The Blackberry Walk

 Most days after work I exercise.  Before I moved to Memphis, I was a bike commuter for two years in Athens, GA, climbing 6-9 miles of hills daily in weather ranging from 19°F to 92°F.  I got used to it, donning a ski mask and windproof gear in the winter, and buckets of sunscreen in the summer.  Honestly, I really liked the sweatiness, but I liked even more the constant physical activity in my day.  Since moving to Memphis 9 months ago, my days have been starkly different.  Out the door by 6:30 am, I hop in my car for a 16-minute highway commute.  I hate car commuting.  Hate it, hate it.  No exercise.  Wasting fossil fuels.  Consequently I became a car-driving gym-goer.  This habit has manifested itself at other times in my life and usually works away from the monotony eventually.  For example, for nearly 4 years I minimized all gym appearances, except during bitter winter temperatures, in favor of rowing on the Chattahoochee River for Georgia Tech.

I Love Memphis graffiti art

Now back in the gym trying my best to maintain healthy compliance, I despise the reliance on a commute.  Alas the weather has finally turned beautiful again, encouraging strolling a few times per week after work; I happily abandon the gym in favor of power walking.  Mapping out a three-mile loop from the VA Hospital to downtown Memphis and back, I stay challenged and sweaty.  On my second walk one 87°F afternoon, I discovered a wild patch of blackberries about 2/3 through that made my heart scream and shout with excitement.  In an abandoned driveway/parking lot between two buildings, a 100-foot length patch of weeds, vines, and bushes grew.  As I sped past the lot a few lone blackberries sparkled in the sun, grabbing in my eye.  Whoa!  Before I knew it, I was near skipping down this lot, popping berries in my mouth as my eyes jumped through the vines.  (Note: I LOVE BLACKBERRIES!).  What a treasure trove!

Dietetic Internship: Staff Relief

DIETETIC INTERNSHIP: Weeks 38, 39, 40 (of 41)

Staff Relief: Weeks 38 - 40

Finally!  The last phase of the Dietetic Internship is upon me: Staff Relief.  For three weeks, I will take over full responsibilities for one Registered Dietitian role at the Memphis VAMC, manage her floors, her patients, set follow-up dates, and complete other required RD administrative duties.  I have to see at least six patients per day, preferably 8, regardless of complexity.  Historically I have met with my preceptor each morning for her to parse out my daily patients; now I will decide and manage all 60 or so beds and determine my own priorities.  This step is like moving into adulthood.  Finally.  Undoubtedly full of challenges, too.

Alas, I did it!  I saw a WIDE variety of patients with different nutritional needs:   Bowel obstructions, Gastric cancer surgery, sudden respiratory failure and progression to vegetative state, emergency guillotine amputations below the knee because of horrible diabetes management, little old men that refuse to eat, pancreatitis, inguinal hernia repairs, and malnutrition.  I accompanied a cardiopulmonologist to the ER to watch him perform an emergency intubation.  NOTE: That is NOT a delicate procedure!  I watched a left and right cardiac catheterization (not part of RD duties, just interesting!).  I visited daily the sweetest 71-year old man w/ Parkinson’s disease that had severe GI issues and required total parenteral nutrition; he made my heart pour out with happiness and sadness simultaneously.

Specialty 2-week rotation to Florida!

DIETETIC INTERNSHIP: Weeks 36 & 37 (of 41)

Alternative / Specialty rotation in Gainesville, FL: Weeks 36 & 37

Hi ho, hi ho, it’s off to Florida I go!  My Dietetic Internship included a 2-week “Alternative / Specialty” rotation at a facility outside of the Memphis VA Medical Center.  It is the intern’s responsibility to seek out the location, find the contact information, and secure this bond.  What. A. Chore!  I wrote, I contacted, I searched for names, numbers, friends or family with whom I could stay for two weeks.  Honestly, it was all a bit stressful and at one point, I questioned why I was not just looking around Memphis and consequently happily sleeping in my own bed.  BUT.  My Internship Director kept telling us that often individuals find full-time employment at their Alternative Rotation site, and I wanted to make a thoughtful decision. 

Oak tree canopy

After a lot of contacts, I very happily secured a contract with the Gainesville, Florida VA Medical Center.  A long time ago (when I was a student at the great University of Florida), I made best friends-that-became-my-family in High Springs, FL, about 25 miles away from the hospital in Gainesville.  They accepted me for two weeks, as well as the VAMC.  Done!  Next step:  Drive.  It is a LONG way from Memphis to Gainesville, specifically nearly 700 miles!

