Outside In and the Holidays

Outside In Medical Clinic--if you think it looks a little bit
like a painted prison, you're right. It's gated with tall walls
and locked down, even though it's a warm, great place
on the inside.

I promised in my last post that I would write more about my job at Outside In, and I have much more to report now than I did at the beginning of December. My job at Outside In is threefold. The first component is to be a referrals coordinator, and this essentially means that I try to connect our patients (all of which are penurious, or else they wouldn't qualify to be seen by our doctors) to the specialist physicians and elaborate procedures that they need for as low a cost as possible. For this part of my job, I do everything from work with a system that coordinates donated services from philanthropic physicians to walking our patients through the process of applying for financial assistance at the various hospitals and clinics in Portland. The second part of my job is outreach, which means being part of the team that drives our mobile medical van to offsite locations to give medical service to the homeless right where they are. I have been going to one site a week, but the outreach component of my job is about to increase substantially since I was hired in part to work on a new project for which our funding begins in February in which we do outreach medical services in conjunction with a mental health organization here in Portland. I'm sure it will be fascinating and yield many interesting experiences and stories. The third part of my job is to be an English-Spanish interpreter and translator, which is not the same thing. (Interpretation is oral, translation is written.) I do everything from fielding calls to the front desk from Spanish speakers to interpreting for the doctors when Spanish speaking patients come in and translating their prescription instructions on the medicine bottles. Since we serve primarily an uninsured, impoverished population, a high percentage of our clients are solely Spanish-speakers, meaning I get to speak Spanish every day without fail at this job. This is one of my favorite aspects of what I do, and I really love serving our Hispanic clientele.

The job has been wonderful, but I would be lying if I said it was carefree. It has caused me a significant amount of stress, noticeable primarily when I lay in bed at night, totally exhausted but unable to sleep because I keep thinking about the work ahead of me or because a work-related nightmare woke me up. I recently had a nightmare that woke me up in which I drove the enormous medical van poorly and got it stuck in a canyon full of rushing water. I can remember other nights over the past month where I've lain awake wondering how I'm going to get the guy with severe epididymitis connected to a urologist, a notoriously difficult resource to find for poor patients, or how I'm going to help another patient who just moved to Washington because of domestic abuse pay for the pelvic ultrasound procedure she got without applying for financial assistance, meaning her radiologist bill is going to be sent to debt collections where she will have to pay it in full or have her credit totally ruined. I worry what will happen if (when!) I do something wrong--with homeless peoples' health on the line, will someone die? Will someone feel like they've been let down by yet another person in their life? Will my co-workers and bosses wonder why they hired me? I do well at school, but  that doesn't mean I know a thing about how a medical clinic operates. Where is the driven, bright scholar that Outside In interviewed and hired? When I make stupid mistakes, I often wonder this.

The flip side of this stress is that my days fly by and I never feel bored at work. Also, I know that I need to learn how to be compassionate and caring without being codependent since this will be a major struggle of being a physician. If I'm worried about making mistakes and harming people now, this will only get worse when I really have the ability to do good or harm. So these are good lessons, even if they cause temporary insomnia and fatigue.

My days are never boring. I had to get a woman out of the bathroom who wasn't responding to my knocks and who, upon entering, I learned was injecting heroine into her thigh. I got yelled at in drunken gibberish by a woman who was crying and very upset with me. Even the doctor couldn't figure out what was wrong with her since she couldn't sit still and speak intelligibly, though apparently her head lice infection was so bad that the doctor saw it from far away! I spoke with a young former-Mormon with a horrible skin fungus who is living under bridges as he tries to figure out the next step for his life. Everyone that I meet has a fascinating, difficult life story. Some of my clients are pleasant, grateful, and truly a pleasure to help. Others are taxing, demanding, manipulative, or insane. My job is always fascinating, and I'm always grateful to have my beautiful desk as a haven from the storm. You'll notice the photos of my family members and my world map from Doctors Without Borders, a reminder to keep my vision large and become a physician who donates his time to help those in need anywhere in the world.

A proud chef holds a tupperware of his cookies.

