3 weeks down - 78 more to go

Sunday-Tuesday all MOTS studying. Wednesday, Janos and I attended an Adult Day Care. It's like Day Care for kids, but for adults. I know it seems silly to have to say that, but most people confuse "Adult Day Care" with "Adult Foster Care" and assume that the clients live at the centre. They are dropped off and picked up like you would your kid at day care. It was a full day that had us up at 6:30am to drive from Royal Oak to Bay City. This week we only had three days that we needed to be up in the Saginaw area for. So we opted to save money by living at home instead of staying at a motel. What that also meant was I got to go grocery shopping over the weekend to buy my staple items (cereal, milk, yogurt, bananas). I also bought some carrot and celery sticks along with almonds (gotta get that protein). It's nice to have a breakfast routine.

The Day Care is in an old elementary school. Half of the building is a children's day care and the other half is geriatric day care. I've never seen that combo before, but it's really cute. They do crafts, story time, and social visits with each other a few times a month. It helps the adults flex their grandpa/grandma muscles and it helps the kids broaden their horizons. I have always enjoyed the "best-ager"s population largely in part to the influence my parents had on my life growing up. We were often around young adults, older adults, and elderly people because my parents' diverse social circles. According to my mother, sometimes when we'd go out for breakfast after dropping my brothers off at school, she'd get distracted for a second or two while she portioned out my breakfast from our order, and I'd sneak away from the booth. She'd look up and be in a panic, then find me a couple booths over sitting on an adult's lap talking about my family. No fear. No stranger danger. Everybody looked like they'd be a friend of my parents. Despite how dangerous this concept may be in today's slightly more shady world, in truth, this has allowed me to feel completely comfortable interacting with all age-groups my entire life. Here's hoping these kids grow up with the same skills and appreciation for people wiser than they.

All the adults at the day care are well enough to bear weight, socialize to an extent, and go to the bathroom when they feel the need to. There are varying degrees of dementia in a majority of the clients, but for the most part, it's a place for elderly people to spend the day while their spouses or family members go off to work or take a much needed break from their primary caregiver roles. We arrived before any clients, met the staff who presented us with our premade name-tags. Thus, I was "Kristen" for the day. No harm, I'm used to that mix-up and typically respond if I hear it called. However, this was the first time I've introduced myself to people as Kristen and it took about four times to not stumble over my name. By the time all the clients had arrived (~12 people), they gathered around a long table and were served their breakfast (bowl of cheerios and some grapes). Shortly after the meal, we went around the table to say our names which is followed by an immediate "Good morning, _insert name_!" So it gets around to me and I say "Hi, I'm Kir--Kristen. Kristen"
"Good morning, Kirsten/Kristen!" (an equal mix of half the group saying Kirsten and half saying Kristen)
Janos - "Actually, her real name is Kirsten, but she's too Canadian to make a fuss over it."
Kirsten - "I'm used to responding to both. So it's not a big deal to me"
(we continue around the circle)
Janos - "Hi, my name is John."
Dick (the man next to Janos pointing to Janos' name tag which clearly says "Janos") - "That's a weird way to spell 'John'."
Janos - "Janos is my real name, but I often go by John (which is true) because most people have difficulty pronouncing my name."
Fred (sitting next to Dick) "Hey Dick, what's your real name?"
Dick - "What do you mean? My real name is Dick."
Fred - "Yeah, you're a real dick!"

That conversation very much reflected our entire day with them. Playful, fun, and uplifting. We played table games, we did chair exercises, we ate lunch together followed by a relaxation/nap time session, then we played hangman, dicebingo, then noodleball which involves us sitting in a circle hitting balloons at each other with cut up pool noodles (genius), then we swapped some life stories and then the day was over. By far the quickest full work day I've endured. The best geriatric experience I've had the entire rotation. Obviously the medical component is very much removed and replaced with a heavy emphasis on a social component, but we definitely need programs like these if we're looking to improve quality of life, not just for our clients but for their family as well.

