A reminder for gratitude

It’s been awhile … apparently, almost 9 years since my arrival to Saipan (see widget to the right)! I just was thinking about this blog and while I don’t have a plethora of sunset/sunrise/palm tree photos to post anymore because life is a little different, there is still plenty to be grateful for. And people still visit this blog! For those of you interested in finding out about Saipan, feel free to reach out. My last visit there was February 2020 — RIGHT before COVID. Talk about gratefulness for travel timing!

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Back in the Clinic

Hafa Adai! It really is like riding a bike — I feel like I’m exactly back where I was and not much has changed in the interim — although that’s not true at all! It’s been about 13 months since my last trip to Saipan. I came back last in early December 2016 and saw patients, did a provider education session and a tiny bit of sightseeing. I had promised I would come back once a year to see the patients with subspecialty hematology and oncology needs so I’m back again!

I had an overnight stay at Narita on the way over and took a quick walk over to the famous Narita temple for a night picture and to walk off the ramen I just ate.

Then, back to the airport for the quick trip on Delta to Saipan. It’s always been a treat to come during the daytime to Saipan because most of the flights come in at night. We had horrible wing seats but were able to catch a glimpse of Saipan as we approached. It was a typical blue sky over the blue waters with fluffy clouds scattered about.

Upon arrival, I got the car and decided to take a quick detour to Ladder Beach since it is right by the airport. The sun was bright in the sky so it made for slightly harsh light for pictures, but my camera will be on overdrive this week for sure regardless of the lighting conditions. I have to savor each moment!

I settled into the apartment that I am staying at thanks to the generosity of friends and run off because I knew I had to catch sunset. My goal is to watch the sunset every day that I am here! I almost did that when I  was living here so this week here will be no exception. I grabbed some takeout Thai food from Wild Bill’s and set myself up on the beach at Pau Pau. Pau Pau was the very first beach I went to when I arrived Saipan so it seemed fitting to go there.

Those sun rays though! It’s interesting how after watching so many sunsets I can slightly predict how they will go and appear but — there are always things that surprise me. I love how beautifully the colors end up being painted across the sky and how it’s different every time.

This morning, I am at the hospital for a full days’ worth of patients. I scheduled them all in advance in order to see these people all in one go. Some fly over from a neighboring island (Tinian) to see me so it takes a lot of coordination. Fortunately so far, things have run quite smoothly. I sat right back at my desk in the clinic room I used to use, set up my stuff, logged in, and was ready to go! I even had my old ID badge that I resurrected to be able to wear here.

Just wanted to record this since I’m back in Saipan — short and not a really exciting post, but so exciting to be back for me! The rest of this week will be almost all play and it will be good to log off a bit but will update with pictures and a summary of what you can get accomplished and see with 4-ish days in Saipan!

 

 

Swim Across America 2017

Hello friends.. it’s been too long! Months actually.. sorry about that.

It’s been a year since my last swim in the Bay and my swimming is DEFINITELY not anywhere near my swimming shape that I was in last year so I chose to do the shorter distance.

Swim Across America is an organization that holds swims across the country to fundraise of cancer. Each swim focuses on a particular researcher or cause in the area — and Swim Across America San Francisco has its beneficiaries at Benioff Children’s Hospital — aka the UCSF Pediatric hospital and two programs within the pediatric oncology department. Besides the fact that this is where I work, I think its a worthy cause.

Honestly, I often don’t realize how worthy of a cause it is until this swim — which is why I feel so privileged to be a part of it.

Let me give you the play by play.

Registration — very early… Sunday morning fun of course! I think registration opens at 5 AM and last year I went right when it started, this year I was a bit later which meant a bit more of a wait. They have a tent setup at Little Marina Park (which is where you end). This year they had tracking ?thingies that strapped to your ankles for safety.

You get a wristband for entrance to the tent after the swim, a bag so that you can leave the things you shed on the boat that will get delivered back to you as well.

From there, you load onto some traditional SF trolleys and take a ride through the streets of San Francisco in the quiet hours of the morning.

Here’s a quick peek at the Golden Gate in the slighty foggy/cloudy morning.

When you arrive, it’s kind of like things are just on autopilot. We all shuffle on the boat, half awake but then the excitement starts to build. There’s food and coffee and opportunities to sign and wear some temporary tattoos.

