Bureaucractic comforts

It's been a couple of months since I posted, and my intention was to make a post entitled "my summer vacation," full of pictures and fun. I will post that one, but not today. Today I'm posting from work, because although I have work to do, I am unable to do any of it due to administrative holdups.

Yes, that's right folks-- I'm working at the VA again, and for better or worse, I'm loving it. This is the end of my 3rd week in my new postdoc in telehealth and rural outreach at Seattle VA. As should be expected when starting (or re-starting) federal employment, I have encountered seemingly innumerable paperwork issues and bureaucratic messes. But somehow there is a nice sense of familiarity to all of it, and I find it oddly comforting. Even though this VA is about 1200 miles from where I worked before, I sort of feel like I'm coming home. Perhaps to a dysfunctional family holiday, but home nonetheless.

Today I should be seeing patients in my telehealth clinic, but I can't because I have to complete several computerized training modules in order to be certified to use the telehealth technology (which basically amounts to skype, but even easier to use). I can't complete the training modules because after waiting two weeks to get a log-in ID (because all training system log-in IDs have to be issued by the national office), it turns out that I still can't log in because somehow someone in the HR department put my organizational code as "PUG.NVA" and it should obviously be "PUG.(T&L code)." Obviously. And unfortunately, the only person who might know how to change that is out today, so I'll have to wait at least until Monday.

I could at least be calling patients to let them know why there is a delay, except that I have not yet been issued a phone. There is a phone in my office, but it is not *my* phone, and I therefore cannot make long-distance calls on it (since I work in telehealth, many of my patients are at long-distance numbers), and I have no voicemail access (so if I call and don't reach the person, I have to leave a message saying they can't call me back). I have been pushing hard for the last couple of weeks to try to get the work order for my phone to be a priority, but no luck. And, unfortunately, I found out this morning that the person who is in charge of issuing me a phone is *retiring today*. I can only guess how this is going to impact how long it takes to get a phone now, but I'm not holding my breath.

I also found out today that while I am trying (and failing) to work, the VA is trying (and failing) to pay me. So it all sort of evens out. For unknown reasons (possibly the same reasons that led me to spend hours in HR during my first week trying to clear up the mystery of the wrongly checked box), my direct-deposit didn't get set up for my first paycheck, which should have gone through today. I talked to someone in payroll, and when he opened my file, the first thing he said was "oh no." The good news is that my paycheck was mailed yesterday. The bad news is that even though everywhere else in my file my address is correct, there was a typo in one place and my check is being mailed to the wrong address. So now it's a gamble as to whether the mail carrier will notice and deliver the check to me, or whether I can go meet my neighbors up the street and ask them to hold it for me if it's delievered there. Because if neither of those things happens, and it gets returned to sender, it takes a minimum of 30 days to get sorted out.

However, system dysfunction aside, I do really like it here so far. I may change my mind once I actually start doing my job, but I don't think so. So far all the people here are very welcoming, friendly, and as one co-worker put it "there are suprisingly few personality disorders among staff here." So far everyone is great to work with, and even the people I don't work with directly are friendly and want to get to know me. And besides being genuinely friendly, my co-workers all appear to be very smart and competent.

I will gladly deal with all the ridiculous bureaucratic issues if it means that I get to work in a place that is interpersonally and profesionally functional :)

A treacherous trip on the Rogue in the rain

Last weekend Jeff and I took a very brief trip to Eugene to see my family, including my sister and her fiance who were visiting from Norway. We spent the weekend hiking, and going on a guided rafting trip on the Rogue. It turned out to be rainy in Eugene the whole time we were there, and we were hopeful that going south to the Rogue would lead us to sunshine, but no such luck-- it was drizzly and cloudy down there too. However, the rain turned out to be the least of our worries, as we had a rather dramatic encounter with a class-IV rapid.

