Do justice, love kindness, and walk humbly with your God

Can I just say that the past year has been hard? Don't get me wrong, many happy things have happened and I am so blessed in the life God has given me. But, commuting daily to an amazing (but out-of-the-box and challenging) job, being very involved in your various communities, and being newly married to a student in the final stages of his PhD work is not a cakewalk. Combined with turbulent political climates across the globe, two friends committing suicide, and general adult growing pains, it has been a lot to handle. My downfall is too much empathy, not too little, which combined with my desire to "do" and "fix" often leaves me feeling incredibly inadequate, overwhelmed, and guilty that I should be doing more. 

But, God reminded me today of what my life is meant to be. Micah 6:6-8 provides an excellent reminder of what life really should be about. I can't solve childhood obesity. I can't make everyone feel loved and valued. I can't end health disparities. I can't be the best family member. I can't even have a tidy and organized house all the time. And I definitely can't do all of these at once. Instead of being overwhelmed and frustrated by what I can't accomplish, I'm choosing to focus on the essentials of what is truly important. And, I think that maybe, just maybe, by refocusing on these things as my primary goals, the "big" desires I have to serve others just might happen. 

There truly is mercy, hope, and joy. And for this, I am forever thankful. 

Image taken from LostBumblebee, http://lostbumblebee.blogspot.com/

Come Then, Lord Jesus

The whole creation groans, and wait to hear that voice,

That shall restore her comeliness, and make her wastes rejoice.

Come, Lord, and wipe away the curse, the sin, the stain;

And make this blighted world of ours, your own fair world again.

Come then, Lord Jesus, come; Come then, Lord Jesus;

Come then, Lord Jesus, come, Come, come.

From the hymn Come Then, Lord Jesus | Horatius Bonar (1808-1889)

This hymn is one that gives words to my feelings of the past few days. I think we can agree that killing another innocent human is a very wrong act, regardless of whether or not this person is living in a manner that we believe to be correct. What I find shocking is the idea that this is not a thought widely held  – even in the Church.

I am not saying that we should disregard we believe to be true. I am not saying that God has not given us a rule and standard to live by. In other words, don’t hear what I’m not saying (quoting one of my former pastors.) Instead, hear what I am saying: We as Christians should be compassionate. This should not be a thoughts-only compassion, but a real, live, tangible, noticeable way of life that sets us apart from the world.

Instead, I feel too often that the Christian community seems to be the exact opposite of compassionate. We don’t support government programs that help so many children and families achieve good health, because we believe they are entitlement programs. We don’t embrace immigrants because of their religious background or their immigration status. We even lack compassion towards one another when someone has different opinions about how to educate their children,  whether a woman chooses to work or stay home with her children (or do both), or even in things as petty as whether someone chooses to consume organically-produced or conventional food items. Even prior to the events of this past Sunday, I have become fatigued with lack of love and compassion found in our world, found in both Christians and non-Christians alike.

I am tired. Tired of the head-in-the-sand, hardened, apathetic attitudes that seem to be distinguishing characteristics of our culture. And, even if complete apathy has been avoided, what are we actually doing to make this world better? How are we actively bringing about God’s kingdom? How are we engaging with our friends and neighbors to show God’s love? How are we caring for our planet, so as to be good stewards of what we’ve been given?

In spite of my often frustrated feelings, there is hope (or rather, a Hope), and this is something that I need to remember daily. I am someone who is empathetic to the point of being almost daily exhausted by what I find in this world. The brokenness of this world is hard to handle. You may not think a dietitian – particularly one working in a retail setting – would see this in their daily work, but I absolutely do. I’ve seen firsthand how Iowa’s Medicaid privatization is crippling the ability of families to care for their children experiencing mental health concerns. I teach nutrition classes for juvenile delinquents who have little knowledge of how to prepare healthy meals or feed themselves well. I overhear conversations at the pharmacy with older adults who aren’t able to access their diabetes management supplies – all because of insurance issues and unnecessary red tape.

While I know that there are many factors involved in these issues and that there are valid points on both sides of the political fence as to how to address them, I still cannot help but feel that some compassion would help. I know the day of real and true compassion will not come until Jesus comes back, but I also think his Church can step it up a little in the meantime.

And so, in the midst of trying to live a life of compassion, I echo the refrain: Come then, Lord Jesus, come. 