Wednesday was also Justin's birthday so we celebrated with dinner out and some delicious cake. Janos learned that he passed his Comp the day before and Justin said that was his birthday present. He's such a loyal and strong support system for Janos, it's really quite endearing. 

Justin & Janos with the traditional birthday confection

Thursday had us at another nursing home, but this time we followed a resident around which was unfortunate because they were all family med residents who didn't want to be there. As part of their residency, they have to spend one day a month at the nursing home to follow-up on the patients assigned to them. So their goal is to get in, present their patient to the attending, and then get the hell outta there. I got to see some interesting things, and got mini-pimped by the attending which thanks to my studying, I was prepared for, and then the experience was done.

Friday was our last day and all it involved was a little test and a debriefing with all the students and one of the program coordinators. A quick hour and we officially completed our first rotation. 3 weeks done, 48 weeks of cores and 30 weeks of electives left. Huzzah! Headed back home to eat lunch and then studied 'til dinner. As per mini-tradition, we went to Lui's for some Detroit-style pizza as our last supper together. Came back home to pack and relax, then hit the sack in prep for an early morning.

Saturday we were up at 5:15am and out the door at 5:45am to drive to the airport and say our goodbyes. The boys drove to Chicago later in the day to have a celebratory dinner with Malini as she took her Step exam on Friday. Goodbyes are easier to deal with now. So this wasn't a tough farewell at all. I had a wonderful time with Janos and Justin, but it's very exciting to have us all on our own moving forward in our studies. We'll keep in touch and that's good enough for me. The flight to Toronto was on a bigger plane and each patron had a row of two seats to themselves. The flight to Vancouver had me in the third row, which came with certain perks that I opted not to take advantage of (it's hard to study with alcohol in your system). Unfortunately, we had an emergency landing in Winnipeg. While waiting for repairs to finish or a new plane to become available, I studied at the gates. Then we boarded a new plane and finished the last half of the trip home. The delay meant that I wouldn't be home in time for a visit with Krauses as Alison and Piper came into town from Edmonton. No worries, I'll catch them some other time.

Step's on Tuesday and then after that, I get an honest break for a few weeks until I get my results. Looking forward to having some quality time that isn't rushed or attached to holiday festivities. I talked about this with Justin about how this will be the only time I can have a true break without having to prepare for another test or an immediate rotation or plan my career path. The next time I'll have this kind of freedom will be after I finish my residency (which is at least another 4 years from now). So it seems like this would be the opportune time to retreat to the island, the place I retreated to in Aug 2011 and came out with renewed focus that jump started my journey to med school. Definitely stoked to work out, sleep well, play guitar and sing at the top of my lungs in an empty house, heck, I might even read a book or two. This is going to be good. 

So long freezing cold Michigan!

Yeah, no, but here we go

Monday I was doing some home hospice visits. I was pretty disappointed with the person I was shadowing. She started by taking a personal phone call on our ride to our first client. The conversation lasted the whole ride, 5 more minutes sitting in the client's driveway, then two more as we stood by the front door (with the client's daughter standing behind the screen door watching us). I wanted to apologize for our collective unprofessionalism. Alas, the daughter was merciful. She was restless and bored because she was chatting us up about anything and everything. The father-daughter dynamic of yelling and swearing at each other was unfortunate to witness, but given that he has dementia and this is as talkative as he gets, maybe she'll take what she can get. Our next visit was at a nursing home where our client lives with his wife. Again, dementia, it sucks. He's changed enough such that she acknowledges that he's not the man she married. For him, she's not someone he loves (and maybe he doesn't remember that he used to love her). It's clear she's struggling with staying there with him (she's healthy enough to not be there). While the person I was shadowing was taking vitals, I decided to distract the wife by asking about her children and grandchildren. We took a trip down memory lane and that seemed to boost her spirits a bit. Before long, our time was up and we bid adieu.

