my new prescription

"You need to exercise less and eat more."

This advice was given to me last week by my primary care doctor. I would estimate that at least 95% of the time, when that combination of words falls from any health care provider's lips, they arrange themselves in a different order. I suppose some people would die to receive such a directive. Then again, they might die in the process.

The epidemic of obesity across the globe is astounding. In my line of work, I am acutely aware of how large people are, and it's not just out of morbid curiosity. I have to plan for the effect increased fat stores will have on the metabolism of anesthetic drugs. I anticipate having difficulties securing the airway in an obese patient, and once the patient is intubated, achieving adequate oxygenation and ventilation can be challenging.

There are numerous factors that have led to the fattening of the American populace. I have not done any recent literature searches on the topic, so what I am expressing is possibly more opinion than fact. However, to me, the most critical elements contributing to our nation's expanding waistline are inactivity and highly processed foods. In Albuquerque, it is almost impossible to walk anywhere useful. In contrast, when we lived in Seattle, I could have counted on one hand the times I drove to get groceries. And then the issue of fast and frozen prepared foods. . . well, that's several posts worth of material.

So back to my opener: exercise less and eat more. Do I have witnesses? Yes! My husband was with me, so he can attest to the advice, and he has enthusiastically accepted the responsibility of feeding me energy-dense foods at every opportunity. My mother has been on board with the plan before I knew it existed, but I don't live under her roof any longer. The tough part is knowing what to change. I am not a "dieter." I don't eat particularly small portions. I have seconds at dinner, and I always eat three meals a day. I love pie and ice cream, and am developing an affinity for chocolate. Ask any of my family members: I do not have an eating disorder.

On the other hand, I haven't eaten a meal from a fast food joint in over fifteen years. I never eat the "fry bar" options in the hospital cafeteria. (Does anyone else find it incongruous for a hospital cafeteria to serve a "complete" meal of deep fried foods?) And, most importantly, I love to be active. I feel one hundred percent better on days that I exercise compared to days that I do not. I have always been a runner, and last summer I discovered Bikram Yoga, which is a fantastic counterbalance to running. To make matters "worse," Micaiah finally got into running seriously about 2 weeks ago after finishing the book Born To Run, so suddenly I have a runner husband who wants to get in at least 8 miles a day, and I want to join in!

Any reader of this entry is likely wondering why it is that I've been instructed to gain weight. The things we post for public viewing would make my grandmother, the queen of privacy, spin in her grave. The basic answer is that, as a woman of childbearing age, it would behoove me to have some energy stores (i.e. fat) to encourage and sustain the development of a fetus. As we have a general interest in becoming parents sometime in the next few years (before menopause hits- yikes!) it seems smart to make sure that I'm in optimal "condition" for motherhood.

So, I get to have a bowl of Greek yogurt every morning, I bring a cup of peanut butter with me to work, and we are buying avocados like they're about to disappear off the face of the earth. I'm not disliking this new health plan. However, I can't stop marveling at the irony of it all, and I am determined to be true to my ethos on nutrition and exercise despite or at least within these guidelines.

So, is anybody up for a peanut butter, guacamole and brie sandwich? Yeah. . . me neither. I think tonight I'll start with a beer, tortilla chips and guac.

My new blog name

When I initially named my blog I had trouble coming up with a phrase that characterized me and my thoughts-- hence, the unfamiliar, confusing, and temporary title of "enigmatic variant." I wasn't satisfied, and was slightly perturbed at the homonymity between "variant" and "deviant." Yikes!

This morning, while packing my lunch, I realized that one of the fundamental elements of my existence was staring up at me from the cutting board. Broccoli. It's true. I am something of a broccoli addict. No meal seems complete without the nutrient-packed, true green goodness of a broccoli spear. Which is not to say that I am a nutrition freak, though I do find the subjects of food, diet and health fascinating. I just feel that each time I eat a sprig of broccoli, I may become a slightly better person. Or at least, my colon thinks so.

Therefore, welcome to my improved blog entitled "it's better with broccoli." Because it really is.

Tonight I began the arduous task of making the February call schedule. My deadline for publication of this monthly life-altering document is the 10th. Usually I have a decent draft prepared by the 6th, but the this time I do not.

Making the call schedule entails deciding which residents work each night and weekend, as well as honoring (to the best of my ability) requests for post-call days (days off after an overnight shift), and weekends off.

I though that by this point in the year I would have the process down to a couple of hours. Oh, was I naive! While it's true I have developed a system for making assignments efficiently, each new month presents me with a new challenge, be it a holiday weekend, multiple residents on vacation, or a personal conflict resulting in a request to "never ever work the same shift or even the same weekend with Dr. X."

Currently, as I lay the framework for the 8th month of this academic year, the challenge is my class: the so-called seniors. We complete residency in June, and suddenly everyone has something better to do than work weekends! It's completely understandable. For five years now, most of us have relinquished control over our nights and weekends to the various services on which we work. Why not try to take charge of one's life again, now that a light flickers at the end of a long tunnel?

The other, perpetual problem is the issue of distribution of resources. You can't put three novices on call together, nor does it make sense to have three seniors working together. And then the finer details: Who's trained in OB? Then two first-years can work together. But then you assume that the first year with OB experience will in fact go to OB. What if they don't?

I tell you, it's weighty stuff, this schedule-making business. I'm glad that the honors and privileges of being the chief resident expire after a year. There is some compensation for dealing with all these finicky details: occasionally I do gain control of my life. Within limits, I can choose which weekends I work and which I do not. But then, when I'm up doing my 2nd 24 hour shift of a weekend (as I was this past Sunday), who can I blame for this ridiculous notion that concentrating calls together is a good plan? None other than myself.

Requisite First Post

Hello world.

Unoriginally, I am sure, I have been inspired to create a blog after seeing a movie about blogging: Julie and Julia. It was a surprisingly delightful and entertaining flick. However, my intent is not to blog about a movie about a blog about. . .

The truth of the matter is, I love to write. My husband has been encouraging me to venture into the world of blogging for some time and I have resisted with the argument that it seems rather self-centered-- writing about one's self publicly-- as if other people really care what's going through my head. But be that as it may, I am excited to have this space in which to explore ideas and reflect on life. I've never written diligently in a journal, but that's mostly due to the annoyance of writing by hand in a small book on which my printing gets distorted on 1/3 of each page.

Topics I expect to explore on this blog include running, running pseudo-barefoot in my Vibram 5 Fingers, food, coffee, wine, tea, etc. . . , life as an anesthesiology resident (I know, fascinating), the West Coast (particularly Seattle, where I'm moving in 6 months!), New Mexico (where I currently reside), and, well, just about anything else that inspires me.

I can already see how this will be a more enticing way to spend my evenings than studying for boards. So before I get too long-winded I had better sign off and get on to the academic tasks that lay before me.

Ciao,

Kate