On Love and Being Loved, Part One

Love it (no pun intended) or hate it, Valentine’s Day is here. While I have only been in a dating/marriage relationship for three of the twenty-six Valentine’s Days I’ve experienced, I must say that I’ve actually always enjoyed the day. Yes, there was some annoyance with the overly and outwardly affectionate couples, and there was sometimes that feeling of awkwardness about being one of the precious few single folks (or, so it seemed at the time.) But, overall, I have fond recollections of Valentine’s Day. From the homeschool group parties growing up to special packages from my grandparents to fun times spent with my roommates during college, I’ve never thought bitterly about this particular holiday.

But, I don’t think this is the case for everyone. My Facebook feed abounds with posts about embracing singleness (or, drowning your woes of such feelings with other similarly-placed friends), “Galentines Day” posts, and any number of other similarly-sentimented things. And, let me say right now, I think this can be good. Everyone is loved and valued and special; when they don’t believe this to be true, it makes me incredibly sad. We all need a boost sometimes. But, behind all of these “singleness power” or “I’m loved, too” style posts, I can’t help but feel that there is a sadness, a longing to belong, a desire to be (and more importantly feel) really and truly loved.

Case in point, my Google Play station just showed a “Being Single” mood for choosing music this evening.

And so, this will not be your traditional “I love my husband and here’s my gushing about how awesome he is” Valentine's Day post. He is, don’t get me wrong, but I don’t think this is the time and place. And here’s why: I think, as a culture, we have a serious problem with the word “love.” We want to be loved, and loved in return, and I sense the hurt and longing associated with that word among those I interact with each day. But, when we place our focus on this romantic love, we lose sight of the greatest love in our lives, the one that gives meaning to the love we experience in our other relationships.

And so, friends, I hope and pray that you feel loved. Because you are. So much that someone (and not just “someone,” but the Creator of the universe) sent His only Son – completely blameless of any wrongdoing – to die for you. If that doesn’t give you meaning and purpose, I’m not sure I know what will. And this is just the point: When we look for fulfillment in dating relationships or marriage or our jobs or our children or any other thing, we won’t feel completely loved. These things are not where we’re meant to find our worth. All of them are good. All of them are from God. They can most definitely be used for His glory and to further His kingdom. However, when taken out of such context, the very things that make up the daily fabric of our lives lose part of their meaning.

While I am very happily married this Valentine’s Day and am looking forward to many more with my husband, I can also say that I was very happily single on Valentine’s Days past. Not that I never wished I was dating someone or never struggled at times with feelings of “what is wrong with me and why does no one seem interested in me?” I definitely did. (To put this in perspective, I went on my first legitimate date during my second year of grad school.) This feeling intensified when a brief dating relationship prior to my meeting Josiah came to rest. Through all these instances, though, I learned that my worth and meaning needed to be firmly and only rooted in my identity as a child of God. My purpose in this world is to glorify Him, and that can be done through a variety of ways – single, dating, or married. It wasn’t an “I don’t need a man!” attitude, but rather, one of relying on God to place me where He wanted me to be. And so, I have embraced the people and opportunities are around me.  I have tried to show others this same love and truth that I myself experience. And in these things, I have been content. In years past, I did not feel lesser (or superior, pending the circles I was in) to my married friends. I wasn’t particularly seeking out to change my life’s relationship status. I was really and truly fulfilled, happy, and loved, just as I am now. This has obviously changed in regards how it is experienced recently compared to previously, but the inner workings of Martha and how I feel have remained much the same. I can’t imagine my life without my husband now; he truly does complete me and points me daily - lets be real, multiple times per day - towards my need for Christ. But, I also felt complete prior to being married.

And so, friends, if my ramblings today have made no sense, remember this: No matter what your relationship status or lack thereof, please, please remember: You are loved, by me, by others, and most importantly, by the origin of all true love. Celebrate the day with flowers and chocolate and all number of other special things. But, please do not forget the essence of what it all means. 

On Love and Being Loved, Part Two

As a continuation of my previous reflections on love, I wanted to follow up with something a bit more specific: What human love really is. I know this varies depending on the person, the relationship, the circumstances, the like. Everyone is different. But, I do think there are some similarities.

And so, this post may really only end up being a shout-out to those in my life who do an amazing job of loving me and others. But, hopefully, this can be encouraging to you, too. Likely you help many people feel incredibly loved without realizing it. I often don’t feel as though I do a very good job at showing love to those around me. But, in that, I’ve went astray: I’m not the one doing the loving. Rather, letting God work through me and being willing to carry out His work is how to share and demonstrate this love.  

Now, without any further ado, the real meat of this message: What love really is.

Love is all the time, not just Valentine’s Day. Few things drive me more insane than the commercialism and single-day-nature of Valentine’s Day romanticism. It is a special day, for sure, and who doesn’t like valentines? However, I honestly really don’t care how I’m treated one day a year; I care about how I’m treated the other 364 days of the year.

