Welcome to Fellowship

Welcome to Fellowship

August 1: Thursday
The Dean of Something Educational stands at the podium of the nearly empty auditorium and welcomes us, the new fellows. After introducing herself, she points us to the stations where we can get our badges, parking passes, and sign some final paperwork. No grand speech. No words of wisdom about what lies ahead. Just the unstated sentiment of get a badge and get to work.

There are a lot less people present for orientation, as compared to when I started my clinical years as a medical student or when I started residency. Few physicians voluntarily extend their medical training beyond the requisite residency years into fellowship.

Although I am an EMS fellow, my emergency medicine residency is complete. While learning about EMS and working on projects for fellowship, I will also be working as an attending in the ED. I’ll be working at multiple sites, both with and without residents. So sometimes I’ll see my own patients, while other times I will supervise residents and medical students as they see patients. I’m not sure which I will enjoy more.

The EMS welcome dinner last week was warm and friendly and also a bit intimidating - the table hosted a collection of accomplished and impressive EM/EMS people! What a cool world to be joining. I can’t wait to get started.


August 2: Friday
My right bicep is burning from where some gangly teenager stabbed me. I tried to hit him back but he was too fast, and he retreated before I could counter his attack. Sweaty and annoyed, I returned to the “en garde” line. One of the best things I did during residency was return to fencing. As much as I love rock climbing and surfing and so many other sports, epee fencing will always be my first love.

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August 3: Saturday

My heart is broken and I feel ill. I awoke to the horrific news of the two latest back-to-back terrorist attacks. I’m at a loss of what to do. I worry about my family and friends. I worry about the EMS providers. I worry about my colleagues and the impact that caring for those victims will have on them.

One of my friends from college, Katie Anthony, writes an epic blog called KatyKatiKate, and I found comfort and support in her entry: Who Needs You Now? It was a gentle reminder that in order to be helpful, you have to know your limits and not force yourself into a situation where you are paralyzed by your emotions.

In the past, I was so incapacitated by terrorist attacks that I was helpless. That’s why 9/11 hurled me towards a life in EMS. 18 years later, as an EM/EMS doc, I’ve dedicated my life to disaster medicine.

I do everything within my power to be in a position to help. I work to make communities safer prior to disasters happening, and then I help treat people when shit inevitably does take place. But it doesn’t feel like enough. I always feel that I should be doing more. How is possible that these events still make me feel helpless? But this is why I do what I do. This is why I am doing a fellowship in EMS and disaster medicine. I am going to combat domestic terrorism.


August 4: Sunday
Watching Indiana Jones and the Last Crusade with my husband. The scene in Germany of Nazis burning books always makes cry. Hubby had never seen it before and I’m guessing you’re thinking, “What? He hasn’t seen Indiana Jones? Is he not American??” And, no, he isn’t American. He’s an immigrant. It’s an odd time in America to be married to an immigrant. Being Caucasian and from Italy, we had a relatively easy time with the mountains of paperwork. No one questioned his motives for moving here, and he appears to be treated the same as every other blond-haired blue-eyed American. On the flip side, reading about the struggles that other families are going through at the Mexican-American border is shocking and disgusting. Every so often I wonder, “Why’d we settle here? Can’t we move to Italy?”


August 6: Tuesday
My emergency medicine board exams are scheduled for November 11th. Whoa. Time flies when you're... Having fun? No, definitely not. Drowning? Hmm, a bit dramatic. How about: Time flies when you’re so busy you can't stop and think about what's going on around you. That about summarized residency.

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Our frontyard and backyard gardens are planted. In the front we’ve got: squash (blue Hubbard, pink banana, and cupcake varieties), corn (yes, we are growing corn in the front yard), cabbage, half a dozen types of lettuce, as well as sunflowers, corncockles, marigolds, and lavender. In the backyard, we’ve got a variety of tomatoes, peppers (both sweet and spicy), beans (purple, rattlesnake, and lima), rainbow carrots, cucumbers, onions, eggplant, okra, and a large herb garden.

