I'm nearing the end of my intern year. In 5 short weeks, I will be a second-year resident. 

I understand when people say "life is short." Though I disagree. The average life is pretty long in my opinion. I think what people really mean is "life can seem to move really fast." 

And this past year is no exception. 

Though cliche, entering this next milestone in my life forces me to be especially reflective. Self-reflection is not something I consciously practice, so it is remarkable that I've noticed myself doing it. 

Professionally, I end my first year of residency a more confident person than when I began. I proudly proclaim, "fake it til you make it," until you're not faking it anymore. I scored the highest out of my intern class on my in-service exam. My feedback from seniors and attendings have generally been positive, which I attribute to my faking it. Ultimately, this has resulted in me not having to fake so much. Just as I was a fourth year medical student nervous about becoming a doctor, I am now an intern nervous about being a second-year resident. I need to work on my self-directed learning (and my organizational skills to contain and compartmentalize all that learning). I need to figure out what else I want out of residency besides just medical training (e.g., mentoring, outreach, leadership, global health). All in all, residency has been wonderful so far. I am truly happy with my professional life. Medicine is the right choice for me and I am so grateful. 

Physically, I am more disappointed in myself than I have been in years. Last night, David and I wore our wedding outfits (which we wear every year to celebrate our anniversary), and this year was the tightest fit so far. I have gained at least 10 lbs since starting residency. We signed up for Tough Mudder, which is about 5 months away. Training will require a huge commitment and change in lifestyle. We've taken baby steps, but have not taken the plunge. I'm not worried that we will take training seriously, because Jenny doesn't waste money. Tough Mudder is a huge deal for both of us, but especially David. I've done a couple half-marathons and a full-marathon. David hasn't even done a 5K. We're talking 10-12 miles of hard-ass obstacles. I was surprised when he agreed, but I'm so excited to share this experience with him. We need this. 

Personally, I'm also doing well. David and I continue to be as in love as ever. Being in love is one thing, but the ability to be your true self with another person, that's why we work. I am an individual, I am my own being...but David and I form a unit, which is its own being. Our individual lives depend on this unit. Its existence sustains us. And that is why we can never imagine divorce. It may sound a little unhealthy and co-dependent, but thanks to my handy-dandy qualities of intellectualizing and future orientation, we've already discussed that we wish for the other to "be okay" if either of us were to die and the other survive. Hahaha, I'm quite the planner. 

I wish I could spend more time with family. And there are a ton of friends I'd like to see. I believe second year will allow me more ease to accomplish these 2 things. I've already made a list of people I need to reconnect with. 

My mom gave me her nearly new car. Me, her grown physician daughter. She's probably subtly reminding her most successful daughter that she'll need to be taken care of in her golden years. She's also probably sick of seeing her physician daughter in a 1999 Nissan Altima, which is now going to my dad. I'm going to continue to pay for the car insurance on the Altima...it's getting closer and closer to the time when I will have to take care of my parents.  

If I'm making my life seem peachy keen, it's because it is. Life has been very good to me and continues to be very good to me. I think the worse thing about my life is the ~$170,000 student debt I'm in, and even that doesn't seem so bad when I think of my future income earning potential, which will be in 2 short years!!

David's phone had a glitch, and he has been receiving e-mails from years ago. I have very little memory of this, but I guess I e-mailed him my personal statement for my medical school application 4 years ago. This was my second personal statement for my second round of applications - I never had to use it. I got accepted into UC Davis at the last minute. But boy, was it wonderful reading the writing of the Jenny from 2010.

