Kindness of strangers...

Ridiculous Richmond observation of the month: 
For the first place prize of crazy bicyclists, exhibit A - Sitting backwards on the handlebars of his bike, no helmet (of course), riding diagonally against the flow of 3-4 lanes of traffic (some turn lanes thrown in). The bike was facing the direction in which in was traveling, but the rider was not. I wish I'd gotten a photo but I think I was so incredulous we were seeing this in person and not reading about it on the Darwin awards that I couldn't process it.

Wonderful Richmond observations of the month x2:
Strangers are so friendly! And the dog park is the social mecca. We had dinner the other week with a couple we met at the dog park, and then again via craigslist when we bought some Ikea furniture from them. They graciously volunteering to save us the several hour round trip drive to the nearest Ikea and picked up some things for us. We then had them and their dog over for dinner and had fun getting to know complete strangers and swapping dog stories! Today at the dog park I chatted with a mom of two young boys that has been at the park a few times when I've been there, and she asked me for my contact information so she could help us get some meals after the baby is born and our family leaves. Amazing! We also inspired their purchase of a child sized ball flinger after her two boys spent a lot of time trying to master our set for the pups. Malcolm of course was happy enough to go after even the zero distance bounce throws.

The park system here continues to amaze. We spent more time on Belle Isle and made it around the entire island, including some creative rock hopping and near flip flop loss. Also some added challenges with hoisting the dogs down a ledge when they refused to climb the ladder. Most recently we went to Pony Pasture park (nothing in it resembled a pasture, unclear where the name came from) and even though it was a Saturday afternoon we were able to take a lovely several mile meandering hike with the dogs scandalously off leash and barely ran into anyone!

Excitement included the dogs crashing into a wetlands pond covered in thick green vegetation (we think Malcolm thought it was solid ground and literally charged in) - for which I was mortified for the delicate habitat our dogs had just likely demolished and Tyler couldn't stop laughing because both dogs had then turned green and smelled horrible; and rescuing a large catfish that somehow got trapped on a fishing line hanging off a pile of driftwood. We have many more parks on the list left to see, and also recently discovered that the local zoo has a litter of teenage cheetahs!

Other random life updates:

• Baby news - the nursery is getting more coordinated. Bought a secondhand glider on craigslist for a steal which is insanely comfortable. We had an Ikea assembling party to take our second hand shelf to a dresser/changing table.
  
  Hung up Aimee's amazing paintings which make the space look so much better.
  
  I finally got some slight motivation for creativity and covered a lamp in fabric and got some minor decorations on the wall. Still have a few more things to assemble and coordinate but while it may not be Pinterest worthy I have at least managed to convince Tyler that my random craft ideas actually do turn out.
  
  Still have a big shopping list to complete but we're not worrying about that yet - hoping for some Labor Day sales to start. I am exercising a lot of self control to not buy every item of clothing when Target brings out new outfits. Baby Laney has been super active and pokey lately. We get to play guess the body part and try not to act like a crazy lady at work when she kicks me so hard I have to stop in my tracks and catch my breath. I also wonder if sometimes my patients can see my belly squirming under my white coat and if that's disturbing? 
• Work news - Tyler is realizing that to get his dissertation written before the baby comes he needs to get cracking, so the fridge is now stocked with Mountain Dew cans and he is chugging away! Still clocking in a lot of miles run each week and keeping busy with his inpatients and clinic patients. I picked up a couple extra shifts this week at my job, their bonus pay is hard to argue with, though I ended up with a string of evening shifts and I miss seeing my husband! I have officially decided that I will never again work full time urgent care, but I did actually have a day or two where I saw more than sore throats and back pain and felt like I did some real medicine which was great. Nothing like treating anaphylaxis to make you feel like a real doctor. I still feel like I'm the only person in the practice who will diagnose pharangytis and sinusitis without reflexively prescribing antibiotics (or low back pain without handing out percocet) but I'm getting used to it.

Still need to work on taking more photos and blogging more often, but better some than none! Missing everyone!

Update Dump

So much blogging catch up!