One of the things I remember vividly about my parents’ relationship is that both lived this sentiment well. Valentine’s Day wasn’t a big deal – in fact, they even both forgot their anniversary one year. But, they never forgot they love they had for each other, which was visible on a daily basis. My dad would bring my mom home her favorite Girl Scout cookies when a coworker’s daughter was selling them or spontaneously buy roses or a plant because he thought it would brighten the kitchen (a location in which my mother, having five children at home, spent much of her time.) My mom made their house a home, caring for it, the kids, the day-to-day work; she would daily pack my dad’s lunch and make his favorite foods on especially rough days. My parents regularly made time to spend together. When my dad worked twelve hour days and my mom was busy caring for a home and homeschooling, I can imagine that was pretty difficult. But, they made it a priority. And because of this, they are still best friends and forever valentines almost twenty-seven years later.

                 My parents, Josiah and myself at the wedding.

In a similar way, Josiah has always very much demonstrated his love for me in real ways, both tangible and intangible. After my parents told him that I get rather, uh, cranky when I’m hungry, Josiah made sure to have my car stocked with (dietitian-approved) nonperishable snacks. Even before we were married, he insisted on doing the dishes each night before heading back to his apartment because he knew that messes stress me out. On more than one occasion (and often on no occasion in particular), he had flowers delivered to me at work because he knows how much I love any and all things green and floral. He custom-designed my engagement ring because he knew that I don’t really like big gemstones or traditional designs. He scrapes the car off every morning before I leave for work so that I don’t have to be out in the cold. I think you get the picture: He shows me, not simply tells me, that he loves me. Verbalizing love is important, too, but so are actions. If my reformed upbringing taught me nothing else, it instilled in my mind a sense of “actions speak louder than words.” I need to be intentional and do something about the things I say. And, while this may not be true always, I do definitely think it is such in regards to love.

And so, I challenge you: How can you show love to someone today, tomorrow on Valentine’s Day, and this upcoming week or year? It may be through something as simple as a smile or quick text message, or maybe through something as elaborate as a special meal or time spent together. And, of course, it should be something through which the other person will feel loved, not just an idea that you personally would like. However, whatever the avenue, know that it does matter; your actions will add true meaning and value to your words of love. 

Of love and marriage

So, a few months ago, I met a guy. At church. A pretty nice one. I quickly came to appreciate his caring and kind spirit, witty and honestly sometimes slapstick sense of humor, and love for learning. Also, let’s face it, he’s an engineer, and we all know how dietitians and engineers tend to get along rather well. J  This appreciation grew into something much deeper and I must say that the past six months of knowing and growing closer to this man have been an immense blessing. But, this is not meant to be a “my boyfriend is amazing and I’m super happy” post (although, both of those facts are indeed true), but rather some way to coherently put together some things that have been floating around in my mind for some time as I’ve tried to piece together how my life could change and what that means for my service to God.

At face value, nothing has changed. I still engage in the same church and spiritual activities as previously. I still love people of all sizes, shapes, and sorts. I continue to desire for my life’s work to be to glorify God with the gifts He’s given me by serving others. But, somehow, these things all suddenly seemed threatened when I began pondering what exactly potential marriage would mean to these core elements of Martha. What if I cannot perform the same (or as many) volunteer activities as before? What if my work or family situation would change? How am I serving God then? And in this, I realized that somehow, my Reformed, Protestant upbringing (and very likely just the way my mind works), didn’t leave me with a great idea of how being married or pursuing marriage helps enables one to serve God. I very much believed that marriage was instituted by God to bring him glory, carried with it distinct responsibilities and privileges, and also was for the good of society at large. I had no qualms with the institution of marriage per se, but rather how exactly Martha could be serving God better in this role than in her current role as a single, newly graduated registered dietitian.

This Tim Keller quote, shared by a dear and wise church friend, was the first item to get me thinking more about what exactly this whole marriage thing is about:

Within this Christian vision for marriage, here’s what it means to fall in love. It is to look at another person and get a glimpse of the person God is creating and to say, “I see who God is making you, and it excites me! I want to be part of that. I want to partner with you and God in the journey that you are taking to his throne. And when we get there, I will look at your magnificence and say, ‘I always knew you could be like this. I got glimpses of it on earth, but now look at you!’ “ (The Meaning of Marriage, p. 132).

As time went on, I started to actually read Keller’s book and talked to God, my parents, and others who care about me to help me grasp a greater understanding of how marriage could be a good thing – and could be a good thing for me. You may be half laughing to yourself, “Oh, Martha….” And, I would agree. I overthink most things, particularly important ones. However, I also am someone that needs to have a reason for things that I do, reasons that are grounded in Scripture and what I sense God is leading me towards. I do not take things lightly. Some people may not require this much processing time (so please do not feel bad if you do not connect with my sentiments!), but I definitely do.