Then, as we get closer to the Golden Gate, we meet up for a safety briefing on the first floor of the boat. Everyone says this is their favorite part — and its true. Now having done this twice, THIS is why I signed up again — nothing to do with getting in the water or doing this crazy swim. After the safety briefing, people share stories about why they are swimming. There are parents of kids actively fighting cancer, people who are remembering those that couldn’t be with them here today, and … well you can imagine. There are waterworks.

Olympians are a big part of the Swim Across America event and I can see why. They really bring the star power and truly are just amazing people. They get to go visit the hospital before the swim and they bring their medals and the kids LOVE it. Recently, for September (which is Childhood Cancer Awareness month), our hospital released a Youtube video to the song ‘Rise Up’.

Check it out here. https://youtu.be/KSQ2y7f717E

After this, we all grab a Gerber daisy and gather around the boat, say quiet prayers and thoughts and shower the water with flowers.

It’s always amazing to be so close to the Golden Gate — such an icon of the city and thinking about the enormity of what we are working together to accomplish is equally amazing. It definitely overshadows the thoughts about what is about to happen next in the swim. You just, do it .. because it’s nothing compared to what the kids go through. It’s nothing compared to what the families go through.

This year, it was definitely more cloudy so didn’t make for as great pictures — but set the mood for me in a way that I didn’t really remember from last year. This is a view looking back at the city (first of all, it’s FAR away.. secondly, those light rays!)

Oh, and… there was a whale sighting as we waited to jump off the boat!

(See the plume?!)

There are plenty of kayaks, stand up paddles, zodiacs, other boats out there to protect and direct us, but it’s always hard to swim in a straight line or sight well. This year wasn’t that different for me — there’s  a glare on the water so I had a hard time knowing where to go — it’s easier to see shadows and head towards those. I was sighting for the dome of the Place of the Fine Arts which had me cut in a bit to the west of where I was aiming so I had to get told to go straight a little bit more, but it wasn’t bad. I did the shorter distance (they drop off the main group under the Golden Gate and then motor in a bit and drop off our group). I’m glad I did since I haven’t been swimming that much.

I jumped in quickly to be near the front of the pack (they ask slow swimmers to jump in first understandably) and kind of forgot about the shock of jumping.

(everyone waiting to jump)

 

Here’s the view of from the boat after the first wave jumped off.. so many small dots of people swimming away.

 

 

 

 

 

 

 

 

 

The first 10 minutes are always just getting yourself adjusted to the water and breathing and moving along in your wet suit .. and about after that I look up and realize I’m swimming in the Bay and have a few moments of awe. I love swimming because it’s my own quiet time in my own head where you just are pulling your arms through the water rhythmically (well… ideally). Those are the moments that some of my patients come to mind (not going to lie.. these tranquil and lovely thoughts usually come between thoughts of ‘why is the shore SO far away still!!!’). I can’t really describe this sensation except that I leave with a renewed sense of doing what I do, a renewed love of life and what it has to offer and gratitude to God for the ways He provides and provisions to each and every human.

If you’re interested in still donating, you can click this link below which will be active for the next few weeks.

Click Here To Donate

Otherwise, enjoy some of these amazing pictures from the shore. Picture credit: Jared

Here you can see the boat!!! This is the boat that we took out and you can see us by the bridge! I think this picture is SO amazing!

Here is the steady stream swimming towards shore. The clouds cleared up and sunny skies were all around!

How on earth did I get found while swimming within the sea of people? No clue — you can also see here that my cap was slipping off — not sure why but it definitely was bothering me near the end!

And here I am at the end (ps.. yes, I wore a full body wetsuit in case you were wondering!)

Thanks so much for those that are still reading. So glad to share with all of you. To those of you who donated… THANK YOU and I hope you know how much of a difference you made!

To those of you who have never heard of this or never have been part of it — think about what you do in your life that might not make a big difference to you, but may make a big difference to someone else. Those things often are the things that give life meaning. Find those things, do them on repeat, and one day, you will know that your days are spent doing enough.

My Dorky Love of Studying

I know this is extremely strange but I felt like I needed to record this. I am in my last throws of studying for my board exam. Tomorrow (April 6, 2017), I will be taking my last major test of my medical career — my pediatric hematology/oncology board exam. This is it!!! The last thing!!!

You may have heard on TV commercials — endorsed by a board certified dermatologist/pediatricians/etc. In the United States once you graduate from your training program you are board-eligible. You then take your “board exam” in whatever field you are in whenever it is offered next. I think it’s a general rule that there is something like a 5 or 10 year grace period in which you can take and hopefully pass the boards before there will be some type of injunction against your ability to become board certified without re-doing your training in some type of way. Fortunately, I have not really been in a situation where I’ve had to look into the details of this so that fact may not be totally accurate. Regardless, you still hold your medical degree but being board certified (or board eligible within the reasonable limit of time) really is necessary to have a job in the United States.