My grandma fell seriously ill this past year, and it has been one of the most difficult times of my life. Her doctor told my family and me that she wouldn’t survive the surgery that could treat her advanced intestinal infection; so all we could do is keep her comfortable as possible. My grandma does not speak English so I stay with her at the hospital on the weekends as her translator. I’ve witnessed her in pain for several hours of the day; I’ve had to explain to her that she is not allowed to eat when she tells me she is hungry.  This experience has matured me immensely and strengthened me emotionally. I feared seeing my grandma ill in a hospital bed; I also feared the responsibility of being the one by her side all day. As difficult as it was to take care of my grandma in her condition, I had to find the strength to be there for her as her granddaughter and translator. I chose a career in medicine before my grandma fell ill; but after caring for her this past year, I feel more prepared for a career in medicine. I feel more prepared to handle people in pain and I feel more prepared to handle death. With my grandma’s infection being so advanced, the doctor has warned us we can lose her at any time. With that thought in the back of my mind, I am still there for her. That is the kind of physician I plan to be: one who is there for my patients and accepts that not everything is in my control.

I also plan on being a physician who is open-minded, culturally sensitive, and politically active. These qualities represent my passion for diversity and service. Everyone should have access to healthcare, yet the people who are most underserved with the least access to healthcare are low-income and minority communities. I believe diversity among healthcare providers will lead to more medical services to these communities. Cultural sensitivity is also a necessary quality as a physician because my ultimate duty is to care for those in need – ignoring any prejudices or stereotypes, and respecting the unique backgrounds and struggles of my patients. I also plan on being a politically active physician because I am a politically active person. My activism as an undergraduate consisted of several rallies, petitions, and initiatives to increase student diversity, seek social justice for the university’s labor unions, bring ethnic studies to the university, and more. Our nation just made its first steps to reforming what had been a broken, ineffective healthcare system this past year, but there is more to advocate. I would advocate for government-funded programs that specifically target the health of low-income and minority communities. These programs could include comprehensive family planning to prevent unwanted pregnancies and providing the information and support for patients to incorporate preventive health care in their lives. I would also promote precautionary screenings in specific communities of color, like heart disease in African-Americans and hepatitis B in Asian-Americans.

I’ve been active in many different areas: education, community organization, student leadership. Those activities have built the foundation for how I want to live my life; I want to live a life for more than just myself, a life of service, a life that matters. I could achieve that life with a career in any of the different areas I’ve been active in, but I have chosen a career in medicine because of my deep respect for life and for living. I know that life is temporary, but that is what makes it precious. I want to channel my appetite for living by treating patients and prolonging their lives. Being healthy is the most basic component for quality of life; and I want to provide healthcare. I want to provide my patients with the most basic component for their quality of life.

My paternal grandmother died the day before my White Coat Ceremony. David's maternal grandmother died the day before our wedding, and his paternal grandmother died a couple weeks later.

And now my maternal grandmother has died - the day before I start residency. David and I no longer have living grandparents.

Four grandmothers lost in four years. And all during important life events. Timing is a funny thing.

There is something about the loss of my maternal grandmother - my Po Po - that feels different this time around. I do know what that something is. It's the legacy she left.

I am not exaggerating when I say that my Po Po exuded pure joy, love, and positivity all the time. I am not exaggerating when I say that I do not know a kinder, more generous heart. She is the cream of the crop of human beings and now she has passed away.

But her legacy lives on in our family. My mom's side of the family is a jubilant, loving, generous bunch. They are a pleasure to spend time with and I mean that for all the dozens and dozens of them. And it all trickled down from the top.

In the end, it does matter that people visit you in your last days. It does matter that people attend your funeral. Meaningful relationships are what make life a worthy life. And my Po Po's life was worth so, so much.

Her personality was full of life. That is why I could not believe, even with my clinical background, that she would pass away so soon. It wasn't just denial and wishing she would live longer, it was because she lived and loved with so much oomph. I did not think it would only be a few more weeks. But I was so lucky to be able to visit her twice in those last few weeks. Especially her last week.

I frankly went to Winnipeg a little begrudgingly the second time. Not believing she was that close to death, I thought buying tickets to fly out the next day was somewhat wasteful. But we went, and it was one of the most grateful and memorable experiences I will ever have.