Through my ponderings and God revealing to me more what marriage should mean/look like, I came to realize these things:

-Marriage is a way to make you holy. Actually, that’s kind of the whole point.

-Marriage is a way of displaying to the world the relationship that Christ has with the Church.

-Marriage is the way through which godly offspring are to be brought into the world.

-Marriage is not something that you have to have. Nor is it something you should avoid. It is something that God gives as a gift according to the council of His will.

-Aspects of marriage and such companionship can bring pleasure – and that isn’t wrong. Should that be your primary and only motivator? Absolutely not. But, can you enjoy what God has given you? I think the answer is most definitely yes.

-More directly serving one person through a marital relationship (versus many people at large) does not make one lesser. It is not less service to God. It is not more. It is simply another way through which God has provided us to glorify and enjoy Him.

I think I can get behind those reasons. Obviously, I probably wouldn’t want to pursue marrying someone that I wasn’t attracted to in other ways. But, many of these aforementioned items are things that I am already passionate about. I very much desire to serve others in meaningful, relational ways. I want to proclaim Christ to the world. I love kids and teaching them about God. And so, I came to decide that I had no reason to be at unrest because I was pursuing a more serious dating relationship. I’m still Martha, and God still loves me, and He will still use me in the best way possible to serve His purposes.

It’s hard, isn’t it, to shift our mindset of how we think God can use us? As I reflected more, I found that my identity was very much rooted in being single. Which, again, is not a bad thing. Probably just as well at times during the crazy busyness of studying that was my undergraduate experience. J But, truly, if my identity is found in being single rather than that of being a child of God, whose primary purpose is to glorify and enjoy Him – in WHATEVER situation that may be – how it this really any different than someone finding their identity in dating someone? Or being married? Or being a missionary? Or a mom? Or any other thing that replaces God? I really don’t think there is any difference, and if there is it is negligible. No matter whether you’re married, single, or somewhere in-between, God has it figured out and will give you the grace you need to accept when those life situations (almost identifiers in our culture) change. He is not thwarted by our human plans and desires, but rather uses them for His glory – which is incredibly comforting, freeing, and humbling all at the same time.

As I’ve already mentioned, I really, really hesitated to actually post this blog entry. I didn’t want to be one of *those* people who post gushy posts about their significant other and how happy they are. But, a part of me feels that there is probably someone out there who needs to hear some words of encouragement. Also, a semi-recurring fear in the back of my mind: What if things with this particular individual don’t work out and then I have this whole post – won’t that be super awkward? But, even in thinking this thought, I am again missing the entire point of everything I just wrote. I am a child of the King. Nothing more. Nothing less. If my identity is rooted in this, I cannot veer astray.

In the meantime, I am walking very contentedly and happily along the path in which God has placed me, assured that no matter what occurs, He will continue to lead me in the proper way.

______________________________________

So, the above post was written by me in late March of this year. Fast-forward to yesterday, July 8, a day in which I made the decision to accept and embrace the blessing that God has given me in the form of a fiancé. His name is Josiah, he’s super great, and here’s a picture because I know you all want to see it:

He managed to surprise me utterly and completely (I was expecting this question to be asked later in the year), and truly did an amazing and humbling job in caring and honoring me that day. The ring included. I’ll probably post more about all that at some point. But, today, too much. Gotta get the story honed down to a 5 minute soundbite for interactions with friends and coworkers. J

Currently, I’m honestly in a state of many and confused feelings. I’m excited, super happy, and feel incredibly loved. Honestly, in a way that is very different and so much greater than anything I've experienced before. There are also elements of surprise, “what on earth just happened”, and honestly even a little bit of uncertainty if I made the right choice. But, I also think those feelings are completely normal. And Josiah has been great in supporting me in all those feelings and assuring me that he loves me for who I am. Just because I’m not outwardly elated and pinging off the walls (not saying that anyone else acted that way yesterday…. J) does in no means indicate that I’m not equally happy and excited for what God has in store. As I’ve trusted God in many decisions for many years, I will continue to trust Him in this one. I am humbled beyond measure to be so loved, both by God and by Josiah, and truly am in awe at the goodness demonstrated in it all. I’ve never doubted that God is good and loving, in spite of my many imperfections, but certain things in life make this all the more evident. This is definitely an indication and reminder of that great love. 

And I couldn’t be happier.

The more things change...

