I'm seeing a pattern, here....

As of today, I've written 475 posts.  Some happy, some sad, some introspective, some silly. But dang, that's pretty cool. I surprised myself.

A theme that seems to emerge this time every year is the 'gotta slim down now' theme. Not surprising, given the indulgencefest that has characterized the eating road since Thanksgiving.

Guess what? It's time. Again. To slim down.

Motivation? Health of course. Also we have wedding related events scheduled beginning in April, and I'd rather feel lean(er) and mean(er) than sluggish and puffy.

My plan? Hitting the Plant Paradox approach hard. Reduce alcohol. (Notice I said reduce not quit? S'rsly people, I know myself, and would rather set a goal I know I can mostly keep.) Get more active, more regularly.

You know, the normal stuff.

But it's time.

Tomorrow I'm headed to the community gym to purchase my 2019 membership. When it's too cold to go out for a nice, long walk I'll head over there and ride the st…

Subie, exit stage left. Welcome Isabella.

So, the Subie finally had one too many muy expensivo fixes for us. We got her fixed up, then started hunting for her replacement.

We found one.

Our criteria? AWD. Reliable. Affordable. New enough to get good interest rate on the loan.

Our choice? A 2017 VW Tiguan. White. Tan leather interior. Heated front seats. (Ok, this is what really sold me...)

Cute, peppy, AWD, in our price range, and (fingers crossed), reliable.

'Cuz Isabella is going to be busy. 5 days a week, 50 mile round trip, 90 min total drive time. For the foreseeable future.

Hubby thinks I should have named her something German, but, I couldn't find anything that rolled off my tongue quite like Isabella.



Feels like defensive medicine, some days.

They call it the practice of medicine for a reason - you're never done learning, never done improving your technique or expanding your knowledge to best serve your patients. It's a lifelong thing.

The dailiness of practice continues to fill me with happiness and gratitude. I look around, at times, and wonder how in the world I could find myself in the middle of health journeys, actively participating in quests for improved strength, reduced pain, better sleep, conception, etc. The road here has been intense, the days now present endless opportunities for connection, for learning, for practicing this amazing medicine.

As we are more accepted within a Western model, we focus significant administrative efforts becoming credentialed with insurance companies, complying with ever shifting requirements (some solid, some not so solid). We have opted to accept insurance. Some clinics do not. There are arguments for both positions. The demographic in which I practice is not one that wo…

148, 473 miles

Our 2006 Subaru Outback is aging, most days well, some days expensively, but all's getting older.

Old isn't bad. But old can mean...being careful instead of fearlessly forging ahead.

Careful about driving too hard, too far, on a hot day. The Subie, it turns out, has a lightweight cooling system, and our climate is far from lightweight. It's heavyweight. 95-103 degrees for weeks on end. Lots of hills and stop and go traffic and opportunities to go " this going to be the day the steam will pour from beneath the hood, the temperature gauge will redline and I will grab my water bottle and medical bag and hoof it to the nearest...exit, or cool place?"

I stress a lot while driving Subie during the summer, I'm not gonna lie.

I worry that the car I lusted after for decades, finally appropriated during my final year of med school because it snows a lot in Santa Fe and I had to drive between there and Albuquerque several times a week..will require …

What's after Celebration of Life?

My fatherinlaw recently passed away after a long battle with COPD.  He leaves behind three children, only one of whom spoke with him at the time of his death. That child, as it turns out, is my husband.

My husband is a middle child - literally and in every possible figurative sense of the word. He has spent his entire life making peace (or attempting to craft lasting detante's in a family full of angst, stubbornness and general dysfunction, like most).  Upon his father's passing he was once again placed in this most tenuous of positions - that between forces, this time forces fueled by grief. These forces were comprised of his mother, the ex wife, and the widow, aka the Step Mom.

Grief, as it turns out, brings out the very worst, the very best, and the absolutely weirdest shit imaginable in people.

In the last month, memories long buried have percolated from the dark depths into the light of day. The hurts, the petty jealousies, the passions, the memories of disappointments a…

Elegance and grace

As I settle into my second year of practice, I am becoming more comfortable with the medicine overall, and am feeling continually blessed to be in a place where I can participate in journeys to better health and well being.

Each day brings challenges, opportunities to test my abilities as a practitioner, and conversations about life, love, health, wellness and managing obstacles along the way. I am continually impressed by how patients cope, how they overcome their unique health issues, and how the medicine seems to support their efforts to improve.

Some days the intensity of multiple patients with intense back stories or clearly nuanced and complex lives and circumstances leaves me exhausted, emotionally.  Therapeutic distance is a beautiful ideal that we're encouraged to employ; the reality is sometimes, often when I 'm physically taxed at the end of a long day or week, applying that ideal of distance becomes a challenge.  When the energy that fuels my barriers is low, som…

Just checkin' in

Wow, time flies! It's now upwards of 90 degrees every day here, and we are all looking forward to a lusty monsoon season.

So, hi.  Since I was here last hubby and I snuck away for a weekend in San Diego that was incredible. We were just a few feet from the beach, and spent the days in that lazy, lovely haze of sunning, walking, eating, napping, chatting. It was awe.some.

Daughter's wedding plans are underway, with venue chosen, colors nearly settled upon, and dress shopping in full swing.  I hope to get to NY for a weekend shopping trip within the next month or so.

Son's fully engaged in his life, and is gardening and developing himself as a poet and fledgling novelist as we speak. His baby dog, Bernie, now weighs in at 105 lb. He considers himself a lapdog, and is, in fact, a champion napper. He and I logged some wonderful snooze time during his last visit. He's kind of like snuggling with a baby bear, only no claws, just warm snuggle dog.

My practice is building, an…