In pediatric hematology/oncology, the test is only offered once every other year. There are only a handful of people that are taking this test so there is no reason for them to offer it more often. I am fortunate in that I just finished my training this past summer technically and am able to sit for the test this year — some people need to wait a year and a half. As you get farther from training, the more specialized you get (at least in the academic system that most people are part of in this field) so the closer you are to training, the more likely you are to have exposure to these things.

Anyway! That’s not why I started this post — I just had a moment where I was listening to my music, doing practice questions with a pen stuck in my hair and a highlighter next to me, an iced coffee in my hand — and I thought… I am going to miss this. This studying/learning. I know I have this feeling because this is what I’ve been trained to do and I am ‘good’ at it (this is what happens when you have years of practice! not because I’m inherently good at this) — I have studied for tests for literally decades. I am not what schools have labeled as a ‘good test taker’ unfortunately so I have had to find my own ways to learn enough to pass the tests thrown at me. But, I’ve figured it out. Tonight I’ll cram some more in but also get a good night’s sleep and leave it up to God and the training that has got me to where I am — I’ll eat a delicious breakfast with some music blasting (after setting multiple alarms all over the house to make sure I wake up on time — but I’ll most likely wake up before the alarms go off) and hope for the best.

Crazy to think this is it (well, if I pass this time …. and except for the re-certification exams I’ll have to take the rest of my life……).

For now, I’ll take another sip of my coffee and enjoy this. Cultivating gratitude — thankful for how far I’ve come and where I am today. Thankful the journey thus far. Think some good thoughts for me for tomorrow!

A throwback picture…. Finish line ahead.

(and an extra for good measure)

Treating People as People

Last weekend, I went to a talk about human trafficking to learn more about what it is. I’d be happy to share more in person or over the phone if you’re interested in hearing more. But, what I wanted to talk about was one of the three ways the speaker said to combat this global problem. It was to do your best to treat people as people.

Valuing people and making that a normal part of who you are is important for lots of reasons but I don’t think I ever thought about it before and as the week has progressed on, it’s stuck in my mind. Part of the reason I started this blog was to cultivate gratitude and that sense of thankfulness. I really do think that even just by writing down some of these things, I have learned to be a more grateful person or at least to more proactively and outwardly express my gratitude.

That’s all to say, I thought I should share my preliminary thoughts on this.

Human trafficking is, in essence, the buying and selling of persons. When your culture, your country, your world, or even you personally can stomach the fact that some or all people are a commodity, that feeds into making human trafficking grow.

I spend most of my days as a physician supposedly ‘preserving and amplifying life’… so I thought that I didn’t have this problem. Some examples the speaker gave though were — think about how you treat the person who bags your groceries/checks you out of the grocery store. Do you look them in the eye? every time? What about a server at a restaurant? What about when you see a homeless person or someone asking for money on the street? What do you think in your head or do with your actions that may not reflect that they too are a person?

As with any change you want to make in your life, you can’t do it in one fell swoop. You probably won’t be able to change your interaction with every single human in order to show them they have value to you — this involves (unfortunately) money, time, and other resources that may be limited. You most likely can’t change your culture, country and definitely not the whole entire world — but you can change you. You can start to think about what you do in your life that may be seen as devaluing the life of another and you can work on how to remedy that. It could just be a change in your thought life, not necessarily an action.

For me, this plays out in the slightly more simple things like making sure I learn the name of my shuttle driver and looking at him/her when I use their services every day and saying ‘thank you’ and things like being patient with people in the service industry … but it also plays out in the infinitely more complicated things like respecting the value in people who may have different motives and cultural background to me both in patients who may make decisions that are counter to what I would make or in respecting the value in people that are making decisions for their family based on their idea of what is good (I find this especially hard when people are motivated by fame or fortune — which is not exactly the same as my ideals).

I think the idea that whatever is done to the least of these, is also done unto me (paraphrase of Matthew 25:40) is deeply embedded into me and this idea that we need to do our best to create a personal practice of seeing people as people deeply resonated with me. And by one person doing that joined together with more and more people doing that, perhaps we can change the world… and one day, the trafficking of human beings across borders, away from their home, into slavery, into sex workers, into laborers, into a door closed on an opportunity to live their own life… maybe that will end too.

