Little League in the CNMI


Welcome Little League to the CNMI (Commonwealth of the Northern Mariana Islands)! I really do love watching sports and it is one of the things that I miss the most here. Well, maybe the better way to put it is.. after watching live sports again, I realize how much I miss watching sports.

This regional tournament is being held to decide which teams move forward in the Little League, advancing towards the World Series. I have always know that Taiwan’s Little League is a force to be reckoned with, but apparently so is CNMI’s! (well, at least CNMI does well in this Asian Pacific and Middle-East tournament). Just like when the Olympics come around, my ethnic and cultural background swells with a little bit of pride. Actually, I have a great granduncle who represented Taiwan in the Olympics before and won a bronze medal in a track event. (No, I did not get his genes!)

The Little League is divided into actually three age segments — I had no idea! Apparently I have not watched enough Little League. I guess I expected 13 year olds — which are the kids who make up the Junior Little League. The Senior Little League is for 15-16 year olds and the Big Little League group is for the 17-18 year olds. (I think) So, there are plenty of games going on during this tournament, and lots of opportunities for me to cheer on the Taiwan and CNMI team.

The team representing CNMI beat out the local competition including competition from Tinian. I’m sure the team representing Taiwan is the same — or maybe hand picked from various parts of Taiwan. I hope to get to know a little more about them as the week pushes on. The tournament lasts from June 26th thru July 4th. I’m sure other tournaments (which have in the past taken place in the Philippines, South Korea, Hong Kong, etc) have been MUCH better attended and quite rowdier than the games here. Here, we play on one of the few formal baseball fields we have on island and reportedly the ‘infield’ has been quite a difficult one! I’m just guessing that we have difficulty keeping it up to par.

I got some friends together and headed out on Saturday for an afternoon in the stands and to me, it felt like summer had arrived. The crack of the bat just was so nice to hear.

IMG_5175 IMG_5177The first teams I watched were Chinese Taipei (what Taiwan’s team is known as in international competitions) versus Hong Kong. This junior little league game was a blow out. The final score was 23-3 I think and there’s a ‘mercy’ rule so they ended it after the 5th inning since Chinese Taipei was up more than 10 points.

The next game was Philippines versus Hong Kong in the big little league division. This game was a little more of an even match up but Philippines still pulled ahead early and kept their lead until the end. There are many Filipino nationals here in Saipan (they make up most of the local Asian population of Saipan) so it really did feel like the Philippines had a home team on their side.


Here’s one of the Chinese Taipei Big little league players coming into the stands to watch their junior little league colleagues.IMG_5180 IMG_5181

The backs of the Big little league Taiwan team. As you can see, we don’t have rows and rows of stands. And.. they are mostly filled with other teammates, family members of the players, and some locals like me!IMG_5185 IMG_5187

Here’s the Taiwan team at the end of the game shaking hands with the Hong Kong team and bowing to the field, the umps, and the crowd. IMG_5190 IMG_5191 IMG_5192

(It gets dark here quickly, it wasn’t actually that much later) but here you see the Philippines team up at bat with the Hong Kong team on the field. IMG_5196

So, more baseball to come in my near future. I’ve got my baseball cap cleaned and .. now just to find something that has a Taiwan flag on it!

In other news, some extra shots from my morning run because it was just too beautiful!

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Pineapple Upside Down Cake

When one gets pineapples, what does one make? Pineapple Upside Down Cake. I actually looked a lot of places that I like to frequent for recipes to find a recipe for pineapple upside down cake made with real pineapple, and it was difficult to find. Well, I guess the issue was that I either went really fancy with baker’s who posted recipes requiring fancy mixers and tempering of things and candy thermometers, or you had Betty Crocker’s pineapple upside down cake with maraschino cherries (not that there is ANYTHING wrong with that).

from google image search pc:

from google image search pc:

I had no idea how pineapples were grown before coming to Saipan. I think many people find out when they visit the famous Dole plantation in Hawaii. Pineapples are labors of patience here taking years to develop their fruit. They can be planted from the chopped off head of a previous pineapple plant which I find absolutely amazing (kind of like green onions/scallions or potato eyes). Something about seeing a little baby pineapple sprouting from the top of the pineapple ?bush just makes you take a second to appreciate the gift of time.