The short story is that our raft flipped, I got caught in the rapid, and had to be rescued. The long version, if you care to read it, is this:

I was with Jeff, my mom, brother, sister, and sister's fiance, along with our guide, in a big, stable raft-- the kind where the guide sits high and uses steering oars-- floating down the Rogue. We were all appropriately helmeted and life-vested. We had successfully and smoothly gotten through our whole trip, including a class-IV rapid called Nugget Falls, and had one more big rapid-- a class IV called Powerhouse-- to get through before arriving at our take-out point. As we approached the rapid, I think that we may have been slightly off course from where we should have been. We went over the first part of it okay, but as we went down the second part, I saw that we were flipping. It happened very fast, but because I was in the back corner, in the last part of the raft to hit the water, I had a second or so to prepare as we were flipping. Later, I found out that most everyone else in the raft had not realized we had flipped, and had been totally disoriented for a little while.

Parts of what happened next, I don't completely remember. I went into the water, and at first I was near the raft-- I think I was even under it momentarily, though I don't recall for sure. The next thing I remember, the raft was moving away from me down river, and I was being pulled backwards, upriver toward the rapid. I was swimming hard, in the direction of the raft, and going nowhere. I realized that I was not going to be able to get out of this by myself, and started calling for help.

During this time, everyone else was getting out from under the raft, righting the raft, getting out of the water, and helping each other to accomplish these tasks. My mom was still in the river but against the shore; she was nearer to me than I was to the raft, but not close enough to help me. I was about 40 feet from the raft, and there was no way the raft could get to me, or I could get to the raft. There was no way I could swim forward, to get to where the water would take me downstream, away from the rapid, due to both the force of the water pulling me the other direction, and the fact that I was in foamy water (which provides less buoyancy and less to push against to try to swim forward). I knew I was going to exhaust myself quickly, swimming as hard as I was in such cold water.

I had to think of an alternative plan, and fast. I looked around, and saw that there was a rock behind me, and an area of water that was moving past that rock. I stopped swimming forward, turned around and turned over, and floated feet-first upriver, toward the rapid. When I got close to the rock I turned back over and swam toward it, grabbed on and climbed up. I was able to get to a spot where I was still almost waist-deep in water, but I was standing on a stable spot against the rock, no longer getting pulled toward a churning hole that would have surely sucked me under.

At that point, I knew I was at least temporarily safe, and I looked around to assess the situation. Jeff, my brother, and my sister's fiance were in the raft, our guide was on land, and my mom was still in the water against the shore. They were working on securing the raft, getting my mom out, and getting to me. But my sister was nowhere to be seen, which panicked me briefly. I called to my mom, she called to the raft, and then relayed back to me that my sister had been picked up by another raft (we were out with another group from the same rafting company). I didn't know until later that everyone was just hoping/assuming my sister had floated downriver and been picked up, because no one knew for sure where she was.

Eventually, our guide got to a point on the shore where she was able to throw me a rope. The rope landed on the rock, I grabbed hold and flung it over my shoulder, and got back into the water. Our guide pulled me in, and then once I had crossed over the wall of water that I had been trapped behind, I was able to grab hold of a different part of the rope and pull myself hand-over-hand to the raft. As soon as I was in reach, my brother grabbed me by the shoulder straps of my life vest and hoisted me into the boat.

Once I was in, we got moving again (with only one of two steering oars and two of seven paddles left), and paddled as quickly as we could to our take-out point, to be sure that my sister was there. She was.

It wasn't until I was on dry land that I realized how physically exhausted I was. My legs were covered in scrapes and bruises, I felt sick to my stomach, and my feet and lower legs were numb from the cold water.

In the rafting company van, on our drive back to their headquarters, our guide said that I had done great, and that someone else might have panicked, which could have been really bad. My reply to her was that it is my job to tell people not to panic. And the truth is, that even when I was in the middle of the rapid, swimming for my life, there was a part of my mind that was being a trauma psychologist. I was having the thought "What should I be doing right now? Should I be trying to stay calm, or should I be allowing my body to have it's natural fight/flight response?" And in that moment I decided I needed to do both, so I did. When I got to the rock and was able to finally relax a bit physically, I felt like I needed to throw up, and I thought to myself, "good, that's a sign my fight/flight response has been doing it's job."