August 7: Wednesday

I visited one of the hospitals where I’ll be working in order to learn my way around and to make sure all my computer logins work. Tomorrow is my first attending shift. The butterflies are really starting to get annoying. One other attending and myself will be holding down the fort. I shouldn’t be nervous. I trained at an excellent residency program and I know there will be other people there to help. Seriously butterflies, knock it off already.

I’m ready.

Totally ready.

Right?


Recipe: Growing corn

  • Variety: Early Sunglow Hybrid or Golden Bantum

  • Full sun

  • Spacing: 1” deep, 8-12” apart, in a block or zigzag pattern of rows set 2-3’ apart.

  • Pollination: Give the stalks a gentle shake so that the tassels (the top part) of the corn detach and land on the silky fronds below

  • Harvest: Pick when the kernels express a milky substance when punctured


Corn, Three Sisters, & corn muffins

Small backyard? No problem. Surprisingly, corn does not need a large area to grow if you’re only looking for a small harvest. We grew sweet corn in our backyard in Fresno, and have already planted kernels in our front yard in San Diego. Sweet corn is made for eating fresh or turning into cornmeal for cakes and breads, as opposed to field corn which is turned into animal feed. We’ve planted Early Sunglow Hybrid and Golden Bantum varieties; both of which grow well in our climate zone. Corn requires and nutrient-rich soil, so consider tilling manure into your plot. Kernels can be planted 1” deep, 4” to 12” apart, and then thin seedlings so they are 8” to 12” apart. Spacing between rows is 2’ to 3’. Corn will pollinate better when planted in a zigzag pattern or a block, as opposed to planting in a straight line. Though, you can always help pollination along by giving the stalks a little shake, which releases the tassels from the top of the plant onto the silks below. Cobs are ready when their kernels express a milky substance when punctured. If clear water comes out, it is too soon to harvest. If the kernels are dry, it’s too late to pick the corn to eat fresh, but you can always dry the cobs and grind the kernels into cornmeal.


Three sisters garden:

In Fresno, we grew sweet corn on a 4’ x 12’ bed. The kernels were placed 1” deep, 8” apart, in a zigzag pattern (a little tight but it’s enough). While corn can be planted alone, it also thrives when planted as part of a ‘Three Sisters’ garden, which references the Native American practice of companion planting corn, beans, and squash. A Three Sisters garden typically includes corn, pole beans (which wrap up the cornstalk) and squash. The three different vegetables nurture and support each other by either using and producing different components of the soil.

Three Sisters Garden: Determine the best configuration for your garden, based on available space and sunshine. First, plant the corn. When the corn is at least 6” high, plant the pole beans. Finally, plant the squash 1 week after the beans have been planted.

You can get an in-depth dive about the history, symbolism, and importance of Three Sister gardens here.

In San Diego, the corn was planted in a 2’ x 10’ bed in our front yard. The kernels were again planted 1” deep, 8” apart, in a zigzag pattern. Corn is delicious when simply put on the grill with a bit of salt and butter. Or, you can dry the cobs for several months, then grind the corn in cornmeal, and make corn muffins!

Recipe: Corn Muffins

Dry the corn for at least 3 months. Remove the kernels and grind them in a coffee grinder til they are uniform in consistency.

I used the recipe below from allrecipes.com as inspiration, using my own freshly ground cornmeal and adding in two diced jalapenos (also from my garden) to spice the muffins up a bit.

Corn muffin recipe from allrecipes.com:

https://www.allrecipes.com/recipe/16755/basic-corn-muffins/

  • 1 cup cornmeal

  • 1 cup flour

  • 1/4 cup sugar

  • 1/2 tsp salt

  • 1 egg, beaten

  • 1/4 cup canola oil

  • 1 cup milk

  • 2 jalapenos, de-seeded and chopped

Preheat oven to 400 degrees F (200 degrees C). Grease muffin pan or line with paper muffin liners.

In a large bowl, mix together corn meal, flour, sugar, baking powder and salt. Add egg, oil, peppers, and milk; stir gently to combine. Spoon batter into prepared muffin cups.

Bake at 400 degrees F (200 degrees C) for 15 to 20 minutes, or until a toothpick inserted into a muffin comes out clean.

Enjoy!!!

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First shifts

First shifts

The Actual Prologue

The Actual Prologue