After my mini search on recipes, I decided to just doctor it up with an adaptation of a recipe favorite of mine from Barefoot Contessa aka Ina Garten. This recipe was originally supposed to be made with fresh apple slices but I just changed it out for the fresh pineapple.

I haven’t done a recipe post in awhile so I missed some steps in the picture taking process, but you’ll get the drift.

First, start with your glorious fruit. Here, on my cutting board. I apparently was too excited and my hands were shaking which is why the photo is blurry.


Then, cut it and carefully try to cut off as little as possible. This pineapple was perfection. I literally cut off only about 3 mm of core from each quarter which I didn’t think was fit for the pie but I consumed immediately. (Hey! There’s good fiber in there! and it tasted good too, really not very woody at all)

IMG_5135Butter your pie dish or cake round generously. This is a very important step to try to ensure that your upside down cake will stay in one piece when you truly flip it rightside up. otherwise, it will stick (often the fruit stick and then you have to piece the fruit back into the hole it came from). Preheat the oven to 350 deg F.

IMG_5136Then, I made some caramel on the stovetop. I added 1 cup of sugar with 1/3 cup of water and cooked on the stovetop. Here you are supposed to get the temperature up to 360 deg F but I don’t have those fancy digs (nor do I need them I don’t think). I just swirl the saucepan gently (do not let hot sugary water splash out on you. That is the stuff of burn legends) and try not to raise the temperature of the caramel quickly. It took a good 10-15 minutes to get the temperature up as I watched the sugar bubble away. You HAVE to keep an eye on this stuff. In less than a minute, you will see the sugar start to crystallize on the sides of the saucepan and the sweet smell of caramel (aka burnt sugar) starts and then you know you’re basically done.

IMG_5138Pour the sugar-water mixture over the pineapples. (Sorry, forgot to take a picture of this)

Then, I turned my attention to whipping up the cake batter. I had already prepared room temperature unsalted butter as well as two room temperature large eggs. First, whip together 6 Tbsp of butter with 3/4 cup sugar until it is creamed. Then, beat in one egg at a time. It should look like this at that point.


Then, add 1/3 cup sour cream, a bit of lemon zest, and 1/2 tsp of good vanilla extract. Mix just until incorporated. In a separate bowl, I combined 1 cup + 2 Tbsp of all purpose flour, 1/2 tsp of baking powder and 1/4 tsp of salt (the original recipe calls for Kosher salt but I just use the regular umbrella girl salt!). I then mix in that dry mixture into the wet mixture. Again, mix until just combined (do not overmix!)

I then poured this out (it’s more of a solid than a liquid) and spread it on top of the caramel/pineapple mixture.

IMG_5140Then, pop it in the oven for 30-40 minutes until the middle is set. As you watch it bake, you can start to see a bit of caramel bubble out on the sides of the upside down cake.

Here it is taken out. I then allow it to cool for 15 minutes after I run a knife/spatula around the outside of the cake.

IMG_5143Then, there’s the moment of truth. I put a larger plate on top of the pie pan and then invert both of them and hope that the cake falls out perfectly onto the plate.


IMG_5148I am writing this as I enjoy a slice with tea. It’s kind of a combination of not to sweet but with intense sweetness soaked into the top layer and amazingly the pineapple flavor (maybe because it’s fresh pineapple) seeps out into that top layer as well.

So, thanks for fresh pineapple — I did prepare a second batch of the upside down cake for my pineapple benefactor!

And, because I haven’t posted much recently — some pictures from a recent sunset run. Stay posted, I may be doing another transport soon and will chronicle the journey for you here.


Flame tree blossoms still going

Flame tree blossoms still going


One of my favorite recent pictures.

One of my favorite recent pictures.

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This is actually in a parking lot that I was running through but thought that the majesty of these trees was so awesome.

This is actually in a parking lot that I was running through but thought that the majesty of these trees was so awesome.

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T Galleria 3K & 7K Run

Annually, there is a fun run that is sponsored by the T Galleria (formerly known as DFS [duty free shops] and just rebranded) that never disappoints. The run distance has been 7k and I think this year was the first 3k distance to encourage walkers or first time runners (or just really fast shorter distance runners).

IMG_5020We started at 6 AM with registration beforehand.