We arrived on Tuesday 6/10/14 in the evening. She was alert and conversant, but significantly weaker than she had been 3 weeks prior and now whispering. She was able to take pictures with our Uncle Pak. On Wednesday morning, I was able to show her my medical school yearbook, where I included pictures of her and my mom from our wedding in Winnipeg the year prior, as well as my Bak Fu on the American River. I was able to ask her if she liked David better with or without a beard, and she was able to tell me without a beard. She was able to tell the pastor that she wishes for god to take care of our "good" auntie. Then on Wednesday afternoon, she would not really be able to talk again.

David and I spent the night in the hospital Friday night, and we were so grateful for that night. We comforted her when she needed comforting (she liked being petted). We were just there for her. David and I held each of her hands, we kissed each other in her line of sight, and she turned her head as if in response. The first time we saw her move her head in days. The ambience of the room was very peaceful because it was lit by a lotus flower lamp brought by the Buddhist temple, which changed colors every minute or so. She also appreciated having a picture of Buddha in the room. My aunt came at 11pm to bring us snacks and dessert. While I was in the washroom, she said thank you to David and hugged him, crying on his shoulder. Then I joined in on the hug. I laid my head on her pillow and just cried...knowing goodbye was coming soon.

We said our goodbye Saturday night as our flight was Sunday morning. I told her I would take care of Helen and mom; don't worry about them, don't worry about us. David thanked her because without her, he would not have me. He felt like he didn't get enough time with her. I do feel the same way, because I only saw her every few years. But I don't dwell because her impact on me is not any less.

And then she passed away on Sunday morning 6/15/14 while we were driving to the airport. At 4:40am.

David's and my wedding banquet was my grandma's last. She couldn't make it to my medical school graduation, but knew I had officially become a doctor and that her sister was there to see me graduate. I will hold these facts close to my heart.

Like I hold close to my heart that my paternal grandmother knew I was accepted into medical school and on my way to becoming a doctor. Like David and I hold close to our heart that his maternal grandmother was invited to our wedding, and was so excited to attend (her granddaughter, David's cousin, didn't invite her to her wedding).

I am not devastated by the loss of my Po Po. Partially because her legacy is such a wonderful one that the sadness is balanced with laughter and love, and partially because I'm starting to master the concept that all things are temporary and everything must come to an end.

So now I know I can't force myself to blog, I just have to feel like it. Stopped journaling about my interviews after Interview #3, haha. I'm already done with Interview #10, and now I'm done. Now it's time to make a rank list.

Just like my decision between Family Medicine and Psychiatry, I change my mind about what I prioritize and thus which residency programs I want on a daily basis and sometimes even more frequently.

I keep on having epiphanies or keep on learning additional information that shuffles my rank list around in my head. I'm glad for these epiphanies though, they help form my rank list.

But I'm too much in my head. If I let my cerebrum make my decision, that doesn't settle well with me. I need to go with my heart. And my heart is telling me that my top choice is: Long Beach Memorial.

I was with David cooking in the kitchen last night when I decided to just stick with it. No more thinking too much. Just commit and we'll be happy no matter what. And I am so happy.

I put so much pressure on myself forming this rank list. By prioritizing programs, I'm also by extension prioritizing the people in my life, the patient populations of those programs, my values. My overthinking did not let the question be as simple as "Which program feels most right?"

But no more guilt. I am happy.

1. Long Beach Memorial
2. Kaiser Napa-Solano
3. UCSD
4. UCLA
5. UCSF
6. Contra Costa
7. Kaiser WH
8. UCD
9. Kaiser SD

Ok. Here we go.

My interview at UC Davis felt very comfortable and familiar. I knew almost everyone I came into contact with. The one person I didn't know was Dr. Nuovo, who interviewed me, and is a former medical school dean ironically.

My first interview was with a resident I had worked with very briefly. But he said he remembered me, and that even though we only interacted for a short amount of time, he could tell I was a hard worker. That just set up for a relaxed interview. The whole day was really relaxed actually.

The only extra information I got from the interview day (that I didn't already know) was that there is an underserved community rotation. That's better than nothing, but there is a definite disconnect between UC Davis and the Sacramento community.