The more they stay the same. I do agree with some connotations of this time-honored phrase. I thought I would be less busy after finishing grad school. I’m not. I thought a new job would make me all the more convinced that I would love being a dietitian. It has not. (Well, at least not often enough for my liking). I thought I would have my life together and feel mature enough to handle it when I was 24. I definitely do not.

And another thing that definitely has not changed for me: My inability to handle silence. Pretty sure there is another blog post on here to that effect. Don’t get me wrong, I do like a little quiet every now and then. A country kid at heart, living in a city (yes, Iowa City is a big place to me; I give you permission to laugh at me) can sometimes be a challenge. I need to be outside in the quiet on a regular basis. I am also one of those odd people that enjoys silence when they’re home alone. I’ll occasionally play music, but I overall very much appreciate the silence after being around intercoms, noise, and commotion for 10-12 hours a day.

So what exactly is the type of silence I struggle to handle? That of not being around people. Alone time is important, don’t get me wrong, but my quota of alone time is 30-60 minutes a day tops and then I start to go stir crazy. Maybe it’s because I grew up always around my family. Maybe it’s just because God has willed for me to be an incredibly extroverted and people-loving individual. I really don’t know. But I do know that it is a hard thing for me to process. And sometimes Martha left with too much processing time can be a very interesting thing…

I spent Christmas this year predominantly solo. Please know that this is not a plea for feel-sorry-for-me pity. My situation this Christmas happened of my own choosing due to conflicting work/family/life schedules. And as a result of these occurrences, I was able to spend part of the afternoon with a pretty great guy. So all was most definitely not lost. J But, this did cause me to ponder, yet again, why I struggle so much with being by myself – for more than an hour. Maybe I don’t want to take the time (or be perceptive and patient enough) to actually think about deeper life questions. Maybe it’s because I’m more exhausted than I care to admit and am embarrassed when I catch myself falling asleep when I was not intending to. (No joke, I went to bed at 7:40 p.m. last night). Or, maybe it’s because humankind is meant to be innately social. Or maybe it is for none of these reasons. I still have no good answers except for the fact that I know it happens and I’m still trying to figure out how exactly to handle it.

I do think it’s a good thing, to be a bit uncomfortable sometimes, to have time and space to think, and to actually take the time to do so. I wonder if the root of all these struggles I have with silence (and rest, for that matter) is that I am a bit too much of a Martha. In spite of the fact that I wrote my entire Christian Scriptures II exegesis to prove that Martha was not as evil as we often make her out to be, I will admit that she had some flaws, ones that I definitely possess. I’m almost always “doing", never resting, not always reflecting, and these are, when boiled down to the heart of the matter, ways to try and exert myself as a mini-god over my life. I was raised a good enough Calvinist to know that I am not solely in control of my life. But, by keeping myself constantly busy, immersed in “noise”, etc., I am in essence saying that I think I can live my life the way I want and please God. No rest or silence needed, both of which God instituted for our own good. For the past 6+ years, God has been trying to get my attention in that area. And while I covered this up with college, grad school, etc., these things are not excuses. It’s really only been over the past 6-12 months that I’ve thought more deeply about these things and tried to make intentional changes – not only for my own sanity and wellbeing, but more importantly to follow the life pattern God has laid out for His people.

Please do not take this all to mean I think I’m a terrible person because I like to be busy and love people, because I don’t. I know God gifted me in those ways for a reason and these Martha-tendencies can be used for His glory. But, I also know, it is very easy to have my biggest strengths become my biggest weaknesses – a phrase my dad repeated often from a sermon or some such source during my childhood. And it is true. And thus I am glad that God has, once again, reminded me of my need for still silence as well as my need for Him.

So, if you’re in a similar place, know you have found a kindred spirit. If not, hopefully this helps you appreciate that the struggle is real for some of us extroverted, busy humans. Good thing God made us all different, isn’t it? I am ever-thankful that He extends His grace to even the most complicated and confused folk such as me. 

Being Secure in Insecurity

I really was not planning to continue this blog, since I do an incredibly poor job of updating it and generally feel that I have very little to say that many would find interesting. But, I have since been reminded that writing helps me process thoughts better. And if it encourages someone else in the process, all the better! All this to say, my ramblings will continue. Prepare yourselves. :)

Life update: I graduated (yay!), have a full-time job as a retail dietitian, am an adjunct professor at Iowa, turned another year older, and life in general has been good. Definitely busier than what I thought – after all, your life gets less crazy the older you get, right? (You can laugh at me now – because I am). I believed at least some of the busyness would subside with not being in school, but that has not been the case. I’ve maintained my long-held belief of “just keep plowing through”, so at least I have that going for me. And I wouldn’t not be involved in any of the things that occupy my time. So I’ve decided to quit complaining about it and continue to enjoy the various opportunities, relationships, and activities that God has placed in my path.