Baby updates:

• Finally got into see an OB physician for transferring my care after the midwife hoopla (took a lot of phone tag with the nurses and very nearly had my only option to see one of the perinatal specialists). She is amazing! We're very happy with her, and I only wish she was a family doc so that I wouldn't have to start the search over to find a primary care doc for the little one as well. She even tries to come in for her patient's deliveries when she's not on call - which would be great!
• The nursery is starting to come together. Thanks to craigslist (dresser/changing table!), an Amazon coupon and some random Target shopping we've started to get some more things together and it actually looks more like we're going to have a baby. We have some Ikea ordering and assembling to do, a minor art project to put together, a used glider to find and a slew of Amazon registry ordering to do (oh Amazon, why do you make us wait until 30 days before her due date for our completion discount? there are so many things we need to get!) and then we should be pretty set. Until I think of something else to freak out about our baby not having (update: she probably won't be naked most of the time, after some Target/Costco sprees and finding a great consignment store in the boondocks she does have some more clothes! although if she wants to get much fancier than a onsie, possibly with some pants, then she might be out of luck).

• We had maternity photos done! Mostly as an add on for the newborn photos I am super excited about, but despite my lack of desire to have my puffy feeling self photographed (luckily my photogenic husband helped balance things out), so far they look great (the sneak peak photos we got are below)! We even got the dogs in a few of the photos, although Malcolm clearly is the most photogenic of the two, Rue mostly spent her time in a frenzied panting state wondering why a stranger was staring at us the entire time and she couldn't go sniff the ducks.

• I'm still feeling overall pretty well, other than a bit creaky after working. Though between the heat and the constantly on my feet for my work shifts I am wishing someone would design some compression stockings that makes sense to wear when it's 90 degrees out. So far I'm going for the sausage digits are sexy angle. 

Work updates:

• Just finished up my final supervised training shifts, so I'm on my own from now on! The DOS based EMR is still not my favorite, but I seem to have it down. I don't think I'll ever like the strange dictation limbo they have us in to dictate just enough for our level of service, but not any more lines than needed, but I at least am getting used to it. The model of patient care and reimbursement structure I think will continue to drive me crazy, but I just try and ignore the fact that I have to sign off on PA charts that give antibiotics, albuterol inhalers, a steroid burst and cough syrup with codeine to every bronchitis or URI (I wish I was kidding, this is one of the PA's "specials," I've already had a patient tell me point blank that every time he comes here with a virus he gets an antibiotic) and go along and try and save the world from super bugs on my own and singlehandedly bring down the vicodin prescriptions handed out every day (you aren't getting narcs from me unless you have a broken bone!).
• There are also mysteriously no stools for the provider to sit on in the exam rooms, and I have to stand to access the computer anyhow. This along with only 1-2 computers I can dictate at that have chairs, contributes greatly to the previously mentioned creakiness and sausage digits. Not to mention there is no such thing as breaks or lunch for the providers, so I just have to make patients wait when I've gotten to the point of no return with my hunger and then eat like a starving teenager! And we can't leave the building during our shift, so I am brushing up on my rusty lunch making skills.
• The silver lining in this job is that due to the high volume of patients I see per day, I have gotten to see some interesting things. Clinical Lyme disease for the first time, aborted a cluster headache (which I've only previously seen as a boards question!), done some fracture management, sent a patient to the ER for rule out appendicitis and she got her appendix out!

Fun updates:

• We weaseled ourselves into our friends' family visit to the Outer Banks in North Carolina and picked them up from the airport in Norfolk and drove down to hang out with them and check out the beach! Despite the 6 hours of driving that day it was a lot of fun and great to catch up and spend some time with friends and check out more of the area. Rue got to see the ocean for the first time and Malcolm got to see the Atlantic ocean! Neither were terribly impressed and found it salty and too wavy. 

• Went to a "Partners in Medicine" BBQ, which is a support group for significant others of medical residents/interns, in the attempt to broaden our nonexistent social support. Everyone was lovely, but none of the women residents showed up and I was the only significant other of a non-MD resident/intern. So I was awkwardly the "doctor wife" rather than a "doctor's wife" and the only MD there who had completed residency. I was able to have more interesting conversations about what it was like to be an attending with one of the senior residents (also a dad) than able to commiserate with the wives about my husband being on night shifts and on call all the time (because he isn't! I was the one who did that already). But luckily babies are a pretty common subject and there were a bazillion kids there. I simultaneously was admonished for not having my hospital bag packed already in case I went into labor early, and complimented on being so prepared that I have a car seat already. But I feel okay about the former, I'm holding this kiddo in until 40 weeks (okay so I know she'll decide when she wants her birthday, but I can dream right?) and the hospital will give me a gown and underwear, what more do I really need?

