Thirty!

I'm trying not to see myself as old but rather as wise or experienced! I actually had a pleasant birthday experience which included a weekend visit from a good friend and favorite Saipan resident Bev, dessert at Cold Stone (yes Guam has a Cold Stone!), golf stuff, snorkeling, discovering local Japanese cuisine, and spending time with Gemma and Maxwell. God has truly blessed this past year and I know he has so much more in store for the future.

Since I don't blog as often as I would like I wanted to share other October experiences. Last week, I went on my first medical evacuation--a.k.a. "medevac"--to Tripler Medical Center in Honolulu, HI. I had to fly with two hemorrhagic stroke patients who needed a higher level of care. As a family medicine physician, this really was out of my comfort zone, but it was cool to get into my cammies for the long military flight (sorry no pictures)! The trip went well, and the patients were safely placed in capable hands. The rest of my trip consisted of jogging, reading, NBA on TNT, Spiderman 3, and Chinese take-out. Good times.

Upon my return from HI, the next morning I ran my first PRT (physical readiness test) on Guam. For those of you unfamiliar with the PRT, it is a semi-annual test which consists of push-ups, sit-ups, and a 1.5 mile run. There are minimum requirements for passing based on age. This PRT marks the first test that I get to be placed in the 30 and over bracket! What I am most proud of is that my numbers have improved in all categories despite being placed in a new age bracket. 10:59 on the run, 71 sit ups, 75 push ups...not bad for an old guy! :)

One last story. These last few days have been a bummer. Our clinic has been pushed to the very limits trying to meet the demand for appointments. We have been shrinking our appointment times to 10 minute appointments, increasing our walk-ins, seeing patients post-call...all bad things. Also, 2 providers from our department are being sent to the Middle East for 9 months which doesn't help the situation. We are constantly being asked to do more with less. I was starting to feel a hint of burnout. But through all this the Lord seems to find ways to speak to me. Today, I saw a patient in clinic with a problem list that included chronic pain, bipolar disorder, depression (the list goes on) and a warning from my staff that the patient was "not being nice". By the way, the patient had no chart and was asking for more narcotic medication. The pain of primary care. My strategy was to listen. He gave me an earful about his horrible experiences with surgeons, his medications, his shoulder pain , his knee pain, his neck pain, his memory loss, his career. I continued to listen, nothing more. After what seemed like an eternity, he began to calm down and then said something that really touched me. He said, "Don't let this hospital get in the way of taking care of the patient." What? Did I just receive sound advice from my bipolar, chronic pain, mad-at-the-world patient?? I laughed quietly to myself. Thank you, Lord, for such timely wisdom.

Eureka!

We've found it!

After almost a month of searching, we have finally found a daycare worthy of our dear Maxwell!

...Which translates into "the daycare that makes Mommy the least nervous to leave her only begotten son." And the corollary (as my dad would say) to this discovery is that I am now available to join the workforce. Bittersweet.

Since July, I've had the priceless opportunity to be Max's primary caregiver 24/7 (of course, with the exception of "Daddy duty" hours). And during that time, I've seen him grow and learn and be all the things that make him Max. With all his "firsts" that we've awaited and celebrated, tomorrow will be a "first" that I can't say I've been looking forward to. But at least I know that Max loves to be around other kids and that he'll be in a clean, safe environment with very caring and qualified people. The biggest reassurance, though, is that I get to see him again! ...before rush hour! Ah, yes. The beauty of working part-time.

Wow. I can only imagine how heavy-hearted God the Father was to send off His Only Begotten Son to this unclean, unsafe world filled with very uncaring and unqualified people. It's a good thing the Creator loves to be with His created! And an even better thing that reunions are a big part of God's plan. ;) Speaking of reunions, tomorrow I get to see my hubby again after a 3-day assignment off-island! Yay!! (I'll let him expand on the details.)

So this is it. Keep us in your prayers for a smooth transition into a new world. Anchors aweigh!

Guam Revealed - Part 1

After several minutes of quiet excitement and anticipation, there emerged from the security-restricted doorway 2 faces that made home feel not-so-far-away. Max required a little transition time to reacquaint himself with Grandma & Grandpa, but after lots of hugs & kisses (and the comedic gestures that only occur between grandparents and their grandchild) he appeared quite content to have 2 more sources of undivided attention.

Despite the unpredictable precipitation pattern, it was great to have Mom & Dad Miranda spend some time with us and experience a bit of Guam life. It was also an excuse for us to slip back into the touristy exploration mode. When the sun was out (or when the rain was up), we made sure to visit the island's most beautiful sights. Many of them rich with a stories of the past...

Just behind us is the bay in which Magellan landed upon his discovery of Guam in 1521.

Further out towards the water is an old Spanish fort--Fort Nuestra Senora de Soledad (Our Lady of Solitude)--complete with intact watchtower...

...as so well-demonstrated by Mom here!

One of the several tiny uninhabited islands along Guam's coastline.


Near the northern tip of Guam, a cliffside lined with coral--evidence of the water line's previous location.

Ga'an Point--a component of Guam's "War in the Pacific National Park" complex--where Japanese and American forces battled for weeks during World War II.

The beautiful Talofofo Bay on Guam's eastern coast.

With Navy privileges, we seized the opportunity to lounge at the military's own Gab Gab Beach.


...and to explore Guam's UNDERwater sights! We were tickled (literally!) to have exotic fish nibbling bread at our fingertips.

Our last day of sunshine before Mom & Dad left was spent admiring the Talofofo Falls which had been somehow converted into a sort of amusement park by a Korean entrepreneur.








