Plan B

In case this being-a-doctor business doesn't work out, there's always the circus.

dating 101

I recently road-tripped home to the Lone Star State for some Phamily time. Good times, good food all around. And you know it's never a trip home without some quality Mama Pham talks.

So, do boys like you and you don't like them back?

Or do boys never like you?

I just want to make sure you aren't defective.

Thanks for the vote of confidence, Mom.

black tutus + red hair

As a part of my family planning elective, I spend two afternoons a week at the Grady Teen Clinic. Every patient is assigned to a counselor and is taken care of by a multi-disciplinary team: doctors, mid-level providers, psychologists and social workers. It's a great resource for adolescents - both male and female - who want to take ownership of their reproductive health and it's a safe place for them to come to when they have problems. I've heard stories of sexual trauma, emotional trauma, neglect, and domestic violence. Grady may be a resource-poor hospital but it's a wealth of complicated personal histories.

But at the end of the day, they're also just teenagers. They talk about boys. And about each other. And they're constantly texting on their cell phones.

One afternoon, Tanesha* came into the exam room with her cousin, who was sporting bright red streaks in her hair. They were both 16. As I talked to Tanesha, asking about her sexual history and what she knew about birth control, I noticed she and her cousin were wearing matching black skirts.

"Hey girls, what's up with the tutus?"

"It's for our friend Jay.* She died last week."

"That's horrible. I'm so sorry. What happened?"

I maintained my composure, but internally, I felt alarms going off and a tight knot already forming in my stomach.

"Her baby daddy shot her in the head. They got into some stupid fight and he started calling her names, pulled out a gun and shot her. She was three months pregnant too. I mean, she shouldn't have been talking mess but he could've just hit her or something. She didn't deserve to be shot and killed like that. You may have met her. She's been coming to this clinic too."

Tanesha relayed this information matter-of-factly and promptly whipped out her cell phone to show me pictures of Jay, who apparently had a penchant for bright red hair and tutus. Her friends were paying homage to her in their own way. When I later poked my head into the waiting area, I noticed a few others in black tutus.

During that clinic visit, we talked about the importance of personal safety and appropriate behavior in relationships. But I'm not sure if my words fell on deaf ears or not. They were listening to me but also appeared accepting of their young friend's fate.

How could my words possibly return innocence lost?

*names and personal information have been changed to protect privacy of patients

top o' the mornin'

Good things in life often come pint-sized.

cute enough to eat (or bite)

The new crop of cousins in my family is full of girls, girls and more girls. Every family event is an explosion of pink and princess paraphernalia. Disney makes beaucoup bucks off of the PNKD clan. Recent count: 3 boys, 7 girls, 1 girl "bun in the oven." 

My theory: Agent Orange altered the Pham Y chromosome.

Regardless, they all make my heart go pitter-patter. 

And yes, I know this is the second recent post with baby pictures.
1. It's not my fault that Asian babies are cute.
2. I'm full-time studying and have mastered the art of procrastination.
3. It's better than being a creepy cat-lady.

too sweet for words

loric | 4 months | 03.14.10

cheeks made to be squeezed &kissed

rylan | 2 years | 03.14.10

wishin' every moment could be like this moment

river pham | houston | march 2010

what type are you

The folks at pentagram have managed to meld the arts of personality typing and typography: what type are you. Four question character analysis and voilà, your perfect type.

emotional

assertive

traditional

disciplined

"If you always demand that things be in order and then are always incredibly moved when they are, Pistilli Roman is your type."

p.s. Jessica, i thought of you especially and your admiration for all things myers-briggs. (fyi, i'm an ESFJ.)

lone star state

I'm spending this month - the entire month - living with my parents in Houston while studying for Step 2 of my boards. This will be the longest I've been "home" in the last decade. It's taking some getting used to but the livin' ain't bad.

