To make an entrance

The walk to the front of the building is a bit circuitous because you exit the parking garage through double glass doors on the side of the building, then walk between the parking garage and another brick building with your eyes hovering at the level of holly-like bushes lining the cement path. I remember after the Atlanta tornado, the path was littered with debris, with one tree snapped in half, hanging over the walkway dangerously at an acute angle.

After the walkway, you have to cross this inconspicuous street through which no traffic is allowed, akin to the streets in Disneyworld, except you don't see the Electric Parade passing by with its tooting horns and dazzling lights all to highlight a incessantly happy mouse.

I cross the street towards Grady Memorial Hospital, which is easy, as I mentioned before, because of the absence of cars, ambulances or trucks. You just have to watch out for the occasional city bus, but those are so big that you don't have to worry about missing them. Crossing the street also may be a bit more difficult on rainy days when multiple puddles highlight the tar's lack of a smooth and straight surface.

Then, after you cross the street comes the decision. Should I enter through the revolving doors and help Grady conserve energy like the posted sign recommends, or open the swinging door to the side and allow blasts of air conditioning to escape?

The answer lies not within my eco-friendly id, or within the sleep-deprived soul that sags underneath the my body that's aged God knows how many years since I started residency. No, the decision is made on the path of least resistance. I may spot the Hispanic family of seven coming through the revolving doors, or the group of white-uniformed night shift nurses filing through the side door one by one, or the random very large man in a faded winter jacket smoking a cigarette. It just all depends.

Or, I may choose to ignore the revolving doors, or the swinging door that leads into a less than majestic atrium, where aged paintings of prominent figures in ceremonious clothing are hanging on the walls. Often, I make a sharp turn to the right after crossing the street, passing by iron park benches, columns of cement, oddly situated trees and lots of dried, crusted pigeon stool. Making this sharp turn, I head towards Mickey Dees, which in a former decade could be the Grady equivalent of The Max on Saved by the Bell.

But I don't succumb to the nonexistent temptations of McDonald's that a vegetarian has.... ha ha... no, I then turn to the left, where there are tall, automatic sliding doors leading into the side of the hospital. Here, there are more patients, patient families, nurses, residents, attendings, and, of course, more pigeons. The main difference is the number of people and the increased likelihood of you finding them clutching a greasy carryout McDonald's bag like it has a leprechaun in it.

What's notable about this door is the blast of air that combs through your hair and slaps against your face as you enter. You can smell it. The cleaning liquid used to sanitize the floors. The cigarette smokes that caries on people's clothes. The sweat of post-call residents. The all inclusive fire hose to your nose gale.

I've been choosing between the three doors since I started my pediatric residency. There's nothing symbolic in this choice. It's just the experience, one that you become familiar with and don't pay much attention to unless you're in one of two situations. The first is when you're driving along I-75/I-85, along the part they affectionately refer to as the "Grady curve," and you see that unmistakable sign in bright lights adorning the entrance to the hospital through which I have never entered that says, "The Fulton Dekalb Hospital Authority Grady Health System." I know that facing these words to start my day as I enter Grady would make my start to the day different somehow.

The second situation in which you think about your choice of Grady entrance for me just happens to be when you are completing your very last call ever at Grady.

Top 10 moments of 2008

I believe that only when we are grateful for what we have received, are we able to receive more goodness in our lives. And I'm not saying that because I want to receive, receive, receive, but more so because the act of stating what you're grateful for makes me feel blessed and thankful, which feels really good! Especially in residency, when there is an inherent default setting in you that points to "complain!" I'm a little bit on the late side, but here are my favorite moments from 2008, which was a great year for me!!

10. Putting up my Christmas tree this year. I know it's a very small thing, but it's been years where I actually took the time to buy a tree and decorate it. It was an activity that took only an hour maybe (yeah, it was a sparsely decorated tree!), but it made me realize that I need to take the time to do little things that make me happy.
9. Reading The Inheritance of Loss, by Kiran Desai. I haven't read a book this good in many, many years. I love the description of the foothills of the Himalayas - the fog and mist descending upon the foothills, covering what appears to the unsuspecting observer as a beautiful village with a shroud of desolation. Anyone who loves descriptive writing should read this book.
8. Passing Step 3! Man, this test was brutal! It was two days long and I had to fight to keep awake to answer all those questions. I was so happy I passed.
7. Finishing 2nd year of residency and starting my third, and final, year of residency. I am proud of myself for doing something that at one point, I didn't know I had the strength to do. I'm also grateful for all those little moments in the third year of residency where my intern was grateful for the time I took to spend time teaching. I love teaching!
6. Along the same lines, there is one specific teaching moment that stands out in my mind - supervising my intern's first lumbar puncture ever this past July. She had a champagne tap - zero white cells, zero red cells found in the cerebrospinal fluid. I was really proud of this moment because I felt that my teaching and guidance that I offered to her enabled this first experience for her to be a success. It also made me realize that I've come a long way in residency... I've gained both experience and confidence.
5. Accompanying ML to her OB appointment and seeing a healthy baby growing inside of her. What a tear jerker.

4. Engagement ceremony in DC in September. It was so cool to have our families and friends together for that special ceremony. The food was really good too!
3. Accepting my fellowship in Pulmonology at Boston Children's. I was on call in the PICU, on rounds when I received a page to contact the fellowship direction. I called back right away and was jumping up and down afterwards!!
2. India trip 2008. Never in a million years could I have imagined that I would actually be able to travel to India during residency! I had the experience of a lifetime at Swarna Jayanti Samudaik Hospital, making beautiful friends and gaining invaluable experience. And most of all, I was grateful to all the children who were my patients, who taught me so much about Pediatrics.
1. The Proposal at Muir Woods, March 24th- I will never look at Trail Mix the same way.

Wow. What a great year for me. Writing this down makes me regret the countless energy I wasted complaining about various things. If I had channeled that energy into something positive... who knows what more could have happened. I think I hear myself making a new year's resolution.