Even in a potentially life-threatening situation, I apparently can't shake my nerdiness.

What do you do with a mis-delivered UPS package?

I feel like I have a string of things to say that are totally unrelated, but which might be interesting, so here they are:

1. Yesterday I came home from work and found a package outside the front door, addressed with the name of someone who doesn't live here, but sent to our address, except in "suite 300." Unless there is a hidden staircase I don't know about somewhere in this house that leads up to a magical 3rd floor, we don't have a suite 300. Jeff brought it in, and he of course wanted to open the package, but I'm pretty sure that's illegal so I didn't let him. With no phone numbers or anything on it, what are we supposed to do with it? I guess we'll have to get in touch with UPS at some point, when we find the time.

2. Our fat gray tabby is no longer quite as fat as she was-- she has gone from morbidly obese to just obese. Sometime during the last year, she has lost 2-3 pounds, and while one might worry that this is a sign of illness, she seems to be in very good health. We did not restrict her diet in any way (our other cat is of normal weight, and we can't really feed them separately without it being a huge headache), but we did get a new laser toy so she's been running in circles more.

3. Jeff and I took a trip to Toronto to visit with Jeff's family. We had a lovely trip, and when I got back to work after being away for a week, I was shocked to realize how stressful my job is. It's like I've sort of known that for a while, but been fighting it, and now I have come to a point of acceptance that my job is just stressful.

4. Here are some of the types of patients I have had to deal with (either directly, or behind the scenes) at work in the past two weeks: Two women with the same name who died within hours of each other on the same floor of the hospital (and related to that a near miss on attempting to console a man over his mother's death, when his mother had actually not died yet), two women whose partners inflicted near-deadly violent assaults against them, a young woman who woke up delirious and confused and thinking she was being assaulted when her doctors were lifting her gown to examine wounds on her abdomen, a young woman who lost a pregnancy due to injury in a car accident but due to brain injury didn't even remember she was pregnant, victims/perpetrators of gang violence (an individual is usually both), a young woman who had to choose between jumping about 40+ feet from burning building or burning alive (she jumped, but is badly injured), and a few people my age who have suffered strokes. Also there was a guy I saw who was having psychogenic seizures (of course he has an extensive trauma history), and it seems like all of a sudden there is an epidemic of people coming in to the hospital for back pain, and going home with a diagnosis of metastatic cancer. So I guess it's been a downer of a work week.

5. Summer is "trauma season," meaning that lots of people get injured on their summer adventures (or construction projects, or mowing the lawn). It appears to be gearing up early this year-- the hospital is suddenly just about full to capacity, bursting at the seams with injuries. I hope it doesn't stay this way for the rest of my time here, for my own sanity and for the sake of public health. Keep your fingers crossed for a safe healthy summer!

6. All my posts degenerate into complaining about work. Oh well. It's temporary. And hopefully it's vaguely entertaining. If not, let me know and I'll try to come up with other topics :)

Admitting that I live here

When I moved to San Diego, I registered to vote, and I registered my car there, and got a CA driver's license. I was going to be a responsible citizen, and besides which, that was my new community, and I was going to be a part of it. But I found that every time I pulled out my CA driver's license, I felt like a fraud. I was not a Californian. When the time rolled around to vote on ballot measures and local candidates, I took a look through the voter guide, didn't recognize anyone or anything in it, and threw it away, failing to vote for the first time since I turned 18 and was legally able. As much as I grew to love San Diego, it was just a place I was living, not where I really lived. I realized that as far as I was concerned, I was still an Oregonian.