Tuesday morning had me back in the familiar confines of Hoyt Nursing Home. I had been there a few times for 5th semester. Half of the patients I saw during 5th were no longer at Hoyt. Surprisingly, my 102 year old patient was still alive and relatively well. By noon, we were at the hospital for journal club discussing an article regarding cancer screening in geriatrics. It's not necessarily a controversial topic, but it's certainly complicated. As a physician you have to keep the patient's best interests in mind while also keeping in consideration the overall cost and burden to society. Both parties will hold you equally accountable and you could be stuck between the rock of a 90 year old insistent on getting all the screening and treatment necessary to increase quantity of life (regardless of the quality) and the hard place of society outraged that their tax dollars are paying for this labour, equipment, bed space, and treatment for what may amount to an extra year of life (if we're lucky). Follow up journal club with a trip to an assisted living home to interview a couple depressed patients, who despite not having any eminently fatal conditions, are ready to leave this world. One patient, laying in her bed, eyes barely open, literally told me "I have nothing to brag about in life" in response to my benign question "How are you doing?". In my foolish desperation, I pointed to the pictures on her dresser exclaiming how beautiful her children, grandchildren, and great grandchildren are and perhaps they could be a source of pride for her. Nope. No go. They're not around (or if they are, they're not putting in the effort to let her know they are around). Dammit. Shit. Fuck. Geriatrics is a killjoy. It's not the patients themselves, but what they live with and without. Living with decreased health and functionality. Living without stimulation and social support. I know it's not like this for every geriatric patient, but certainly more than less. It's like everything good disappears all at once and it's insanely crippling. Life ceases to exist as they knew it, because they certainly don't call what they do "living".

Wednesday was so pointless. We had to be up early to attend an interdisciplinary group meeting for a hospice organization. They wouldn't include us at all. Literally pointed to seats along the side of the room, told us to sit and stay there...for 3 hours. The agony! They were just going through all their patients and updating what was going on with them. They had a couple different family members show up mid-meeting to voice their concerns regarding the care for their relative. That's when we paid attention. Otherwise, we were essentially flies on a wall.

Thursday, Janos had a morning rotation at a Rehab clinic (I had already done that last week) so I went with him and found a nice study spot in the cafeteria. When he was done, we had an hour to eat lunch and drive to our next stint. May I just say that I love that Canada (or at least BC) doesn't have a $1 menu at McDonalds. I got a McChicken and a yogurt parfait for $2.12 after tax. It's been a while since I've bought a McChicken in Vancouver, but I'm pretty sure it's over $3. They weren't kidding when they said it's cheaper to eat crap than eat healthy food in the States. Money's a huge factor and you can definitely understand why obesity is so prevalent here. Even when I look at Janos' eating habits, I get alarmed. He's a bit of an anomaly with all his syndromes and auto-immunities that keep him stick thin, but you'd be hard-pressed to find a day where he doesn't consume more than one soft drink and/or a caramel macchiato with an extra shot of espresso. On the other hand, I enjoy a hearty glass of milk in the morning, a good dilute juice hear and there (Deen can instruct you on the proper juice-to-water ratio), and when the occasion presents itself, a nice craft beer. But not too many drinks make it on a day-to-day basis for me than water. A day where I don't have my water bottle with me or a tall glass of H2O within arm's reach is a sad day. Seriously guys, water, give it a try (it's free).

Studying while enjoying a taste of home (they love Timmy Ho's in Michigan)

