Just Go....

Just wanted to share my video from my recent trip to Hawaii... specifically Maui... I had a lot of fun putting it together, hope you enjoy it!  Aloha!

Random Thoughts #2 of 2011

1.)  I often wonder how much of my day I should write about on my blog since I live in a small town and almost everyone knows everyone.  I can talk in subtleties, but still, how many chest pains and shortness of breaths can you stand?  If I talk about the really interesting cases, chances are someone here will know whom I am talking about.  HIPAA and all that.

So I don't write.  Then I feel guilty about not writing.  Then I think about writing but then wonder if you will find it interesting.  So I dont' write.  Wash, rinse, repeat.

2.)  Tonight I was told to read and write about a book called, "Squirrel Seeks Chipmunk" by David Sedaris.  So I downloaded it to my Kindle for iPhone... which I have started to become obsessed about.  I love books.  I would live in a bookstore if I could.  Now that I can instantly download and carry a virtual library with me I am reaching Nirvana.  Of course, having the time to read all of these tomes will be difficult, but I'm collecting them like a miser, "They're mine, all mine..."

3.)  So this patient walks up to the triage window and states, "my daughter just got bit by this, what do we do?" and lays a glass jar on the counter with this inside...
I don't like scorpions and having one put on my desk by the triage nurse was not something I quite expected.  I live in Northern California.  Redwood forests and the Pacific Ocean.  Not sandy deserts and scorpions.  But, I was surprisingly informed that, yes, these creepy crawlies do inhabit woodpiles in this area.  Freak out!  I was only slightly perturbed to find out that I actually did have to know about rattlesnake envenomations since there is a local species, but now I have to know about scorpions, too?!?!? 

4.)  I just came back from Maui, and I am working on the video pictoral from my trip.  Tonight I am working on a pile of dictations which I haven't been able to do since I lost my voice from this cold I got.  So, my video is pending... but I will share here once I have it.

5.)  I came across this MEME on a blog I follow, which prompted me to put in a blog posting of my own, so in a way, this inspired me to write today.  Post on your blog and share in the comments... I can't wait to read your responses!  Until next time... cheers!

ABC's of Me:
A: Age: 43
B: Bed size: Double
C. Chore you hate:  anything to do with cleaning
D. Dogs: 0 but will be 2 within the next year
E. Essential start to your day: Check on Facebook and morning news
F. Favorite color: Ceylon Blue
G. Gold or silver: Platinum!
H: Height: 5'1"
I: Instruments that you can play: Used to play the guitar and know my way around a keyboard
J: Job title: Emergency Medicine Physician
K: Kids:  Three fur babies
L: Live: in NorCal....
M: Mom’s name: Ana
N: Nicknames:  Montey, VerBon, Vern
O: Overnight hospital stays: Only when I am on night shift and when I used to be on-call.
P: Pet peeve:  People who can't control their speed while driving because they're talking/texting on cell phone
Q: Quote from a movie:  "I guess it comes down to a simple choice, really:  get busy living, or get busy dying."  Andy Dufresne, Shawshank Redemption.
R: Righty or lefty: Righty
S: Sibling: None
T: Time you wake up:  0630 or 1830 on days I work, whenever I get up on days I don't.
U: Underwear:  Always
V: Vegetables you dislike: onions and brussel sprouts
W: What makes you run late:  My husband... he takes a while getting ready
X: X-rays:  Knees and CXR's
Y: Yummy food you make:  my hubby loves my cheesy grits and chorizo
Z: Zoo favorite animal:  meerkats.  always have to get a pic!

A Spalicious Start

Ok, so I just got back from a short trip to Maui, and it was amazing.  After driving five hours south to get to San Francisco to catch our plane, and then flying five hours to get to the island, I thought we'd start off our trip with a little decompression therapy.  Since I had heard so much about the spa at the hotel where we were staying, I thought I'd book us a little spa package.... so worth it!