So then when I moved to Washington, I went ahead and registered my car here (because it is the law), but I didn't bother getting a Washington driver's license, didn't register to vote, and didn't make any real effort to become a Washingtonian. But now I'm creeping up on 2 years since leaving Eugene, and I have been starting to realize that I can't pretend like I still live in Oregon for the rest of my life. In the back of my mind I've had the idea that I will wait until we are "settled," with permanent jobs, and a house, before I bother trying to connect to a new place. But we really don't know where we are going to end up long-term, or when we will be "settled" somewhere. So, mentally, I've been sort of homeless.

Well, we expect to be in Seattle for another year and a half or so, and with no specific plans yet for after that, we very well might end up being here longer. So I'm coming to terms with the fact that maybe I actually live here, and maybe I should start acting like it.

As a first step, on Saturday, Jeff and I went to our local Seattle public library branch (walkable distance from our house), and got library cards. It felt like a big step. As soon as I can find time during DMV hours, I'm going to go replace my CA driver's license (I feel like even more of a fraud with that one now) with a WA one. If I want to work on living in the moment, I also need to work on admitting that I live in this city, and this state.

So, here are a couple of pictures of this city I live in, that I took on my phone while biking home from work on Friday. These are some of the lovely views along my bike commute, loveliest on sunny days, which are more and more frequent as it starts to actually be spring:

Drunk Dialed

Today I was drunk dialed. By a patient. At work. At 10:40am.

The back story is, another psychologist on the hospital psychology consult service (which I manage) has been following a patient who is a chronic alcoholic (24-36 beers per day anyone?) with an injury requiring medical care. But, the patient is not willing to stick to the hospital protocol for managing alcohol withdrawal, so he keeps checking himself out of the hospital to get drunk so that he doesn't go into DTs. But then he comes back through the ER when he needs medical care.

It's actually a total nightmare of a situation, both for providing adequate care, and for figuring out the legal and ethical issues (e.g., would it be safer to just supply him with beer in his hospital room? Is that really any different than providing massive doses of benzodiazepines, which the hospital will do to prevent DTs? Can we hold him against his will in order to provide adequate care?).

But, today, I got a phone message, that was prefaced by about 5 seconds of background noise, leading me to think I'd been pocket dialed. But then all of a sudden, an enthusiastic voice jumped in and said: "Bridget! It's (patient's name)! I'm at Harborview Medical Center! 206-744-####" and then he hung up the phone. The most awesome part of this is that I have never met him, and I have no idea how he got my name or my phone number. I think he was just randomly dialing numbers from his hospital room, got my office, and learned my name from listening to my voicemail. I'm 95% sure he has no idea who he called.

Better

I just re-read my last post, and while much of it is still true, I find that I am much less distressed by all that than I was a month ago. So this post is about how things are better-- than they were a month ago, and a year ago.

Things that are better than they were one month ago:
1. The day after I wrote my last post, I got asked to interview for a one-year position (a postdoc) at Seattle VA doing primarily PTSD/trauma treatment. The day after that I interviewed, and the day after that I was offered the position. I start in mid-September, so I will have over a month off this summer between jobs, at the most beautiful time of year up here (if you want to visit, I'm free in August!). I am looking forward to this job. I believe that the work environment will be a better fit for me, and so will the work, and my commute will be better because I will avoid downtown. Yay!

2. Some individuals that I work with have begun talking with me about their dissatisfaction with our work environment, meaning that I now have some people to gripe with. These are people who are even lower on the totem pole than I am, and because of this I feel like I have a new purpose at work: I've taken on the project of collecting feedback from those at my level and below, with the intention of diplomatically providing some constructive suggestions to our supervisors. I'm trying to figure out the best way to do this, and the best timing, and I have several months to make it happen. If this goes well, it could have a positive impact for a number of people, and if not, it doesn't really matter because I'm leaving :)

3. Daylight hours are longer, and I now bike home in daylight (well, at least dusk) most evenings, making for a less stressful commute.

4. We started planting the garden (peas and lettuce so far), and I have been knitting more often, and even baking occasionally. Hobbies are good.