At the Saginaw Geriatrics Home, I spent my time with a gentleman with fronto-temporal dementia that presented itself through marked expressive aphasia. Completely functional motor and sensory-wise, memory largely intact, all that's missing is the ability to communicate what he's thinking verbally and through writing. The discouragement with that reality was written all over his face. I kept it to yes or no questions because he could handle one word responses, but there would be times where you could see he wanted to elaborate. He'd try, spew out incoherent sounds with appropriate conversational hand gestures, let out an exasperated breath, shrink down, and look at the floor. The junior supervising doc came in to check-in on me and sit-in on the interview. I knew him from 5th semester and didn't care for him much. The way he talks about patients in their presence really pisses me off and this time was no different, except that my patient can understand what this guy was saying about him and knows it's not great stuff. So I stopped my interview, asked the supervisor if there was anything he needed. He said he just wanted to watch and asked if I wanted help with anything and I kindly responded with "Yes, I'd really appreciate it if you left us alone to talk in private. I think we'll have an better conversation without being pressured to come up with the 'right' responses." He was a bit surprised, but thankfully not offended. So he left us and once he was gone I said "Norman, I see that this has been a frustrating experience for you. I know you've just met me, but I want you to know that there are no right or wrong answers I'm looking for. I want you to know that this is a safe place and you are welcome to tell me how you're truly feeling so that we can work towards making your life as enjoyable as possible. Would you like me to re-visit some questions I've recently asked you?" He looked up at me and slowly nodded. I won't lie and tell you that I said that without stumbling or choking up more than once or that I didn't have to fight to hold back tears when he nodded. I proceeded to re-ask him about his affect (re-screen him for depression) and he changed most of his answers such that he jumped from "normal" to "moderate-severe depression" on the GDS. Unfortunately, Norman's at that stage where he understands his condition, what he's experiencing, and the prognosis. Eventually, he'll get to a point where he won't be so aware, and therefore not as frustrated or disappointed with himself. But for now, he's just in that tough spot. We finished up our interview with a quick physical. Then he got up and left the room, waved me to follow him, and he proceeded to walk me all around the complex. With his broken garbled sentences he informed me that he does this walk everyday, usually multiple times. Great pace, pleasant affect, and improved articulation. He likes these walks and it shows. We returned to his room where he lay in his bed in preparation for a nap (my kind of man) because that's what he does after a good walk. We shook hands and said our heartfelt goodbyes. Then I gave my verbal report to the senior supervising doctor who, thank God, has a similar empathetic approach.

I'm two thirds of the way through this rotation, but I know for sure that I can't dedicate my entire career to geriatrics. It's too disappointing. I can handle sick and dying people, but as I'm sure you're learning or already know, I struggle with the care (or lack thereof) others have for a person of interest. While I can't necessarily expect someone to have the same amount of passion I have for a person, there are still minimum standards. When I don't see those standards being met or if I see things get worse, I get very upset. Because no matter how hard I work or how much I love a person, their quality of life isn't significantly increased if I'm the only one. You need strength in numbers. So even if I do everything right as a physician, my patients may hate life if their family and friends aren't around, just like if I did everything right as a companion, my friend may hate life if there's no one else. Successful geriatric care has to be a team effort with the doctors, nurses, care aids, social workers, and families. Unfortunately, I don't see that with the conviction I expect.

If I had to sum up what I feel my life's purpose is in a few words, it's getting people to realize they are loved. Not to just believe it (because a delusional person can believe anything), but to have them actually recognize and acknowledge their self-worth based off what they know about themselves and how others treat them. I want people to have an awakening that there is something so precious in them that makes them amazing in general (not just to me). It's so basic, but I am incredibly aware that my purpose hinges on the involvement of others, that success is entirely out of my control, and therefore, that failure is guaranteed if I act alone. It's tough, and maybe worth changing my purpose for, but I guess that's where my faith keeps me grounded. I believe that God wants this for people too and that He will always provide people we can collaborate with, people we can inspire, and people who inspire me. That's how it has been so far and even through the darkest moments, I have always had people in my life who motivate me to work harder, love better, and live worthier.

"It's frickin' freezing, Mr. Bigglesworth!"

Holy crap! I'm definitely not going to settle down in Michigan or the Northeast in general. With highs of -15C and lows of -22C (excluding the windchill factor), I am woefully unprepared to handle extreme cold, save for my go-to accessories of scarf, fingerless mittens, and toque.