1. Home-cooked Vietnamese meals. 'nuff said.

2. Sunny and 60s. Goodbye schizo Atlanta weather, helloooo sandals.

3. My brother's TV. Jack Shepard & Sawyer never looked so good.

4. Cousins, cousins & cousins, oh my. Catholics are good at procreation.

5. Cruising through the 'burbs in my mother's Mercedes. Strangely, it's a smoother ride than my Toyota Camry that recently got recalled.

6. Last but not least, FOB parents (and grandparents) are funny.

Me: Dear Mom, I hate studying. Love, your daughter.
Mom: I hate study too that why I have no degree. [verbatim]

Grandmother: You're 27? Your goods are getting dried up.
[rough translation]

It's good to be home.

unbeing dead isn't being alive.

e.e. cummings

XX v. XY

I'm currently at the VA Atlanta Medical Center on my second month of internal medicine. Read: lots of old crotchety men. Many have fought in the Vietnam War. Many have PTSD. Clearly, I pick and choose who I tell that I'm Vietnamese.

I spent one morning talking to a Navy veteran who had served in WWII, Korean War and Vietnam War. His wife was at his bedside and the easy comfortable love that flowed between them was palpable. He suffers from dementia and repeated himself often but his personality and spunk were wholly intact.

Some of his pearls of "wisdom":
"It's not, did I shoot down any kamikazes. It's how many did I shoot?"
"When you discover something bad, name it after me!"
"Every day is a holiday and every meal is a banquet."

Point is, I like old crotchety men. And they like me. And it's making me reconsider my current decision to go into OB/GYN. Read: lots of women.

What's a girl to do?

I know what she should do. Take a year off. Get her MPH. And spend that year deciding what she'll be when she eventually "grows up."

The Rain in Spain

good food.
good times.
good company.
what more could a girl ask for?

bearing witness.

This week I performed chest compressions on a patient who was coding.
This week the patient passed away.
This week has been hard.

Mr. R was only 36 years old. He came into Grady with severe abdominal pain and distention. During his work-up, our team newly diagnosed end-stage liver cancer that had metastasized to his spine and bones. The final pathology report was still pending but his prognosis was not good. The goal of this admission was to control his pain and to have him follow-up with oncology as an outpatient.

But on day # 6 of his stay, he coded. As I pumped on his chest - ironically to the rate of the Bee Gees' song "Stayin' Alive" - I thought of his 9 year old daughter. She had lost her mother when she was 2 years old; she had died suddenly in the home while pregnant, likely secondary to preeclampsia complications. The body was found a few days later with the small child alone in the home. With each pump, I thought to myself, "That little girl is not going to become an orphan today, not today."

Mr. R was resuscitated, but before being transferred to the medical ICU, he looked directly into my eyes and asked, "Am I dead?" I answered, "No sir, you're going to be okay. Hang in there. We're going to take care of you," as I stroked his hand.
After a family meeting, his code status was changed to DNR/DNI: do not resuscitate/do not intubate. The following morning, he coded again and passed away at around 7am. His little girl, only 9 years old, was now an orphan.

My friend Howie once challenged me to write more uplifting blogs. But it's hard. I don't feel the need to write as much when I'm full of cheer and glee. But when something causes the emotional equivalent of a punch to the gut, I'm more likely to put my scattered thoughts into words. I debated on a public blog vs a private journal entry. But I opted for the more public option: as a means of bearing witness to this man's life, as a way to remember that we were a part of this man's care at the end of his life, as a way to document one of those defining moments of my fledgling medical career.

I had helped keep this man alive by literally keeping his heart pumping. And less than 24 hours later, he was gone.

I cried in my car as I drove away from Grady that afternoon. And then I went about my business: a haircut followed by dinner at a Thai restaurant. It was surreal to be going through the motions of everyday life - small talk with the stylist, ordering a beer at dinner, reading an article on acute chest syndrome - while waves of raw emotion intermittently drowned me. I tried to talk to my mother and that didn't help. I tried to talk to my sister and that didn't help. I tried to talk to classmates and that didn't help.

I wanted to cry and scream but instead, I packaged my emotions into a neat little box ... and moved on.