Things that are better than one year ago:
1. I got a better birthday present this year-- last year the day before my birthday I was told some very scary things by a neurosurgeon (some of which turned out not to be true, or at least not to be nearly as scary as he made them out to be, but at the time I thought I was going to have to face some life-changing stuff). This year the day before my birthday I was offered a job. Better.

2. My health. Last year at this time, I was sick, feeling pretty awful every day, and worried that I was going to have to have brain surgery. This year, I feel so much better that most of the time I am back to normal.

3. I live with my husband, whereas one year ago I did not.

4. I have officially made it all the way through graduate school-- I forget that sometimes!


So really, stuff is pretty good right now. I'm still going back and forth, in and out of that existential crisis, but fortunately it seems that knitting on a sock or digging in the dirt (aka gardening) is enough to snap out of it, at least for a little while :)

Existential crisis

For a while now, I feel like I've been in the middle of an existential crisis. The "what am I doing with my life," "what should I be doing with my life," and "what do I want to be doing with my life" type. And I think maybe I'm not the only one; it seems like a lot of people in my general cohort-- those of us who have just finished or are just finishing grad school-- are having the same dilemma. My situation as I see it, is this:

1. What am I doing with my life? Objectively, I am working in a 1-year postdoc position, and looking for another job that will begin when my current position ends. Outside of my regular job, I am attempting to write publishable papers based on research that I have already completed. My time is divided so that during the week I spend approximately 42-45 hours at work, and 8 hours getting to and from work. Right now I also wake up in the dark, and come home from work in the dark.

Subjectively, I am exhausted much of the time because my job is demanding and I don't have a good social group at work. I hate commuting, I resent my work/commute hours because I miss out on all the daylight (at least while it's winter) and I really don't like going jogging in the dark.

2. What should I be doing with my life? This is all subjective, but I think a lot of people come up with similar "shoulds" so I'm sure we've learned it somewhere. I feel like I should be working toward a successful research career, applying for grants, and for positions at research universities (no matter where they are located). I feel like I should be working on this career on my own time (outside of the job I am paid for), because it is in my best interest. At the same time, I feel like I should be accomplishing this happily and with ease, while also having a balanced life full of hobbies, friends, family, etc. And somehow, I shouldn't feel like it's actually stressful, because this should be exactly what I want.

There is another (competing?) set of shoulds that comes from health research, saying that I should be (and so should you be) exercising 30-60 minutes 5-6 days a week, living a low-stress lifestyle, cooking and eating healthy foods slowly, maintaining social connections, and getting in touch with spirituality.

3. What do I want to be doing with my life? This is a tricky question, which sometimes causes me to hyperventilate a little. Right now though, the answer is that I want to have a job that I find fulfilling, with co-workers I like. I want an easy commute (maybe walking, biking, or some easy and short drive). I also only want to work at my job about 30 hours a week (up to 35 or 40 hours if I really have no commute at all and get a reasonable lunch break), so that I have time during my weekdays to exercise every day, keep in touch with friends and family, do housework, and enjoy my hobbies. I do not want to come home and work after work. I want more than 10 vacation days per year, and health insurance. I want a slow-paced lifestyle, and I want to live in a place where I have friends, in a location that I like living. Oh, and also? I want to live in the same place as my husband, and I want him to be happy in his job too.

So, the major dilemma is this-- these three things are not fully lining up at the moment. I do have some of the things I want, but there is a lot of room for improvement. The obvious answer is that I should be trying to achieve the things in #3, but it's complicated. How do you get there? It seems like sometimes you have to do the things in #2 first, and then after many years of struggle, you might be lucky enough to get to #3. Well, I don't want to wait that long.

There is a quote by Annie Dillard that I really like: "How we spend our days, is of course, how we spend our lives." I'm tired of spending my days waiting for my "real life" to start! Is this just me, or is it true that others are feeling this way?