IMG_5017T Galleria is the brand name of the department store for DFS – duty free shops. I used to think Duty Free stores in the airports were just a general thing – never realized it was a brand in itself. Well, everything here is Duty Free technically so of course there is a duty free shop on island. It is really a tourist destination on island and I know many local people who have never stepped foot inside. My first visit was just because I was curious actually!

IMG_5022As you can see here, this mini-mall hosts brand name shops like Gucci, Marc Jacobs, Coach, Tiffany & Co, etc. For tourists visiting from Asia, these high end products are less expensive than what it would cost to get it in Asia. But… these are still QUITE expensive. It’s a different level of person that are purchasing these types of goods honestly.

Back to the run though… A 7 km run is a bit more than a 4 mile run for those that have an idea of that distance. The run is an out and back and as are all runs here, it is early in the morning to help to combat the growing heat.  (Starts at T Galleria and goes to Quartermaster Rd and then back) This year it was not so much the heat that was an issue since the sun was just peeking over the clouds but the humidity. It had just rained overnight and you could feel that clouds close to their tipping point, ready to wring out rain – but not. Instead, you just start to glisten :) The 7 km distance is just long enough to feel like a longer run that you cannot all out sprint either. So, the run started and I slogged on through. It actually wasn’t so bad after I started because exercise is like life — you don’t have to be great to start, you just have to start.

Then, just under 37 minutes later, I was done. Whew!

IMG_5024(oh and PS, there’s a Hard Rock cafe attached to this mini-mall. Another place I never go, but I could be arm-twisted to go there for a milk shake!)

We had registered for a fee of $10 which helped raise money for charity. There are prizes for the top winners overall in the male and female categories as well as prizes for top winners in each age category. Surprise surprise, I won my age category! Here are pictures of other winners.

IMG_5027I won an Adidas watch from the store. The overall winner got a bag from ?Gucci I think and the 3K woman winner won a Kate Spade bag.


The men overall winner for the 7k got a pair of male/female Giorgio Armani watches. There was also a raffle so that everyone had a chance to win. I wasn’t able to stay for the raffle so don’t know if I won anything there, but I had to run off to make it to the nurses convention… More to come about that soon!

And.. a recent sunset for your enjoyment!



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Near Drowning Community Advocacy

During your training to be a doctor, there is always a component where you are encouraged to do ‘advocacy.’ It was always a bit of a nebulous topic and for us, our rotation (i.e. time set aside during our training, usually two weeks a year or more at other programs) was always considered down time from the rest of the hectic year.

I remember one of my assignments during my rotation was to write a letter to the editor of a newspaper. I honestly don’t remember at all what I wrote, but I do remember sending it in to the Washington Post. I never once thought to check to see if the newspaper published my letter and then submitted the ‘receipt of letter’ and copy of my few paragraphs to my advisor and called it a day. Much easier than any other assignment or research I had to do!

Well, little did I know how much this would become a part of my experience here in Saipan as a pediatrician. Actually, it probably is a function of me working in various very large academic institutions that are very research based that I did not see that much community advocacy at work. But, it is a big part of being a doctor. As a physician, you are called to be a part of the community in more ways than just your civic duty. You could be the first line person to medical outbreaks or changes in your community. You could be the one to identify problems that are happening in your community and help seek out solutions to change it.

Most recently, I have been involved in things related to cancer like the oral health forum where we talked about betel nut use and an upcoming talk at the Commonwealth Cancer Association about medical needs for survivors of cancer.

But, a slightly different thing came up recently. I was working in the hospital and noted a string of near drowning events. Drowning is defined as an event where water submersion leads to death so the right term for people who may have had a submersion event is a near drowning. The majority of the patients were toddlers who were undersupervised — one of the main culprits of near drowning.

The American Academy of Pediatrics has put out guidelines on advice to give to families about preventing these types of accidents. It is recommended to put a hard fence around any pools (even the soft sided inflatable pools – these are often culprits of drowning because the child leans on the edge of the pool and falls in as the side collapses). Most importantly, children are to be at arms length from the parent at all times — even toddlers. It actually is even mentioned that small children can drown in the toilet so should not be in the bathroom unsupervised. It is true that you can drown in even a puddle or inch of water.