Ugh, I'm blogging about this late (8 days later), and I don't know what to say anymore. Basically, I am almost positive they will rank me highly. But I've realized about myself that program directors I consider inspirational are those with a passion to serve. And I want to be at a program that inspires me. I really do. And UC Davis does not exude this passion.

Regret.

It's something I don't feel very often. I believe in the Butterfly Effect that any small, tiny change would have taken my life in a different direction. And I'm fortunate to love my life. So I don't regret very much because I don't wish for anything in my life to be different (though I do wish for other people's lives to be different).

Two weeks ago, I did feel a strong sense of regret. I found out that Ron Wilson died. He was a former Vice Chancellor at UC Irvine, and he got me into UC Davis medical school. I hadn't seen or spoken to him in nearly three years. The last time was Thanksgiving of my first year of medical school. And now I'm a fourth-year. Not only had I not seen or spoken to him in so long, I had seriously contemplated visiting him this past summer when I was in southern California. But I didn't follow through. I can't for the life of me remember any specific reason why I didn't follow through. Just a general mis-prioritization. I knew he was old and ill. I missed my chance.

I immediately started sobbing when I read that he died. I believe the source of the sobbing was regret more than grief. This man was a huge reason why my life is so great, and I never told him how wonderful medical school has been. I never told him that I chose Family Medicine. He would have been so proud.

I called his wife to give her my condolences, and she ended up comforting me. I told her about how I wish I kept in touch better, and she told me that he wasn't doing well in the past year. Then she told me that even though he died >1 month ago, the memorial service was the following week! I knew I had to go.

It is quite coincidental that I found out about Ron's death. My sister's friend Lisa told me. She works in the UCI Chancellor office and I had told her about Ron Wilson nearly 2 years ago. She actually had heard about him from other people in the office and Ron's daughter worked there too. I was so lucky to find out from her.

Though a trip to OC was unexpected, David and I managed quite nicely to attend 2 memorial services in OC in the same week. And it was actually a very wonderful trip where we spent quality time with a good amount of people without feeling too spread thin. Including David's childhood friends I've never met before.

Ron's memorial service was attended by ~300 people. They even ran out of programs, and Ron's wife Carol graciously gave me hers. They displayed his beautiful photography of landscapes and portraits. Ron had said he would give me one of his prints, and again I didn't follow through. The quotes from the speakers I purposely remembered were:

"Ron didn't just touch people's lives, he altered their lives in a positive direction." Spoken by a former mentee of his who is now a fellowship-trained doctor. I had to introduce myself to him. Ron had a 100% track record of getting students into medical school, and I'm pretty sure I was the last one. Ron retired from UCI before 2002, so I'm from a totally different generation of students. I had to meet the doctor who spoke. We are both products of Ron Wilson's mentoring. I told him I was a fourth-year medical student and that Ron helped me get into medical school. And he said, "if Ron believed in you, you must be special." He also said that we are supposed to be celebrating his life, but it's hard to celebrate when the guest of honor isn't here.

"He believed in me when I didn't believe in myself." Spoken by his successor, who was hand-picked by Ron to succeed him. This reminded me of when I was driving up for my interview at UC Davis. We were on I-5 and had passed 152, the farthest north on the 5 I had ever been. That's when the nerves of my first medical school interview hit me. I started having palpitations. And then I thought about Ron. I remember he told me to believe in myself. Words that are said all the time, but rang true coming from him. I was able to share this with Ron after my interview. He even bragged about it to his wife Carol. I cherish that.

"Carol was his rock." David hugged me tighter when these words were spoken and whispered in my ear, "thank you for being my rock." I love my man.

I learned that Ron had a heart transplant in 2002. He was days from dying, and they could not find a heart big enough for him. How poetic.

Jodaiko gave a wonderful performance at the beginning of the service. Jodaiko is the taiko Japanese drum group at UCI. I didn't know Ron that well, but I even knew that he always wanted Jodaiko to perform at his funeral. It was a little surreal to watch the performance. Ron had wanted this for many, many years, and there they were.