Made in the USA

Whenever I do laundry, I am on the lookout for Commonwealth of the Northern Mariana Islands — let me explain… unlike in Saipan where you pretty much have to be exceedingly lucky or not afraid of rats to do your laundry at home, I have to use coins to do my laundry. Fortunately, when I first moved, my mom exchanged copious amounts of money for quarters which has literally been a life saver. (PS You do your laundry with coins in Saipan too actually.. at least most people do, except lazy people like me who took full advantage of the wash/dry/fold drop off laundry services)

Anyway! That’s all the say that I am always looking for CNMI quarters (see one here). Literally, every single quarter I put in I flip over to make sure it’s not accidentally a CNMI quarter I am sacrificing to the clean clothes god.

And then this… as I was separating out my clothes that needs to be hung dry I find THIS! … On a pair of pants that I have had from The Limited.

Sorry, for some reason cannot figure out how to turn it but if you can’t see… it says “MADE IN THE USA (NORTHERN MARIANA ISLANDS) OF IMPORTED MATERIAL”

So that satisfied my treasure hunt for the day while doing my laundry. So interesting to think I probably know exactly which one of a few buildings it was made in (unless the building was demolished)! And also glad that there are no more purported ‘sweat shops’ in Saipan although I’m sure there are just as many all over the world still that are not treating people right.

In other news, I made another run to Nimitz Trail and caught these two shots.

 

 

A reminder

My Facebook newsfeed is filled with friends reminding people about the importance of the next generation, the importance of respect for everyone, the importance of a people … and reminders of the way time can slip away but also feel so close. I imagine that yesterday, many who knew Melissa were marching in part in her memory.

Four years ago, I wrote this post from an island far away. The unimaginable

Please visit it again. I hope Melissa and her family know that she lives on in the people that knew her but also in the people who she never met but touched. Four years from that moment seems almost impossible. How is it that the days have gone so fast? Recently, I’ve been reflecting on the passage of time. These thoughts are magnified by seeing an arc in my life that was unexpected and unplanned — this whole blog talks about it. The excitement and anxiety over a whole new world and now returning back to the world that I left — but a world that is changed and a person (me) that has also been changed. That is what the passage of time does. I hope, if you have already forgotten your New Years Resolutions, that you at least take some time to reflect rather than sit slack-jawed over the newsfeeds on what time has done to change you. I hope that every day is not just a day where I embrace life — (that’s too millenial for me!) — but a day where I learn something new about myself, about the bigger plan there is out there, and how I can contribute something to the world or just my neighbor. I don’t think I realized it four years ago, but that was what people treasured about Melissa — even back then when it may not have been in vogue to ‘be the change’, she already was.

Nimitz Trail

I found myself a great new running trail! Maybe it’s the excitement of a new year or the freshness of the air or who knows, but this was a great run so I wanted to share it.

One of the thing I’ve missed is just having nature all around me .. like the whole sky opened up around you without buildings around so here was the perfect antidote.

This trail is in Tilden Park, a Oakland Regional Park about 15 minutes from my house. There are apparently many many different trails, some of which I had hiked before but I went looking for ‘running trails in Oakland’ on Google and came across Nimitz Trail. The Internet talked about stunning views and gentle up and down hills suitable for a long run so.. off I went.

From my time in Saipan, I am used to getting up early for runs so I headed out to Inspiration Point, the starting point, as the light was just starting to get bright.. about 30 minutes before sunrise.

Then, from the parking lot if you are looking out at the view, the entrance is to your left. There are bathrooms and water fountains there but I was prepared since it said there was no water the rest of the way. It’s a total of 8.2 miles out and back although some online things said you could hike on the non paved trail at the end to a view of San Francisco. I’ll maybe do that next time to let you all know how much extra distance that is.

I had my Garmin watch but the path is all paved and has 1/2 mile markers (and some random 1/4 mile points but not all). The sun was just starting to poke out from the horizon and everything was a beautiful tint (like a real life photo filter!).

At around 1.8 miles there is a turnoff for the Peace Grove that is supposedly a nice hike so if you want to go somewhere that’s not as far, that’s probably a good option (but won’t be all paved).

As you’ll see in the next pictures, most of the rest of the trail is open skies and and .. wildlife (aka cows) but there are a few groves of trees that you pass by. The terrain is up and down but not that strenuous.. enough to remind me that my run is not just a joyride but also a bit of a workout.

I then hit this cow grate and just felt temporarily back to Saipan. The cows cannot walk thru the grate so it’s as effective as a gate!