Diabetic spirits

DIETETIC INTERNSHIP: Weeks 33 & 34 (of 41)

Intensive Diabetes Management: Week 33

Pediatrics: Le Bonheur Week 34

What type of pills would you like to take?

Let me be honest.  I didn’t take many (personal) notes during the above-named rotations.  I toiled, but I left significant lacunae in my bank of memories.  Here are a few memorable moments:

Intensive Diabetes Management was primarily outpatient driven and functioned like playing a game of Magnum PI crossed with Dr. House.  Patients come in reporting high and low blood sugar extremes with seemingly perfect compliance to medication and insulin.  Dietary compliance?  That is always questionable.  I saw patients with blood sugars ranging from 30 to 460 daily, and supposedly taking the correct dosage of insulin.  Riiiiiight.

Levitt Shell & Cotton

Cotton blossoms in Henning, TN

A funny thing happened as I drove out to Mud Island one late Saturday morning: I saw things flying through the air everywhere, like great big allergens just waiting to cause a giant sneezing fit.  My afternoon plan was to sit outside at a café, read, study for the RD exam, and have a cold drink.  With my allergies, this plan suddenly seemed impossible…  However, I wondered, “Why did I not see all of this air debris at my house 13 miles away?”  I can thank the Mighty Mississippi River for my answer, and more specifically the barge traffic upon her.  It is cotton season, and all of the large and small flying puffs was cotton blowing off of the barges!  Thankfully I successfully sat outside for over 3 hours, with only one incident of cotton inhalation, momentary watery eyes, and a fit of sneezes.

Memphis has a great “shell” in midtown, Levitt Shell, an outdoor amphitheatre.  Young Elvis Presley took the stage here on July 30, 1954, in what historians have called the first-ever rock ‘n’ roll show.  Built during the Depression, it served as an orchestra performance venue in the 1930s and 1940s.  Today they put on more than 20 free summer concerts for the people of Memphis.  On this same Cotton Saturday, I packed up my bamboo mat and headed for a seat on the grassy knoll for my inaugural experience.  I was greeted by 5,000 other Memphis residents, many packing picnic gear and adult beverages.  The Memphis Dawls played, backed by various string players, and the Memphis Doctors Dance Band. They sang and played fun toe-tapping current tunes and covers from the 1940s.  Halfway through the night, dusk started to approach everyone embraced the relaxation and entertainment.

Memphis: World Championship Barbecue Competition

Friday

What a riotous event!  Sheer gluttony!  A weekend dedicated entirely to … BARBECUE!

After work on Friday, I quickly headed to the Mississippi River in search of myoglobin-outlined perfection.  After a 10-minute weaving search for free parking, I stepped out of my car… into what seemed like a meat smoker of goodness.  ALL of Downtown Memphis: Smelled. Like. Barbecue.  WOW!!  I am not kidding. 

You should know that I only eat meat a few times a week for health and ethical reasons– but when I do eat meat, it is often barbecue driven.  I love barbecue.  (I also love pattied sausage, but that is for another post.)  This new downtown aroma smelled like heaven! 

When it comes to barbecue, I have always been a lover, but I have my preferences.  I have never been a huge fan of ribs; they just haven’t had the right taste and texture for me; I am more of a pulled pork kind of girl.  Well all of this changed on Friday & Saturday... 

Welcome to Memphis in May  2013 World Championship Barbecue Competition!

Creative BBQ team names!

Thousands of competitors are on ‘teams’ that complete for various BBQ categories from ribs to whole hog to best tent (see categories and winners here ).  Each team has a ‘tent’ for cooking and, most importantly, for partying.  Team sizes range from 5 to 50, and tent sizes are up to 2 stories tall!

Tell Me What You Eat

DIETETIC INTERNSHIP: Weeks 31, 32 & 35 (of 41)

Foodservice Systems:  Weeks 31 - 32
Culinary : Week 35

Where do Registered Dietitian’s work?  As of Oct 2013, there are approximately 89,000 RDs in the US and abroad, the vast majority of which (~70%) are employed in a clinical field (healthcare in hospitals, long-term care facilities, etc).  The other main RD fields are foodservice systems, and school foodservice.  Research and community dietetics round out the list.  Unquestionably, the preponderance of public opinion associates RDs commonly with “food” only despite its low occupancy.


     As soon as I utter the words “Dietitian,” most people:
             a) pat their belly or hips, grumbling out regrets regarding dietary intake;
             b) recall what was consumed at the last several meals; and/or
             c) silently, yet assuredly, bring food and weight to mind.
     It has not taken long to recognize this repeating response. :(