In light of the events, I decided to reach out to our local television station — the only one that broadcasts local news. As you can imagine, there is actually not THAT much local news so they only broadcast Monday thru Friday for I think a 30 minute segment.

After a few emails back and forth, they decided to go ahead with the story since summer was around the corner and came to interview me at the hospital. I donned my white coat (which I never ever wear – I actually had to clean it since it had been hiding in my closet before wearing it) and got interviewed right outside of our pediatrics unit.

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There I am! I actually did not know they were going to put it on air that day so didn’t catch it on television although a friend who saw me during lunch today told me I was on TV (it’s a small island!) They have the recorded news on the KSPN2 website but it will be archived by the time you probably are reading it. If you want to watch the local news in general, you can always go visit

I got to talk a bit about how you may protect your child from near drowning and bring awareness to the community. I’m not sure how many people it touched but hopefully at least one person is more careful because of it. This is the beauty of being in a small island. I appreciate that I get the opportunity to share information and bring to light information that people may not have paid attention to. It is one of the reasons this job has such a broad description. As a professional, we get to have the opportunity to do things like this that may have an impact on the local community – maybe not required, but if it protects someone or improves someone’s health — that’s advocacy.

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A Gorgeous Sunset

I will let the pictures speak for themselves today. (All shot with iPhone 5, please do not reproduce without permission) IMG_4940 IMG_4951 IMG_4951 IMG_4949 IMG_4953 IMG_4956 IMG_4958 IMG_4961 IMG_4990 IMG_4972

View through my sunglass lenses

View through my sunglass lenses

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Kicking off Nurses Week

After a flurry of work recently, it is now Nurses Week! I consider this the spirit week of the nurses — and they really go all out here in Saipan. The CNMI Nurses’ Association gets together all the nurses on island for various events, many of which are athletic. It’s quite a packed week actually!

It kicked off yesterday (Saturday) early morning with a 5k run. This run from the Minatchom Atdao Pavilion to the area on Beach Road across from Triple J motors and back is basically the same run that they do for the Jingle Bell run in the winter months. It’s fun seeing the nurses get together and since this isn’t a formal running event (although the public were invited to participate), it mostly was made up of people associated with nurses or nurses themselves. I especially appreciate these events because it brings people together and out exercising who may never have done it before. This holds especially true for the 5k run since a number of people had never ran (or walked) 5k before!

Light of dawn on the water before the run.

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(The clouds of the morning were a prelude to the sunset that night!)IMG_4839

(Registration desk)

IMG_4843Here the nurses are afterwards, tabulating scores next to the timer module. Honestly, it’s crazy how much work goes into events like this — even though it’s just a small event in the grand scheme of things. The total person count was around 85 participants and the top 50 finishers for Tshirts. I ran my 5k in 26:31 and got 9th overall and was the first female to finish! Woohoo! (As usual, my success is only because of the low numbers and .. as I mentioned, many first time runner/jogger/walkers)

IMG_4855 IMG_4857Despite all the hard work, all smiles still!

Yesterday’s sunset was epic. I wasn’t on the beach to see it since I was out eating dinner with some friends, but we took a break when we caught glimpses of the pink sky to go out and snap a picture or two. IMG_4896 IMG_4895As I mentioned, this is nurses WEEK — not just nurses day. So, more events were in order. They had a 3-on-3 basketball tournament later in the afternoon after the 5k and this morning, the 2nd annual mini-triathlon! This was an event open to only nurses or those related to nurses. I got to participate since you are allowed to have one non-registered nurse on your team. Again, all these participants are not known triathletes by any means. There were only six teams and each time had three participants — no one had a team where someone did one leg.

Honestly, one leg was enough! I was the swimmer on the team — a couple of the other swimmers had not done an open water swim before so it was exciting for them. For me though, it was rough! Well, not really — but it was a 400 meter swim which is basically a sprint. I am more of an endurance athlete so I knew it was going to be a challenge. Six minutes of all out heart beating, trying to breathe, spotting where to go, etc. It didn’t help that most people at the beach cheering us on knew that I routinely swim — so I was not exactly the underdog. (and I always prefer an underdog story!)

The colors and water at dawn did not disappoint. Sorry it’s a little hazy, should have changed some settings on my camera first.