This cold front welcomed me back as I flew from Vancouver to Toronto to Detroit last week. The Toronto flight was delayed as to be expected. At least it was delayed and not cancelled altogether as many flights were. I flew in one of those tiny propeller plans that seats 14 people. I wasn't worried about my well being. Why you ask? Because I tend not to worry about my well being (to an ignorant prideful extent) and because there was a terribly annoying toddler who screamed at the top of her lungs during taxiing from the gate, take off, landing, and taxiing to the gate. The entire trip is just over an hour, so a large proportion was filled with crying and screaming and the overall feeling of my ovaries saying "Don't you dare!". Because of her age, she was supposed to sit in a seat by herself, at least for take off and landing, but her parents told the pilot that she'll make a fuss over it. He informed them that it's policy due to safety guidelines. They continued to fight him, and he gave them an ultimatum equivalent to "She sits or you get off the plane". Well that ended the fighting. So like I said, she cries while we taxi and she's sitting in her dad's lap at this point. We get to the part where the propellers rev faster in prep for take off and he decides this is the opportune time to put the kid in the seat next to him to buckle her in. She's already upset, and now she's hysterical. I may have bled from the ears (whether due to piercing sound or pent up rage is another question). Again, pediatrics, definitely not my thing.

The weather is quite a force here. If you don't have snow tires, you're going nowhere. Janos, being the handyman that he is, got straight to work in the basement after picking me up from the airport. He was putting up plastic sheeting around the walls as the wind was so strong that it was making its way through the old house's brick walls. By the time he was done, he had also put up curtains to cordon off a bedroom for me complete with a queen size bed, night stand, and dresser. He's too kind. I insisted that they don't leave on any space heaters in the basement because those things eat up so much electricity and I sleep fairly well in the cold. They left me a sheet, comforter, and 3 throw blankets. It was all so heavy (this must be what Bailey likes) but it kept me comfortably warm. We spent Saturday and Sunday studying, then after dinner on Sunday, we drove up to Saginaw. Due to the endless snowfall during Sunday, we thought it best to head up that night instead of waking up ridiculously early on Monday. It's normally an hour drive, but it turned into a 3 hour drive with the horrible conditions. We checked into a motel. It's no Ramada being equipped with a small bathroom and two double beds, but we're poor med students and don't need much more to survive.

We coordinated our wake-up times as my gay island husband takes longer than I do to get ready. So I get to snooze an extra 20 minutes while he showers. An added plus is that he doesn't snore. In fact, I "snore" (he calls it heavy breathing that nearly reaches snoring status). Up early Monday morning, in anticipation to grab a leisurely breakfast and then head to orientation. We get into the car and discover that a car has been left stranded in the driveway and the snow has only been cleared enough for one lane. Cue cussing. Talk to the office to see what's going on and they are the furthest thing from helpful. A patron got stuck there, left their car overnight, and hadn't woken up to take care of it yet. I'd have a few choice words to say to the inconsiderate schmuck who thought their car wouldn't inconvenience any incoming or outgoing patrons. Sadly, we didn't have time. We frantically called taxi companies only to find out that they weren't working due to the horrible conditions. We finally got a hold of our classmate, Siby, and got he and his girlfriend to pick us up. We had to pick up another classmate who was stuck in her hotel parking lot too. All schools and some businesses were closed, and some of our faculty cancelled on their presentations allowing our day to end around 2pm instead of 5pm. By the time we returned to the motel, the stranded car was gone, and the driveway was plowed to allow for two lanes. Thank you, God! We quickly changed out of our business clothes and into our sweats, jumped into our beds, and napped for a couple hours. Then we headed out to study, eat dinner, and then went to bed.

Tuesday, Janos had something scheduled. So he dropped me off at Barnes & Noble where I spent the day studying. He returned at 5pm and we studied 'til 7:30 before getting dinner and heading home. Wednesday, we had the cancelled presentations in the morning, followed by an exercise to replicate an elderly person's life. We had an ankle weight, wrist weight, an earplug in, cotton up one nostril, tape over our knuckles so the fingers couldn't bend, then gloves, a tensor bandage over our knee to prevent it from bending, popcorn kernels in our shoes, a straw in our mouth to breathe through, and altered goggles to mess with our vision. Long story short, growing old is going to suck a little.