One of the park's features was a replica of "Yokoi's Cave" named after a Japanese sergeant who fled into hiding during WWII and was not discovered until 1972 by 2 hunters...who informed him the war had ended! This mural illustrates the structure of his hideout.










Within just a few steps, a scenic gondola lift ride, and an obligatory walk through the "Ghost House" (ask Mom & Dad), we reached a place of beauty and serenity... which, apparently, mosquitoes enjoy also.

Well, that sums up the outdoor portion of Mom & Dad's visit. As captivating as those scenes were, however, I think it was all the "resort fun" they had at Leo Palace that made Dad ask if they could come back next Christmas! We'll save those pictures for the "Leo Palace Revealed" entry!

Having my parents go out of their way (and out of their continent) to come spend time with us was really a sweet blessing and a reminder of how God uses family to teach us what it means to belong. And for the relatively nomadic life we're living, that sense of belonging is invaluable. Praise God, He's been fulfilling our need with awesome friends and neighbors... and even new found relatives! (More on that later!) Of course, in the greater scheme, all of us who've been adopted into the Family of God know that Home is a long way off, but what a comfort to belong with those who journey there together--all the others on the water, too.

ONE

Today, Maxwell is 1 year old! (Although, technically, tomorrow is when it will be September 22 in CA.) At 11:07 pm, on a late Friday night, Max was born at Naval Hospital Camp Pendleton in southern CA. Weighing in at 6 lbs, 14 oz, he made his presence known--thanks to a healthy pair of lungs! Now estimated to be at least 20 lbs and pulling some of his own weight around, my itty bitty baby is turning into a little boy.

The 1st birthday seems to be a milestone for us parents just as much as, if not more than, for our child. Sure, he's growing and learning to make sense of this strange new world... but so are we! If only babies came with owners' manuals! Maybe Mike & I should bake a cake to congratulate ourselves for keeping Max alive and kicking (and celebrate our own survival) for a whole year! Truly a miracle. :)

The main festivities will take place next week with some of our closest friends on the island. But the climax of today's celebration is the welcoming of Lolo GJ and Lola Beth (the Miranda grandparents) whose plane shall be landing in about an hour! Here's how Max is keeping busy in the meantime...

Before...

You want a piece of this?

...

...After! :P

On My Own

The journey towards physicianhood can be arduous, painful, and thankless (8.50 per hour!). Nothing is sweeter than breaking through to the "other side", and removing the "resident" label which now entitles me to a little more freedom, respect, and reasonable monetary compensation. At the same time, nothing is more frightening than removing the "safety net" we residents refer to as "the attending". No more drawn out inpatient rounds, required lecture attendance, gathering data at o'dark thirty in the morning, or "guess what I'm thinking" medical trivia...I am on my own!

This past week marked my first week on the Inpatient Medicine Service which equated to heart failure, GI bleeding, pancreatitis, stroke, heart attacks, cancer (all bad things)...all managed by a team of 1 (also a bad thing). The week was inaugurated by a call night of laboring OB patients and crashing heart failure lady. Also, crashing heart failure lady didn't seem to care if I was post-call either. The week seems like a blur to me. Was it scary...yes. Did I kill anyone...no! Can't wait to do it again!?!

Step by step

A milestone reached... A frontier entered... A step taken...

Max is walking!!!

This little guy's first observed step actually took place about a week ago as he crossed the ~20-inch gap between the chair and the couch. But it's the kind of event that incites both excitement and doubt--for fear of rationalizing it into reality because you're so eager for it to happen. "Did he really take a step? Or was he just moving his foot while falling?" Well, we held off on marking it as Max's official first step since we weren't sure if it was "for real"... plus, Mike wasn't there to see it (and believe it).

Since then, Maxwell has been proving to his father that he, indeed, can walk. It fascinates me how he grows more and more confident with his new found skill, and I'm even delighted by Mike's expressions of amazement every time he watches Max walk.

Oh, how deep the Father's love for us! That even our grasping of simple truths brings joy to His heart. That He watches us test, then try, then reach those new horizons... places He has been waiting for us to enter and enjoy.

Back to the Beginning

Well, the moving-in is still in progress with over 10 boxes that have yet to be unpacked. Not too shabby, though, considering there were 130-something numbered items unloaded from the moving truck! With God's grace, that day actually went a lot smoother than expected. And despite the dreaded precipitation (the movers had to take 2 breaks due to sudden downpours!), all our stuff was moved in and major furniture assembled in less than 3 hours! Woohoo!! The only apparent casualty was our corkboard bulletin board which arrived broken in pieces... so long, faithful office accessory.

We did, however, locate and unpack the intact USB cord for our camera which facilitated the downloading of ~480 pictures! (Hey, carpe Kodak!) But we shant overwhelm you with all of them at once. We'll give just enough to keep you coming back for more. ;)

And now... the long-awaited visual update begins!

Our very first day on Guam is, honestly, a big blur... likely due to its 1am commencement! Hence, the lack of pictures documenting our "first day." What we do have is a photo of our first Sabbath breakfast on Guam which took place in our fairly spacious hotel room. Nothing beats Goober PB&J and "pan de leche" from K-Mart!

We took advantage of our jet lag (it was ~2pm Califronia time!) and went for a morning stroll outside our hotel before heading out to church. What a great way to start the Sabbath!

"Toto, we're not in Murrieta anymore! "

Here, the Philippine Sea reminds us just how far we've come... and how far God has yet to take us.

More to come!