After this cow grate, there is a beautiful valley to your right with some lakes that were reflecting the rising sun. Seriously, breathtaking. (And good thing for the views so I could have an excuse to rest a little bit! I haven’t run as much lately so 8 miles is quite the distance for me!)

Well, I found the cows! They were just chilling out close by so I again had an excuse to not to run so much since I didn’t want to do something to get the cows angry… haha, no waving arms or anything.. just stealthily walking by and taking pictures. The cows didn’t last that long and then it was back to the other wildlife. I didn’t get any other pictures of animals but I saw SO many rabbits! Seriously, every few feet! I also saw a fox and a whole ?flock or ?gaggle of wild turkeys!

Here is a picture at the end of the paved road at the approximately 4.1 mile point. You can see that the road turns into a dirt road veering off to the left but I was pretty pooped by this point and knew I had to make it back to my car so didn’t stay to hang out on this bench with this awesome view.

Here’s a view of the ‘Wildcat Canyon’ from the way back.

A absolutely beautiful way to start a morning and get a great workout in at the same time. I think I’ve found my favorite trail here!

 

A visit back to Saipan

I cannot even begin to describe everything related to my one week trip back to Saipan — so will just give some a short summary of the work-related stuff I did here.

I went back to Saipan for a quick trip the day after Thanksgiving. The trip lasted a little over a week without the travel time so fortunately the holidays and weekend after Thanksgiving helped me not have to take as much annual leave as I took. Actually, I didn’t take annual leave from my job for the whole time because I did go primarily to go back to see patients. I had set up a follow-up conference to a educational conference that I had held two years ago that included myself, a internationally recognized physical therapist in the world of bleeding disorders, and the head of pediatric dentistry at the hospital I work at. I spent a day seeing all the patients who I had previously diagnosed with bleeding problems and had two half days of lectures that I gave. In addition, I got certified for the advanced training for using kinesiotape (that cool thing that everyone saw Kerri Walsh use two summer Olympics ago). So, it was a lot of work-related stuff and left only a little bit of time for Saipan visiting.

It was refreshing and so good to be able to see my patients again and update them. It was so good to do some teaching for the providers there as there were many new doctors and also ancillary staff who had not heard me teach about some of the basics of my field before. I taught at ‘Grand Rounds’ (the place where all the physicians on island come once a week to discuss something that is educational to them) on anemia (aka low blood count) and at my conferences about bleeding disorders. My patients were all seen by a physical therapist as well which was a first for all of them. One of the awesome things I got to do was take samples from my patients and get all of their diagnoses (aka medical conditions) genetically confirmed. This is a big deal since most of the time, genetic confirmation of a rare disease is both an expensive and difficult endeavor with only one place in the country or just a few places in the country that do the test. Fortunately, I was able to find a new company in the United Kingdom that was working on the validity (aka the correctness or accuracy) of their test that was looking to get samples and report on the results for free! I’m super excited to be able to get my patient’s results back and share it with them. It will help them make decisions about their future children and may even change some of the medicines I am able to prescribe for them.

All in all a really good time. I know this is not nearly enough and certainly does not encapsulate my feelings around my time there but that is hard for me to explain in words so I’m leaving it off the blog for now… It’s a feeling or thought that can’t be described – it was good to be back! even for a short time!

Enjoy these pictures from my trip!

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Residency and Medical Training

(Lots to update everyone on — an update or two coming soon about a recent trip back to Saipan!)

I am facilitating a small group session today — which is a fancy medical way of saying that I am teaching a class to medical students at the main campus of the medical school. Since it is at a different campus than I am usually on, I got up extra early to make sure I got there on time since I didn’t know how the travel would go. So, I find myself sitting in the cafeteria of the hospital and thinking…

This is the picture of residency and medical training. I watch tired appearing people in bedraggled scrubs with papers sticking out of their pockets carrying a plate full of breakfast and stumbling to find their payment. There are older attendings who have gathered over coffee to discuss their lives and their work in the corner — not stressed over the day ahead. And small 3-5 person teams of medical students and residents who clearly are working together and have banded together for a quick break from the day. Then there are the bright eyed residents in crisp white coats and scrubs — probably between their first cases of the day and fueling themselves for the day ahead.

There’s something about an older hospital with a small, clean, but all-inclusive seating area with the buzz of medical trainees and the staff that support them. The shine-y new hospitals have these restaurant style eateries with complicated ordering systems and partitioned areas to eat… just not the same.

And…. to reminisce with them all, I grabbed this ginormous breakfast :)