I spent the afternoon at a compounding pharmacy. It was my first experience with one and didn't know much about what they do, but boy was it an awesome eye-opening day. If commercial drugs aren't working well with a patient for whatever reason, a compounding pharmacy can concoct a formula that might work leaps and bounds better. They can even change the form the drug comes in (capsule, tablet, liquid, topical, lozenge, etc). I was able to watch a progesterone cream be made from scratch, various suppositories and capsules be packed with drugs, liquid morphine flavoured with Coke syrup. Talk about a creative and collaborative atmosphere. A physician could call them up saying, "My patient isn't responding well to this drug I've got them on for reason x, y, z. What do you think we could do to rework it so that we keep the main treatment and minimize the adverse effects?" and by working with the pharmacist, they could come up with a formula that would work well and then adjust the dosage of the various ingredients as needed. It's a very flexible and personalized form of medicine that appeals to me so much. It makes me wonder if the general public knows about the world of compounding pharmacy and the alternative solutions they may have.

The rest of the week was MOTS - some sort of rotation activity, study, eat, sleep. I clued into the fact that this was my first time living with a male roommate. Granted it's not at all uncomfortable because he's gay and a dear friend. We have a good dynamic. He likes to talk a lot and has attention deficit so I'll listen to him, but if he gets carried away, I can rein him in and we'll enjoy hours of quietness. When I don't have to endure someone talking all the time nor feel responsible for entertaining them, I'm content. On the flip side, he knows when to joke around or leave me a little note so that I don't get "stuck" mentally. We've always had this and it's a big reason why we call each other our island husband/wife. We know each other's strengths and weaknesses, accept them, know when and how to look out for each other to allow for a healthy balance. For those who keep up with this blog, Janos is no question mark. For those who just casually creep on Facebook to look at pics, Janos is always "the boyfriend?". It's always fun to correct them. More often than not, I'll be blunt, but every now and then, I'll quickly say "Oh yes, he's my gay boyfriend!" and then they'll go from a look of elation to "Wait, what?" I find it pretty amusing.

We drove back down to Royal Oak for the weekend and today we spent the entire day studying at Barnes & Noble (he has a thing for the business). While taking a quick eye-break, I looked out the window and noticed in the reflection, an old woman looking at me. It was a bit jarring knowing that I'm spying on someone who's "spying" on me. I discretely turned my head back toward my books and as my head was en route, my eyes made contact with hers. She was looking right at me and her lips were moving. Those tend to be the usual cues that someone is speaking to you. So I took out my earbuds and said "Pardon?"
"Restoring dignity?"
"Come again?"
"Your scarf. It says 'Restoring dignity' on it. What is that from?"
You should know that I have a small grey scarf. I was wearing my hoody over most of it. So I was surprised that the words were visible. The words are also in thin embroidery and aren't easy to see in general.
"Oh this is from Watoto. It's an aid organization based in Africa that focuses on helping children who have been orphaned or turned into child soliders. This scarf comes from a Watoto project that focuses on women who have been affected by war crimes. Those who have been widowed and the many who have been sexually abused."
"Hmmm that's very interesting. Thank you."
"No problem"
to herself as I put my earbuds back in "Such good words. 'Restoring dignity'"

Well that was a nice study break. It's a nice scarf too. She went on to strike up conversations with her husband and the other people around her. Through the intermittent breaks in my playlist, I heard the conversation jump from people who treat this place like a library and don't buy the books, failing businesses, Obamacare, lazy med students who quit and leave the country to pay off their debt (I don't have time to fact check for the States. But if I quit, I have to pay off my debt unless I die), oh and pizza (yup, pizza).

We'll sign off here by wishing Grandpa a happy 90th birthday. Wish I could have been home celebrating with you and all your friends and family that came from out of town. Eat up (but don't overindulge or your dialysis nurses will be pissed), have fun, and bust a move to some Glenn Miller. Just have them play "In the Mood" or "Little Brown Jug". That'll get everyone going. Then take it down for a little "Moonlight Serenade" for you and Grandma, you cuties you.  To the rest of the Yip clan, I'm sure you'll all drink to your hearts' content (it's in our blood). You stay classy.

Bring it on, 2014!