Now for the video of the post - fetching in the Atlantic! Or how the puppies ingested more sand than could seem possible:

We're Not in Seattle Anymore...

Richmond thoughts:

• The bugs are terrible. Even if I am barely outside at all, and cover up and/or use my non-DEET hippy bug spray when I am outside for longer than a 3 minute dog potty break, I end up with at least 2 new mosquito bites per day. And they stick around for 1-2 weeks. I think I just need to get used to having legs that look like I have the chicken pox on a daily basis. Somehow they still don't bite Tyler, go figure.
• It has been, apparently, unnaturally cool here lately. Which means that we haven't seen triple digits in a while and there has been rain off and on. Still got up to 90 yesterday and I was melting at the dog park.
• The bicyclists here are crazy. Not hardcore, spandex wearing, eye on the prize, Seattle crazy. But no helmet, no lights at night, not obeying any road laws whatsoever (again, not the Seattle technique of going from car to pedestrian or rolling through a stop sign - but more along the lines of going the wrong way down the street against traffic) Richmond crazy. I think it's a wonder that there aren't more bike accidents here.
• Pedestrians have a prolific "meandering jaywalk." In Seattle we make a big deal about our jaywalking, but that's a joke when you see the people here. Seattle jaywalking still involves looking both ways, often still at a corner, and briskly getting from point A to point B. Here in Richmond, jaywalking is deciding you actually would like to be on the other side of the street and at that very moment, meandering into the road, preferably at a diagonal so you can spend as much time in traffic as possible, and strolling across the street at a leisurely pace, regardless of which cars were coming at that time or how many lanes of traffic it may be taking you to get to the other side. Also included in this are: walking down the middle of the street when there is a large sidewalk available, driving your motorized scooter down the middle of the street against traffic. Ironically, getting drivers to stop for you at a crosswalk is almost impossible. Who doesn't stop for a pregnant lady at a crosswalk?? At least 20 Richmond drivers in a row, that's who.
• Turn signals appear to be optional. Slightly pulled out into an intersection at a green light and not moving? A new guessing game! Are you: (a) stalled and can't go, (b) lost and don't know what's going on, (c) turning left but are confused as to how to communicate this to the other drivers, (d) stopped for an invisible family of ducklings that only you can see. Option C inevitably wins, but I still root for D. There need to be some billboards up about what the stick to the left of the steering wheel does to educate the public. We're constantly seeing wrecks on the freeways and I can only guess that they were among the large group of people that feel that letting people know you are changing lanes is an unnecessary wrist movement, particularly when you are busy on the phone. 
• Taxes here are confusing! I was excited about the 5% sales tax (compared to Seattle at almost 10%), until I realized that food is taxed here at 2.5% (way to support your low-income classes Richmond), and dining out food is taxed at something close to 12%. Which makes it very painful when you try to go out to Thai and have the worst Thai food you can imagine paying for, and terrible service, and still have to pay over $40 for it! Not to mention the fact that we'll have to pay VA income tax since we'll have been a resident for 2 days over their cut off. You would think with all this tax money that they could teach their residents some traffic safety and throw in a food waste collection program for composting!
• The dog park is a social mecca. Our most recent craigslist purchase (a bookshelf/dresser for the nursery) was from a couple that we had met at the dog park and they've offered to pick up a few more things from Ikea for us when they go, since it's a 2 hour drive out there and Ikea shipping is a bit ridiculous. Yesterday Rue took a treat from a stranger for the first time ever! It helped that the lady was giving them giant dog biscuits - who can pass that up?
• The peaches and tomatoes here are incredible. There is a great farmer's market about 15 minutes away, that's like the Ballard market, only you don't have to drive through awful traffic to get there or deal with horrible Ballard parking once you're there. The first time we went we bought 12 lbs of tomatoes and I made a bunch of tomato sauce, the next time we bought a huge bag of peaches and have been eating them every day! Not to mention the amazing freshly made donuts, super friendly vendors (can't find basil? the friendly tomato guy will tell you which vendor has some today), and lots of other delicious food (there is a bagel truck!). 
• The River park system here is incredibly. We've only checked out Belle Isle but have been very impressed. Rue also learned she loves water! Here are some photos from the expedition there a few weeks ago as a reward for getting through all these words (and a naked tomato photo, before I threw them all into the pot):