IMG_4899 IMG_4900 IMG_4902The swim ended up being quite the sprint for me but I was able to beat one of the nurses on the short sprint from the beach to the transition area while running — I guess I’m better on land! The water, as usual, was relatively shallow and there were definitely parts where walking in the water proved faster and more efficient than swimming.

Up next is biking. They did a short 10 km bike which also was a sprint. Basically it was petal to the metal the whole time — certainly not a leisurely bike ride! Here’s one of our former ICU nurses, now nurse coordinator for our utilization review/discharge planning. IMG_4912

My team was made up of two of the pediatric units’ nurses — so we considered ourselves already winners since our team was all female — claiming that title in advance of the race. We had fun though.. here’s my biker coming in. IMG_4916

So, she decided to make an entrance for sure.. the road was a little slick and the excitement of coming into the transition area after a fully winded sprint made her slam on her brakes a bit too hard so she slid just at the transition area. Fortunately ;) there were lots of medical professionals around although all she needed was a little water and triple antibiotic for the road burn. It was her first race so I’m sure she felt super rewarded in finishing (and fending off a guy biker who was neck in neck with her). IMG_4918

There were only six teams total which made for a very very very small race. Here are the bikers lined up as we waited for the runners to finish their 5k run. There was a lot of support though — there were a few police watching the bikers and runners and several lifeguards in the water for us. Since there were so few participants, basically the police followed people around as their biked or ran and shouted encouragement via their police horns! It was fun to see and nice to have their support. IMG_4921All in all, a good healthy, fit start to Nurses Week. Up this afternoon is a soccer game and some parlor games on the grass as well as a potluck lunch. Later this week they are doing two medical outreaches for blood pressure and glucose checks. In addition, there will be some events and.. shhh, a special surprise at the Nurses Ball this Saturday. Plus, I have to prepare for a talk on anemia I am giving to all the nurses on island at their convention on Saturday morning. Okay, gonna go work on that talk now! Have a great week.

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Saipan? What do you do again?

Hello all! Sorry for the radio silence but I run a department of pediatricians that involves five of us — and two have been off island for vacation. So, that leaves three of us working to cover all the duties that we have to cover. It’s a lot surprisingly — we cover the following:

newborn nursery: Here we see the babies that were just born. All babies need an exam by a doctor but usually these are not urgent cases. The nurses there know what signs to look out for and if they see any baby who does not look well, they will inform the doctor and sometimes we have to do extra tests on these babies or come into look at them. Contrary to popular belief, we are not present for every single baby that comes out. We only attend deliveries if there is some concern that the baby may have trouble. We usually see between 3-8 new babies a day here.

neonatal ICU: This is actually where we usually have our sickest patients. Unfortunately, babies need to stay inside their mother’s for the full nine months of pregnancy to have the best chance for success. Coming 1-3 weeks early is usually okay but any more than that means a higher chance of complications. Much before that usually means that the baby needs to probably be dependent on a machine — specifically usually a breathing machine. These babies are very fragile and so we need to watch them like a hawk. This is where the majority of our patients who need off-island transports come from. Because they can get sick so quickly (and newborns sometimes come out and we find problems that we could not detect before the baby was born), we can get to the limit of what we can do off island quickly on these patients. Since sometimes these babies can be in the hospital for more than a month, the number of patients in this unit can vary. At its busiest there can be 6-7 patients but in general, there are 1-3 patients I would say. We apparently have a bigger NICU than Guam so people sometimes assume its the other way around but we have on occasion taken patients from Guam to get transferred to us if they overflow or cannot handle the case when we can (again, rare, but has happened).

ICU (intensive care unit): There are four rooms in the hospital that are equipped and specially set aside as our ICU. Here, we can provide intensive levels of support — which usually means special monitoring, special machines required to help people, etc. Most of the time, the rooms have adult patients but occasionally (probably about once a month on average) there is a pediatric patient (i.e. under the age of 18 years) here for some reason that we take care of. As you can imagine, these can be very ill patients as well.

pediatrics unit: This is what you might think of when you think of a traditional place kids stay in the hospital. We have decals on the walls and kid books to read to them. Here, we see patients who have to be in the hospital for some reason (they need medicines thru an IV line, they need help breathing with oxygen masks, they are not growing well or need special tests done, they have infections, etc) but are not sick enough to need the ICU. These patients usually don’t stay for very long — it’s also the place where patients that are getting better from the ICU or are getting ready to go home finally from the neonatal ICU go for brief stays so they can be together with their parents/families/caregivers. We have up to 8 patients but usually in the 3-5 range patients in this unit.