You start off in a sumptuous lobby area and are then separated (boy's side and girl's side).  You're led into a locker area where you get a towel and your own pair of slippers.  Clothing is optional in the spa area (I opted for coverage), and then you're shown around the different baths.  You get an hour to wander around and enjoy everything from 4 different hot tubs at various temperatures, to a variety of salt soaking baths, to dry or wet sauna rooms, and then a choice of different showers from a full body power wash to a muscle-pounding waterfall shower. 

At some point during your "bath time," one of the assistants takes you into the treatment room for an exfoliation.  It's a combo salt, oil and warm shower massage which leaves you tingly and ready to go back to the baths.  All around are extra towels, water or mango iced tea and fresh fruit.  You can sit and soak or lay back on a lounge chair and relax.

After your hour is up, you're given a robe and told to undress before heading upstairs to your spa treatment area.  I met my husband on a landing which overlooks the fountains, pools and beach in front of the hotel.  We sat and sipped water on lounge chairs while waiting to be called for our treatments.

Soon a pair of assistants called us into our own private room for the rest of the afternoon.  There we had the most amazing exfoliation and wrap treatment followed by a scented oil bath and then a luxurious hour-long deep tissue massage.  We came out of the spa feeling buffed, polished, smooth as silk and as relaxed as we could possibly be at that moment... then the real fun began!

Would You Like Fries With That?

Excuse the rant, but seriously?

I've seen electronics develop greatly since the time I was in medical school.  I remember getting my first Palm and "synching" programs to help make studying easier with my fellow colleagues.  I remember our brand new auditorium boasting that one day all of the students would be able to instantly download the lecture to their personal laptops.  Wow, how could a medical student afford the $3300 a laptop would cost....?

Fast forward to now where I look up everything from medication interactions, to the latest antibiotics therapies, to calculating free water deficits on my phone.  My laptop is my, almost, constant companion.  And that dream of one day using a tablet-based medical logging system is now becoming a reality.  I, of course, should have patented my App for that.

But, what I find hard getting used to is patients who come in and tell you what their problem is, how they would like it treated, and could you freshen their coffee while you're at it.



I have always advocated for patient rights.  I tell patients it's their responsibility to ask questions of their doctors so that they are well-informed about their illnesses.  But, really?  I've called primary care physicians at home to talk to their patients who come into the emergency department because they don't believe me when I tell them to stop their medications, and that, no, they won't die, well unless they don't stop their medications.  I know what you read on WebMD but that relates to a certain population which you're not a part of.  I know that "Diagnose That" said that because your skin looks green under a full moon you could have a metabolic disorder, but if you read further or did some more research,  the fact that you're still alive at 22 means you probably don't have something where the average survival age is 2.

I read somewhere that a little knowledge is a dangerous thing... just continue to quote the internet to someone who's dedicated at least 12 years of their lives to studying medicine. Mmhmm...

Making Headway



photo by v.bonales 2010

 So, hubby and I were having dinner with one of the traveling physicians, and he told us about the Headwaters Forest Reserve which is located about 8 miles north of where we live.  He talked about a paved mile hike followed by about another 2 miles of graveled trail.  After that is a steep, uphill 2.5 miles leading to a grove of untouched redwood trees.  And this is just a small part of the 7500+ acres that make up the reserve.

Yeah, we made it to the three mile marker and turned around.  But, I was amazed yet again at how much beauty and history is located so close by.  The BLM has signs posted along the first mile of the trail that give you information about the area;  where prior dwellings were, the history, etc.  One picture showed a bustling logging town named Falk some time around 1902.  Now, there is just forest.

photo by v.bonales 2010



You look up the hill and can't even begin to imagine that a mill, a general store, a saloon, etc. even stood in that site.  I think what I am sometimes most amazed about is how quickly nature reclaims the land.  My mind is blown away when I stop to think about these 1,000+ year old redwoods that have withstood forest fires, logging companies, a town, and are now a part of reclaimed forest.  This truly is an amazing place, and I am lucky to be here now and able to continue to explore and stand in awe of nature.