As per usual, I enjoyed my radio silence by spending it with friends and family during the Christmas break. Took it even further by choosing to take less photos to just be in the moments. Christmas blessed me with a bounty of iTunes gift cards, meaning I was able to do one of the things I love the most, buy music. I purchased Vampire Weekend's, The National's, and Arcade Fire's latest albums. Very much enjoying both of them. I'm pacing myself on the music though as I intend on making these gift cards last until my birthday or hopefully next Christmas. 

I was able to see some faces that I hadn't seen in a very long time. I got to see Erin whom I hadn't seen since April 2012. We Facetimed with Alison and baby Piper (in Edmonton) to catch up with the other half of the Krause clan. Peter (White Dad) and Darlene hosted a mini Drouillard, Krause, and Yip reunion. It had the familiarity of old times when we all grew up at NDEFC together, but the conversation was far more adult (save for Erin and I...there were too many "do do"s said that we couldn't help but laugh and we ended up playing a childhood board game too). White Dad and I made no excuses about watching the Canucks. We gave everyone fair warning that we'd pop out for intermissions, but we wouldn't commit to socializing 'til the game was over. We beat the Blackhawks in the shootout. Last game I saw with White Dad was a win against the 'Hawks too. Got a nice thing going there. As for the whole reunion clan, we've got two engagements with weddings a week apart, we've got a granddaughter, and the rest of the kids are about the same - school, work, and life all abroad. We've all come a long way and it's been neat to see that and have the encouragement from each other.
 
I hadn't seen Deen since last Christmas and that's been a tough adjustment for us since we used to live together and were used to seeing each other every day. No matter how many times we spoke or saw each other during this break, it didn't feel like enough. I'm already looking forward to the next time I get to see her and spend some quality alone time with her. We saw The Secret Life of Walter Mitty together and it was an entertaining artistic film with an awesome soundtrack.
 
I hadn't seen my cousin Alison since last Christmas as well. She's about to start her last semester of her Master of Journalism program at Carleton, which is very exciting. We got our meals with Grandma in along with some bubble tea, chocolate banana cream pie, and hockey. We watched The Perks of Being a Wallflower which was pretty awesome. Mae Whitman is in it. She's a talented actress whom I enjoyed watching in the TV series Parenthood (which is an awesome drama that will make you cry often).

It was very relieving to see the Deutschs and the ND people with the trials of Courtenay's year less fresh in our minds. It's wonderful to see the familiar faces and enjoy the hugs and catch-up sessions. Awesome to ride with Yan and have every thing be as easy as it's always been with us. Even with Yan's courageous year and the frustrations she's endured, we were able to enjoy our time together and continue to seriously talk about things. We also saw Frozen together and loved it.

There were other brunch, lunch, and dinner dates had. Plenty of sleep, delicious food and beers consumed, the standard Cousins Night 'til 2:30am (and we could have gone longer). It was a wonderful 3 week vacation to rest in and take time to reflect on 2013 before heading back to Saginaw.

In looking back, as 2013 progressed, I found myself getting less attached to NDEFC and to an extent, disappointed with it. Knowing that they still struggle with the same things, that they've nearly lost an entire demographic of young families with middle-aged kids (save for those who belong to families with 3 generations in attendance), and how they (those who are in the know) have handled Yan's situation has been tough to stomach, and on the other side, easy to accept that ND is the church I grew up in, but not the church I'll grow old in. Yes, they're great at welcoming some people and the proof is there in the new faces who openly shared those sentiments. But God I hope the church can commit long enough so that these people feel like they belong and are connected.
 
