to try again next time I’m down.



That night G was pretty tired from work, so we hung out at his place, ate some leftover burgers. I found out that he had never seen “The Great Escape,” so we rented it and watched that. I began to plan my next day.


For Day 3 I decided that I needed to finally visit Balboa Park and hit up the art museum. The drive to the park was a lot shorter than I expected and the park was much cooler than I thought it would be. Built in the 1920’s in the Spanish style, it almost feels like you’ve been transported back in time. I took lots of pictures, but the angle of the Sun made most of them wash out.



You never hear much about the San Diego Museum of Art, but I was surprised at how good it really was. The building is on the smaller side, but it’s laid out well and has a nice collection. I wasn’t expecting to see much from famous artists, and was surprised when I started noticing so many. Dali, Magritie, Renoir, Picasso, Degas, Rivera, O’Keefe and Gauguin were all represented. Color me impressed.







When I was done at the art museum, I still had a little bit of time, so I walked over to check out the Japanese garden. I’ve always liked Japanese garden’s and this one was quite nice. Larger than many and in the process of being expanded. I think that when they’re finally through with it that it was be quite nice indeed.




Day 4 G didn’t have to go into work until 10pm so we slept in a bit hoping that there would be enough wind to go sailing. Things were looking dim when we decided to grab lunch at the local Carnita’s Shack, a place I’d been hearing about for weeks now. We shared the pork belly appetizer and I had the Triple Threat Sandwich. It was delicious, composed of pulled pork, schnitzel and bacon, but sat like a brick in bottom of my stomach. By the time lunch was done the wind had picked up enough to take a boat out. It’s the first time I’ve been sailing.



We rented a 22 foot sailboat and headed out. At first the angles that the boat leaned to were uncomfortable, but I adapted pretty quickly. G operated the main sail and taught me how to work the jib. We coordinated and I feel like I became somewhat proficiency at tacking maneuvers. Quite thrilling.


After sailing we drove over to Mission Beach and went for a walk. It was a great afternoon. Mid 60’s and large swells crashing into the beach. We walked up the boardwalk all the way to Pacific Beach when we saw “World Famous” a restaurant that had been recommended to us for their lobster taco’s. We figured we may as well check them out. Luck was on our side. The Happy Hour special was Lobster Taco’s for $1.75 a piece. I was still pretty full from lunch, but when faced with discount lobster taco’s one must partake. I had two. They were delicious.


We made it back to G’s place after dark and I was feeling pretty tired, so I took a quick nap before I had to load up and drive back home.


All in all it was time off spent well. Next week I have another stretch off and if I’m feeling better, I’m going to take a drive up the Pacific Coast Highway.


Wish me luck.


Something is wrong when your patient is an inanimate pile of human meat and you’re still angry at him.


It started several weeks ago when I did 6 days very close together and since then, I’ve noticed that it’s been happening more often.


I got my patient, sedated and intubated, for whom ER and day shift hadn’t done anything for. I was already irritated. He was a chronic alcoholic who is a regular visitor to the ER for routine GI bleeding, only this day he hadn’t made it anywhere. With a critically low Hemoglobin he was just found unconscious by family.


For six days I pumped unit after unit of product into him and cleaned his foul regions as he kept shitting it out again. As I spent hours starting down at him, cleaning him, keeping him alive, I became more angry at him. Angry that he was so careless with his own life as to cause this. Angry with the resources that were used, who knows how many other lives could have been helped?


This is not a good state of mind to be in. I have been noticing my general irritability increasing.


Last night my patient was a 36 year old with cancer. Her prognosis is poor. I busied myself with my normal tasks and didn’t think much about it until I had a talk with her parents to determine her code status. Then it finally hit me. Hours into my shift, and I realized the humanity of the situation.


I’m not fixed. I don’t know what to do, but I can’t continue down this slippery slope.


Hopefully happier posts await.