I no longer feel regret about having not kept in touch better. Attending that memorial service showed me that Ron impacted many, many people's lives. He knew what a great life he lived. He knew how he helped so many people. There is no need for me to dwell on my relationship with him specifically.

He wrote a letter to all of us, and it was in the program. It was a very interesting letter about how he's hanging out with all these cool people in heaven now. And that he wants to hear from us. I find myself back to a naive, younger version of myself wishing that heaven does exist. Wishing that there is more to this life, and that he was able to enjoy the Jodaiko performance too. Wishing that he knows how grateful I am for the impact he's had on me and my life.

If you're listening, Ron. I want you to know that I'm going into Family Medicine to help transform the health of our country. That I will be a kind doctor that makes my patients feel valued. That I will always remember what you did for me.

David’s cousin’s grandmother passed away last week. Her name was Betty also. I met her a handful of times since I started dating David nearly 5 years ago. I even brought egg rolls to her birthday potluck (which were a hit). She always remembered David even though she was very old and nearly blind.

I didn’t know her well, but well enough to know that she was very sweet and kind. I knew she was very Christian. I knew she opened her home to many people to the point of adopting some of them. I knew she was cared for by one of her daughters, who the rest of the family did not think was doing an adequate job.

Her memorial service confirmed all of this. The recurring theme was that she lived for Jesus and lived by His word. I like Jesus’ message of love and generosity and humility. And I do believe Grandma Betty personified Jesus’ message. But that is the extent to which I agree with Christianity. Another recurring theme at the memorial service was to take Jesus’ message a step further, into worship. I guess that the Bible is His message, but the talk about worship and not idolizing false gods does not make sense to me. There were times that the service stopped being about Grandma Betty and started being about the Bible. In my heart, I know that a book does not determine a person's worth. Grandma Betty's belief in Christ allowed her to feel supported while being a good person. But she was a good person independent of Christianity. 

My favorite part of the service was when her son Noonie read a note that Grandma Betty wrote years ago. She described what hardship she had raising 5 young children as a single mother. How she had to walk 8 miles with the children in a wagon to get to work on the farms. Then walk 8 miles back for a nominal amount of money. Food and money were scarce. While the story sounded like acknowledgement of what she's had to overcome, she sadly ended with thoughts of worthlessness. The thoughts were to the effect of, "so what?"

It was written on a single piece of paper, it wasn't even a journal. She must have been in a dark place when she wrote it, even depressed. We will never know why she wrote it down and how she got out of the dark place. But it was very special. I feel privileged to have listened to her words. 

I also loved when several family members played recordings of her singing. They were recorded in her last days. It was very sweet. 

This side of the family is very troubled and complicated. But the one value they all have right is their value of Grandma Betty. She kept this family good even when they made dark choices. As messed up as their lives have gotten, they were always able to look at Grandma Betty to be the good. I don't wonder about how they will get on without her, I honestly imagine that they will get on in a way that I don't want to know about. 

At several points in the past ~14 months, Kaiser Vallejo was my “#1 choice.” I think its biggest selling point is that it’s the first family medicine residency for Kaiser Northern California. This is a selling point for me because I want to be a Kaiser doc, and because I love Nor Cal. Even as recent as the National Conference in Kansas City 2.5 months ago, I wanted to match there so bad.

That feeling has waxed and waned. As I learn in more detail about which programs are highly respected, I see myself more in one of these excellent training programs…and I see myself less in a brand new residency.

I don’t mind the frustrations and growing pains that are anticipated with anything that’s brand new. But I do worry about the quality of the training. It’ll be a huge leap of faith.

The reason I was so excited about this program in Kansas City is because I learned that they have a relationship with Vallejo Unified School District, and that each resident will be assigned to a school to assess its needs and execute an intervention. This idea still excites me very much. I still have a deep passion for education, I still believe that education can solve our world’s problems. I would love to influence the health of a community by targeting its youth.