One incredibly beneficial activity I’ve been able to be involved in this fall is a discipleship group at my church. More focused on how we cultivate a Gospel-filled life, how to disciple others, and theology versus solely Bible study, this is exactly what I needed at this point in my life. I had inklings, but didn’t fully realize, how many spiritual things I’ve either not thought through completely or have ignored for the past 6ish years while being in college. I don’t regret decisions I made about my faith and how I engaged in it during these years, but I am definitely aware that more intentional cultivation needs to happen as I embark in my adult life.

One area of weakness that has become especially obvious to me during this study is that of insecurity and self-worth. I have always had a firm foundation in my worth being defined as a child of God whose sole purpose and mission is to serve and enjoy Him. I am ever-thankful that my parents instilled this in me at a young age. However much I may hold this belief, however, deeper reflection has revealed that I don’t always act that way.

Take my job, for example. First, starting a new job is always hard and you will be worried about a variety of things. However, I have noticed that I have been thinking much more about how my actions are perceived, how others subsequently treat me, and other similar things, which in turn play into how I feel about my work. Some of this is a good thing, to be sure. Reflexivity is often beneficial. But, I also cannot let these thoughts cripple me or make me feel awkward and ineffective all the time.

In a similar way, my relationships with others should not define my worth or security in myself. Obviously, these relationships with family, friends, and others are incredibly important. And being someone who is rather extroverted and incredibly people-centered, likely I am more affected by this than others. However, I need to derive my ultimate assurance of worth, satisfaction, and security in Christ alone. 

When I take the time to dig through my thoughts and actions down to the core, it is amazing how many are rooted in these sinful patterns of insecurity. Naming and owning it is part of solving the problem, but the true solution comes when these things cause us to fall all the more on Christ’s atonement and God’s redeeming love and grace. I cannot be full and complete on my own, to be sure. But, I do happen to have a God who makes this possible and who uses these things to draw me closer to Himself. And for that I am forever thankful.

Now that my philosophizing for the day is complete and the temperature has risen to 20 degrees, I think it’s time for a Saturday morning run. We’re even supposed to get snow today, so I’m pretty excited. J Enjoy the day, friends! 

Culture. It matters.

       Wow, my history at updating this thing is beyond nonexistent…whoops! Let’s just sum up the last four months with: It’s been crazy busy, filled with more than I ever thought possible, I’ve grown a lot as a person, and I’ll be done with classes in one week. I know that description doesn’t do things justice, but…

       This year has thus far been filled with many triumphs and joys, but definitely not without corresponding trials, sorrows, and ever-copious amounts of incredibly hard work. Life has been full, academically, emotionally, spiritually, socially, and otherwise. I truly think this semester has been one of the most enjoyable and also influential for forming my thought process and how I see myself working in the future. At the very least, I think I’ve finally found my niche. I am yet to be enlightened on what exactly that will look like, but, I know God will let me know in due time.

       My elective courses this semester include maternal, child, & family health and also promoting health equity, both of which pretty well encompass my passions. I also had the opportunity to travel to Washington D.C. with the Iowa Academy of Nutrition & Dietetics for a public policy workshop. Talk about being out of your comfort zone…an inexperienced Midwesterner talking to legislators on the hill, especially when politics aren’t exactly your favorite thing. But, I was able to discover that I actually do like this type of work, likely related to the fact that I would talk to anyone, anytime, about anything. Extrovert problems. But, I am excited to be more involved in public policy work in various ways over the upcoming year.

       One recurring thought and reflection I have had this semester revolves around the concept of culture. Prior to this term, I honestly thought of myself as one without a culture. After all, I don’t fit into a cultural or ethnic minority group, I couldn’t really tell you my ancestry if I had to (eastern European is about as good as it gets), I’ve never been oppressed, I’ve never really moved (I feel like the Illinois to Iowa transition doesn’t really count), and I don’t necessarily fit in with the American mainstream culture. However, my lack of acknowledgement of my own unique background, experiences, privileges, challenges, barriers, and other such factors is actually potentially harmful as I interact with others. If I’m not willing to recognize myself in these ways, I am not truly able to see the entirety of the individual sitting next to me – whether that be a student, patient, or friend.