Can't wait to find that next hidden treasure.  Oh, and also can't wait to get into shape to make it up that last 2.5 mile climb.  I am sure it will be well worth it!

Spring Forward

I've spent the last 13 years living in the Midwest and East Coast, and to be honest, I've never much looked forward to spring.  I can remember that very first fall in Wisconsin;  breathing in the wonder of it all.  Seasons.  You don't get those much in Southern California.  There's dry and there's wet.  That's about it.

But, in Wisconsin it went from a warm summer to a crisp fall.  I started headily anticipating winter... my first snowfall.  Then it came.  I ran around taking pictures of the light dusting.  It all disappeared by the next morning, but for me, it was all so amazing.  Of course, driving in it became another issue, and by February I was really looking forward to seeing some sunshine.  That's when it started raining and the white piles of snow became brown piles of mush and mud.  Then it would freeze, then it would snow, then it would thaw, then it would rain and the cycle would repeat.

Then one day... somewhere around late April the landscape suddenly went from brown to green, then the heat and humidity of summer fired up.  Seriously, when was fall coming back?  Wash, rinse, repeat.  Given the choice, I preferred fall and winter.  None of this yucky brown-white mess for me.

This year, we're on the West Coast.  Can't really say there's seasons, but what I can deduce so far is that for the first time in many years, I am looking forward to spring.  We moved here at the beginning of fall, and all of the hills were changing to a golden brown.  The trees had mostly lost their leaves.  Now, there's lambs appearing in the fields.  The rain seems to be slowing down.  The days are getting longer.  There always seem to be calves around, but I think the hillsides show a sign of promise of green waving grasses and a covering of foliage.  I can see the bulb plants pushing their way up toward the sky.  I see hope all around me.

Random Thoughts #1 of 2011

I've been very lax about writing recently. Funny thing is, I keep thinking of all these great blog postings, then I get distracted, then I get busy, and I never write them down. So I thought I would take a moment to write about a few things that have popped into my brain over the last week or so... caution, this may go long.

I love to travel, and I love taking photographs.  One of my colleagues asked what I liked to take pictures of, and I said, "Everything!"  My mom got used to pulling over to the side of the road frequently during road trips so that I could take a picture of something I saw that looked interesting.  My husband is slowly learning the same thing... My photographic life has been just that more interesting with the advent of camera phones.  I carry my phone everywhere, so instantly I can point and shoot.  In fact, my entire cross-country trip was shot with my iPhone... yeah....

We started eating "raw" again this year.  After finding that I gained a bunch of weight back following finishing residency and getting settled in a new place, it was time.  Time to get back that energy I had before.  Time to start fighting against the aging tide.  Time to get back into my old clothes.  And, time to truly test my self-discipline.  While not 100% raw, what can you say about the healthiness of self-made veggie patties, in a lettuce wrap with pinto bean chips?  My DH said, "Yum!"

I work in the emergency department.  While in residency, I worked in a trauma center which I sometimes referred to as the "drama" center since I enjoyed the back story of patients to the actual medicine.  I find that while I am not seeing the amount of trauma that I trained under, the drama certainly hasn't diminished in the least.

A few nights ago I found myself counseling a just-20-something patient who is pregnant and living with her almost-30 year old "baby daddy" in his parents' home.  The "he should understand what I'm going through because he's already got two other kids from when he was married," comment started a tightness in my shoulders that lasted throughout the entire 20 minute conversation.  I let her talk despite having several more patients to see because, literally, she has no one else.  She was a foster kid who was finally placed in a home at age 11.  She left this home in another state due to frictions between her and her foster parents.  I didn't ask how she ended up pregnant and alone several hundred miles away, but here she is, and I am sure it will not be the last time I see her in the E.D. during her pregnancy.

Did you know there's actually a "Squirrel Appreciation Day?"  I celebrated it this year by taking a nap since I am on the night shift over the weekend.  Had I known earlier, I might have done something a little more festive around my blog.... 

As, you can see... I am the tail-end of my blogpost..... Until next time!