outpatient clinic (aka ‘Children’s Clinic’): We have one doctor who works here full time now after some staffing changes (see this post from back in the ‘old’ days for some pictures of the clinic). But, I also enjoy going to outpatient clinic although I’m not that designated doctor. We rotate through and try to keep 1-2 doctors there at a time. We see patients for regular check-ups to make sure the kids are growing well, are nourished, are getting to school and learning, are being emotionally taken care of, etc (and getting their shots — we are pretty darn good at getting most people their immunizations — much better than the States). In addition, we are quite busy because we also see patients who are sick and need to be seen by the doctor. I consider this the most diverse clinic that I’ve ever been a part of because we also see patients who have complex medical issues. Unlike clinics in the States who have to refer their patients for subspecialty care (i.e. sending them to a pediatric cardiologist (heart specialist)), we see them all — because there isn’t any other specialists here. Now that I’m here, I have a clinic once a month for pediatric hematology/oncology that I try to see my specialty patients at. For each doctor, we see about 20-25 patients a day. To someone in the States, this may not seem that many since often they are expected to see patients in 10 minute blocks (And if you multiply that out, that’s a lot of visits in a day). Since we often see patients with complex issues, we often have a handful of patients that take 30-45 minutes of our time. We also don’t have ready access to people like social workers to help us or dieticians, etc .. so a lot of time we do some coordinating things on our own that takes time. We have a great team of nurses in the clinic though and with some scheduling changes this year, I think we’re doing a pretty good job considering how many patients need to be seen and how few doctors there are.

consults: We do have some help taking care of kids since not all of them show up to our clinic. Some appear at the emergency room and some who can be sick can show up an outside clinics where they see patients (specifically also from Rota and Tinian, where we very occasionally send doctors to visit). We can get called at any time if they see a patient that has an issue. We decide over the phone whether it warrants getting the patient sent to us so we can evaluate it, sometimes give advice over the phone about what to do, or figure out a way for us to see the patient at a later time.

Whew! That’s just the pediatrician part of things although I wear a few other hats as well. I just thought I’d record a bit what else I’ve been doing since it’s been awhile since I’ve put something more ‘work’ related on here.

In other news, I saw this video pop up on a friends’ feed and wanted to share it. I am a sucker for aerial footage of the island lately (or just movie footage in general) since I think it shares the feeling of Saipan better than pictures (although I still love my pictures for sure!).

And some recent pictures for good measure :)

A flametree blossom - they are all falling down now so likely we will lose our red trees in the next week or so.

A flametree blossom – they are all falling down now so likely we will lose our red trees in the next week or so.

A recent favorite of mine of the sky at dusk.

A recent favorite of mine of the sky at dusk.

Sunset over the water - a classic.

Sunset over the water – a classic.

A view from a friends' house -- yes, it's ridiculous and yes, that pool is really nice. I had my ukulele lesson sitting on this porch last week!

A view from a friends’ house — yes, it’s ridiculous and yes, that pool is really nice. I had my ukulele lesson sitting on this porch last week!

Sunset from my porch - love it when the sky has little streams of pink as the sun sets behind some clouds.

Sunset from my porch – love it when the sky has little streams of pink as the sun sets behind some clouds.

I should have put this in a separate post but it's been so long since I've posted. This is a recent favorite of mine from one day when I decided to just sit on the beach for sunset. It turned out to be glorious.

I should have put this in a separate post but it’s been so long since I’ve posted. This is a recent favorite of mine from one day when I decided to just sit on the beach for sunset. It turned out to be glorious.

Same day -- saw a kayaker/fisherman coming in from an afternoon on the water. Had to catch a picture of his silhouette.

Same day — saw a kayaker/fisherman coming in from an afternoon on the water. Had to catch a picture of his silhouette.

This was prior to the sunset from the pictures before. Beautiful fluffy clouds!

This was prior to the sunset from the pictures before. Beautiful fluffy clouds!

Posted in cnmi, department chair of pedaitrics, drone, My Work in Saipan, nicu, pediatrician, saipan, sunset | Leave a comment