       So, what is my culture? Terms like Christian, Midwestern, moderately conservative, female, homeschooled, Caucasian, twenty-something, grad student, and other similar terms immediately come to my mind. But, I’ve increasingly realized that there is much more to my story than checking boxes off a demographic sorting sheet. Even if I don’t think my story is interesting, it is important. What makes me Martha? How is my worldview shaped by my culture? What does this mean for my interactions with others? I need to be aware of my own biases and beliefs before I can help others in the most effective and humane way. Even for things as “simple” as nutrition education and counseling. Or teaching. Or talking to someone at the grocery store. These things matter. So, I challenge you, what is YOUR culture?

       Yes, these are the things I think about when my mind needs a break from other things. Who knew the dietitian could be philosophical. But, I’m afraid my procrastinating under the guise of blogging should probably come to an end. Now to start researching evaluation data for the National School Lunch Program for that 15 page paper due next week…

2013

       One of my biggest pet peeves is celebrating holidays (or any occasion, for that matter) without remembering the background meaning. So, on Christmas, I reflect on Christ’s birth. On the 4^th of July, you’ll probably find that I’ve read the Declaration of Independence recently. I doubt I’m unique in this, but, I do like to be a conscientious celebrator.

       So, today, I’ve taken time to reflect on the past year. I’ve noticed several friends’ posts regarding all that has happened over the past year and have been reminded that a lot happens in a year. A year ago, I was hopeful, but not very confident, that I would still be in Iowa City. I would never have guessed that I would now be employed as an RD at UIHC or teaching classes at UI this academic year. In 2013, I celebrated my second graduation in two years, passed my RD (thankfully, after 5 years of work!), continued grad school as a second year MPH student, moved into my own apartment, purchased my first car (sad to see the Alero go, but, I do like my little Honda Fit), have taken on more responsibilities at church, moved into the 21^st century with my first smart phone, and probably many other things that have slipped my memory. I’ve been challenged, in both good and perhaps not so good ways. I’ve strengthened existing friendships and gained many new friends, for which I am incredibly grateful. A few things that I’ve learned or been even more convinced of their importance this past year:

1. Never underestimate the importance of smiling at someone. Truly, I think it is among the easiest, comforting, and meaningful things that we can do as humans.

2. Take time for people and invest in them. Worth it every time.

3. The more you learn, the more you realize you have absolutely no clue.

4. Reflexivity is incredibly important. Interesting that it took my qualitative research methods course for me to realize how beneficial (and disturbing at times, to be honest) it can be to reflect on things.

5. New situations are only difficult and challenging if you believe them to be. Fake it ‘til you make it if nothing else.

6. Being a teacher is ten times harder than anyone thinks, whether actually teaching classes, leading children in learning music, or helping interns learn to become competent, confident RDs. The content is the easy part, it’s finding how to enable others to learn that is the tricky part.

7. Pretty much everything my parents taught me I have found to be true and I’m thankful every day to have had such God-fearing, devoted parents. I am ever amazed that they’ve pulled off raising 2 grown kids that are at least somewhat normal with 3 more still at home. Parenting isn’t for the faint of heart, that’s for sure.

8. People are often interested in your friendship, even if it seems that they are not. Worst case scenario, someone takes you to just be nice and polite. No harm done.

9. Connecting to a church is probably among the most important things you can do.

10. Life is perpetually in transition. Maybe it’s because I’m 23, but, I’ve decided that it is much better to simply accept this as the norm rather than fighting it.

11. Almost everything I’ve learned in public health revolves around treating people fairly with integrity, humility, and compassion. Where have I heard that before…

12. There is no point in complaining about things you cannot change. Deal with it, do the best you can, and move forward.

13. I like people. A lot. Anyone. I love nothing more than playing with a squirrely almost two year old, chatting it up with one of my adorable “older adult” patients, or interacting with students.

I know that 2013 has been a year filled with joys, sorrows, triumphs, and disappointments for virtually everyone. I hope you all have a splendid 2014. I’m excited to see what God has in store. 

The journey continues

In one paragraph, I shall attempt to catch you all up on my life since my last post - apologies for that being so long ago. You've been forewarned that this will probably be one long paragraph: 

Over the past 4 months, I have completed and graduated from my dietetic internship, successfully passed the registration examination for dietitians (aka, I'm an RD!), become a licensed dietitian, started work as a PRN relief dietitian at UIHC, took two online grad courses over the summer (while working full-time...it was busy), moved, purchased my first car, and just today completed my fourth week as a 2nd year MPH student and grad assistant at Iowa. On the extracurricular side, I've continued to be involved in my church in varying capacities, been able to babysit some pretty adorable children, run a few races, tried my hand at painting canvases for my wall (which actually turned out half-ways decent), went camping. I probably left something out somewhere, but this description will suffice. 