The work schedule will be relatively light, and that used to be very appealing to me. But again, as I learn about these highly respected programs that are inpatient heavy, a demanding schedule doesn’t seem so bad. I do value free time and sleep and wellness…but a part of me wants to challenge myself. Really pay my dues. Just jump in the pool. I believe I will grow more in a more challenging residency. And I love growth.

I didn’t feel the same enthusiasm that I felt at UCSF. While it’s a great hospital and the program has some great aspects, it’s lacking that excellence UCSF exuded. Obviously, a new program cannot provide examples of excellence. But the attendings were new, and they were lacking the ability to inspire that only experience can provide. 

I still want to be a Kaiser doc, and a Kaiser residency would be the easiest road to take. But I can still be a Kaiser doc even if I did a non-Kaiser residency. 

Today was my first residency interview at UCSF. I was eager to start the interview trail, and today confirmed it. Getting to know programs is fun! The traveling might suck after I go to So Cal for the third time, but I get to visit family and friends when I do so that's not too bad at all.

So today was a very exciting day. I was a bit nervous, but not palpably so. It felt quite liberating to not doubt myself too much. I was asked how I changed throughout medical school, and I responded that I've gained a significant amount of confidence. And today exemplified that. In the bathroom before my first interview (there were 2), I said to myself "you got this, Jenny, you like the person you are, just be yourself." Hahahaha! True words. Hysterical, but true.

I was originally going to separate this blog entry (and every entry I do for each interview) into pros and cons. But I think I'm just going to write from my gut. Just like Dr. Fong would promote (my professor in the Family Medicine department).

My gut says...

San Francisco General Hospital serves the poorest of the poor. They are a true safety net hospital and they serve despite a patient's ability to pay and they mean it. The people there feel the need to serve in their veins. One frightening thing I must admit to myself is that I don't know if I have that same passion that today's residents and faculty exhibited. What's even more frightening thing is that the undergrad me did. Even the first year medical student me did. What happened? The old me said $100K/year is enough to live comfortably on, so go on and serve the poor for that much income, serve the people who need you most, be the giver since you'll have more than enough to give. Then somewhere along the way...I became more greedy, more materialistic. I want Kaiser's $100K sign-on bonus, their $200K starting salary, their pension. At what cost?

Well that's a question I don't want to spend time answering in this entry that is supposed to be about UCSF. But it does take me back to the discomfort I feel about fitting into with those amazing people at UCSF. Discomfort is good, especially for me. Someone who struggles with self-doubt several times a day. Thankfully, my self-doubt continues to improve as I gain life experience, and I know that would be the case at UCSF. I know I would grow there. I do not imagine myself even slightly miserable there because I know that serving that patient population would fill me up everyday, I'd make sure of it. 

UCSF is unique in many ways. Its patient population and the system they work in are two of the ways. They also have a clinical psychologist on faculty who sounds amazing and I would love to learn therapy from. Being able to treat my patients through conversation is something I'll always strive for. 

As a married woman who wants kids soon, as someone who hates difficult parking, and dislikes driving with so many cars and pedestrians...San Francisco might not be the place for me, but the surrounding areas might be?

David and I had a hot date last week. We went to Berkeley to see Fun. and Tegan & Sara in concert at the Greek Theater. It was a BLAST! I had never heard David sing that much, EVER! It was very shocking and very romantic. We haven't had that much fun. together in a long time. And we had never had fun. like that. What made this concert experience unique is that we both knew the songs and thus we both could sing along. We have not been to a concert like that together before, but the problem is we don't listen to the same musicians either. The only other musician whom we both know well is Dashboard Confessional, and who knows if he's touring anymore.

It'll be hard to replicate that night. I felt very in love with him...in a way that's different from my day-to-day love for him. I felt very much aware that he was my husband and I had found my partner for life.

I was reminded of a time when I was ~12-13 years old watching the fireworks at Disney Land and wishing I was being held by a significant other. David held me throughout the concert and I found myself very grateful that I will not have to experience that loneliness again. There is nothing more romantic than dancing with the one you love to a romantic song.