My life, of course, is more than just my job. I've enjoyed the company of wonderful people lately, especially since this is the holiday season. Christmas Eve I spent with Susannah and Margaret over at their Uncle Ryan and Aunt Jean's house, and it was wonderful. We ate a homemade delicious crab bisque that is a Malarkey tradition and enjoyed some great conversations. Susannah's Aunt Jean was raised Unitarian Universalist and wrote her undergraduate thesis on Mormonism, so we instantly connected. One guy at the party had just finished a masters in an English/Philosophy combined program, and since we both love Shakespeare, we instantly started talking about our favorite plays and their meanings. It was a great dinner. The holiday season gave me a great excuse to cook, as well, so I made some homemade whole wheat honey bread, a Moroccan lentil stew, and some pumpkin chocolate chip cookies that were, if I do say so myself, quite scrumptious! 'Tis the season to be jolly and to bake and eat as well, I suppose.

Christmas Day, too, was wonderful. I wasn't expecting much for the day other than enjoying talking to my family since I worked a full day the day before and after, but my roommates had done much to make it wonderful. There were gifts and stocking stuffers for everyone, and I got a whole season of Modern Family from my Secret Santa Laura (thanks, boo!), warm socks and candy from Maria, and other great gifts. I then Skyped with my family for a couple of hours, which was the highlight of my day. Knowing that I was going home that weekend, we kept conversations perhaps a little shorter than they could have gone and knew that we would pick them all right back up in person the following weekend.

There's no snow outside (just the Northwest rain), but
indoors all was very Christmas-ready, with stockings
and a tree!

Two other things are worthy of note in my life. One was the amazing evening I spent with Brad Ackerson and his wife Stephanie while they were here in Portland (well, Beaverton, actually) for winter break. Brad and Stephanie came and picked me up from work on Thursday, December 27. We had a multiple course meal that included sushi at Tasting East and the best desserts ever at Papa Haydn's. The conversation was wonderful and flowed from catching up about old BYU friends (most of whom are rocking on in life!), to dreaming about the future (Brad wants to go to U. California San Francisco's medical school) to getting to know each other better, since I had never met Stephanie before. It was more fun and fulfilling than I can describe, and I thank the universe for a friend as good as Brad who's stuck with me for more than 5 years from when we first met as new freshmen at BYU.

Me with my niece Nora, and boy is she a bundle of
pure love!

And lastly, as I mentioned earlier, I was able to fly home to Laramie for an amazing post-Christmas vacation! Thanks to the incredible generosity and largess of my parents, I was able to get a last minute ticket to spend an extended weekend (Friday, the 28th of December to Tuesday, the 1st of January) with the people I love the most on this planet. My days there were unbelievably precious to me. We played a board game called Wits and Wagers. We danced to One Direction on the Wii's Just Dance 4. We went sledding at Indian Paintbrush where Lainey kept asking me to take her down on the sled again and again. We sang Christmas carols while Amy played the piano. I spent one night in Paul and Carmella's beautiful new apartment in Cheyenne. I spent one night having a great heart-to-heart with Carolyn who, poor thing, had to wake up only a few hours later to give her sweet daughter Nora juice first thing in the morning. I just truly had so many stellar interactions and conversations while at home. I just felt perfectly at peace and so incomprehensibly grateful to have as brilliant, compassionate, and happy a family as I do. I truly have the best family in the world, and I finally see and understand that. I had so much fun and so many deep interactions that it was really hard for me to say good-bye. Once I hugged Mom, Dad, Amy, and Josh good-bye, I sat down in Denver International Airport and cried. Even though I love my life in Portland, I didn't want to come back. I wanted to stay and keep enjoying my wonderful family.

Clockwise starting with 12:00 o'clock is Dad, me, Josh,
Amy, Lainey, Kip, Carmella (who must not have known
the camera was flashing), Paul, and Mom. The
beautiful Carolyn took the picture (and I wish she were
in it!), and Laura is unfortunately not in it, either.

Thank you to my family for accepting me and being so good to me. I love you all so much. You made my holidays magical, and you give my life meaning. I love you!