If you asked me what one thing ND lacked, it's follow-through. Follow-through requires passion to pursue, persistence to probe, and perseverance toward progress (you still have no idea how much I love alliteration). Nothing is accomplished if you don't have the passion to involve yourself in a ministry or a person, the persistence to know the details of the ministry or that person, and yourself better, and the perseverance to work towards dynamic goals. Don't get me wrong, I've had much of these frustrations before I left for med school, but it continues to simmer even as I've been away because these shortcomings have greatly affected people I care about (and I'm continually reminded every time I return that I maintain some influence through this blog). There are so many awesome people at this church and it's like everyone is missing out (or has already missed out). Everyone is friendly with each other and on the surface it's all smiles, but where's the meat? Where's the fucking meat?! Where's the stuff that articulates to a person that you see them, you hear them, you know them, you respect them and want them around? Where's the stuff that causes you to think "I don't completely understand this. What questions should I ask to fully appreciate this person/situation so that I can encourage them/help make things better?". I don't see it. I see avoidance of tough, but necessary conversations. I see confusion reconciled by making the wrong easy assumption. I see hesitancy to show love. I see reluctance to engage in accountability. I saw a cancellation of a Christmas Banquet (which was a first for me). So people live out their lives and others think "For shame. However, I can't be bothered to do anything about it". I love you guys, and I know that I've shared these words with a bunch of you one-on-one, but man, I can't keep these thoughts private anymore. Far too many people that I love have been hurt by this shit and it's heart breaking to see the complacency up close and personal, knowing that more people (that I don't even know) have been lost too. Follow through! For the love of God (literally), follow through!

I know it seems like I have no right to say these things now that I'm not there anymore, but I figure if I don't say anything then I fail in accountability. Despite how I feel about ND, I would absolutely love it if it would strive to better itself. I know ND folk read this (I'm still surprised, but I know you're somehow still there). The truth is the more I look at ND, the more I see what I don't want to be, the more I will be instead in my nomadic life, and the more I hope to be at my future home church when I finally get to establish some roots. Believe me, I'm not trying to be self righteous here, but I look back on the time I spent at ND, what I did there, and yes there are people I failed, but I have a clear conscience about the work I did - in ministries and the relationships I poured myself into. It's work, but it's worth it. People are always worth it. Always.

The first Sunday I was back at ND, Pastor Mark pointed me out mid-service and asked if I wanted to share any words with the congregation. I politely declined. The last Sunday I had at ND was a sharing service where people were given the opportunity to say how God worked in their life in 2013. Last year, I was strongly encouraged to share and reluctantly did. This year, I didn't make eye contact because I knew I wouldn't have anything good to say. Yes, there were happy occasions (engagements and births), but the crap of 2013 outweighs the good and it probably doesn't help that I'm not a huge fan of ND either. No year has rocked me to my core, shaken my faith, tested my resolve, tried my mind more than 2013.

During a typical night at the Deutschs', I lay in bed with Bai and we had a great pillow talk session. Surprisingly in my relative emotional instability that has been 2013, this night was the only night that I cried during the entire Christmas break. We were talking about what the year did to us. There's something so comforting and yet (for me) frightening when you feel the exact same way as someone 10 years younger than you - angry and confused with what God's done and no idea how to move on other than just to take it a day at a time. I'd expect myself (being 10 years older) to have more of a clue than Bai, but alas, I humbly admit that I don't. With Court's brain, there's been so much that hasn't made sense and the parts that do make sense just piss me off. Yes, I am happy she's alive, but these damn headaches, I cannot fully articulate how furious their presence makes me. Throw in the insecurities and familiar struggles and it makes it that much harder for me to find any sort of resolution. I know I've said it before, but you seriously have no idea how much I love Courtenay. I could dedicate an entire blog of weekly posts to her, but it still wouldn't be sufficient. She deserves a win. A win without conditions or only meets you half way. A win that means something to her. A full fledged fucking win. I would give everything for that, but it doesn't matter because it's not up to me. It's up to God, and He's got a timing that only a few can appreciate. So there's nothing left but to have hope and trust that we'll get that win, I'll get my answers, or I'll learn to be content without all of it. And honestly, I'm fine with any of those options. I know that I'm going to keep living the best way I know how despite all the "unfairness" and uncertainty. I will be patient through the agony. I will seek to love better. I will try to meet new people and opportunities to be good news in. I will attempt to be Heaven on earth.

Seriously, I'm so ready to take on 2014 without knowing what the year will look like, where I'll live, who I'll meet, or what my support system will be as I wander the States. 2013 pushed me and now I'm armed with a fury that's ready to push back.