Throughout this incredibly busy, challenging, and oftentimes stressful time of life, God has remained to be ever-present and faithful. He's given me supportive friends and family to keep me sane, communities in which I am able to minister and serve, I get to live one more year in a city that I love, and my knee is finally better and I can run as much as I want! While the above paragraph may lead you to believe that I have it all together, by no means allow yourself to think that for a moment. I struggle with life issues just like any other human, I still don't know what I want to do with my life following graduation in August, and my courses and jobs have been challenging me in unforeseen ways. Not so much due to the content (grad school for me is not near as intensive as that of the didactic learning of undergrad), but more because of the issues, ideas, and thoughts with which I continually wrestle and regarding which I try to develop educated opinions. Let me explain. 

In public health we are, obviously, concerned about the health of individuals, families, and communities. So, basically everyone. Furthermore, we quickly learn that, when public health is doing its job correctly, no one knows we exist. So, I'm earning my masters degree in a basically unseen/unknown area that often not appreciated and does not receive enough funding to complete desired activities. Additionally, my heart breaks most days for the stories told by researchers who have worked with the Native American population, other ethnic minorities, health disparities, abuse (physical and otherwise), and many other scenarios. Furthermore, my brain starts to become challenged in regards to human rights (what things do or should we consider a basic human right?), the government's role in the nation's health (when can we intervene appropriately when individual responsibility is not failing?), how to effectively help others, do these efforts really make a difference, why has the human race done such a terrible job of caring for the health of themselves and the planet, and many more ethical dilemmas. All this aside from the fact of me trying to figure out how a dietitian fits into this public health arena. 

And then there's the issue of me still being unsure what I really want to do for my life's work. I have continued to really enjoy teaching (I'm teaching two sections of one course on my own, grading for another course), I like academics (yay school!), but I also like the clinical aspect of my RD job, too. About the only thing I've concretely decided is that I really like pediatric work of any variety. I have recurrent thoughts of completing a BSN, or going to medical school, or PA school, or earning my doctorate. I sometimes wonder why I became a dietitian in the first place and question whether this is really where I'm meant to be. So, once again, I'm not 100% sure of what I'm currently doing and I am in the place of not knowing where the next year will take me. It's becoming a trend. ; ) Honestly, this has been causing me some unrest, although this is subsiding now. I want to serve people in the best capacity I can while using my gifts. SO, what does that look like? And, who decides this? Me? Maybe my unrest has been due to an issue of control: Perhaps, unwittingly, I think I should be the one to determine where I am "best" serving and using my gifts, rather than my Creator who truly is the one calling the shots. Going back to the trusty Westminster, my primary purpose is to glorify God and to enjoy Him forever. Outside of that, I just need to trust God and remember that other life decisions and career paths will be evident at the necessary time - and not before. Micah 6:8 sums it up pretty well: 

He has told you, O man, what is good; and what does the Lord require of you but to do justice, and to love kindness, and to walk humbly with your God? (ESV)

So, friends, be just, be kind, and walk humbly. The rest will come. 

Nearing the finish

            Enjoying my first evening off in…let’s just say quite awhile, I realized that this blog needs some updating. Two months is perhaps pushing it just a bit. Not surprising to any of you, I’m sure, my life as a dietetic intern has continued to be busy. But, the big news is, we graduate next Friday, meaning that we only have 6 more days of actual rotations! I’m excited, obviously, but also have been feeling a little down. No matter how many times it happens (which I have learned is, essentially, all the time), change is hard. And moving on to a more normalized adult life, while exciting in many aspects, means that I have to come to grips with the fact that I will soon and very soon be a licensed professional working independently.  I know that I am competent, generally confident, and able to perform my job. It’s just weird to know that I am so close to being at the finish line of five-and-counting years of difficult and ever-challenging work. Good thing I’m prolonging the whole full-time job aspect of this thing for another year. ;) Yay for grad school-which, sidenote, begins again for me in 1 ½ weeks!  

                In regards to an update on rotations, I’ve now completed community nutrition and, within the food service management realm, retail and patient services. Community nutrition was four weeks primarily of observation, which I didn’t mind due to the fact that we were exposed to so many different aspects of dietetics. We spent time in long-term care, working with the Blue Zones Project in Muscatine, IA, taught a health fair for 5-6^th graders, taught a nutrition lesson to 3-4^th graders, visited a school food service operation, Johnson County WIC, and other things that I’m unable to remember at this time. All in all, it was a good experience. We did have extra free time, which was nice, as it gave me an opportunity to finalize grad school details.

                Both retail and patient services were great as a way to gain more exposure to still other areas of dietetics. They also served as a good reminder of the importance of knowing your employees and being a manager whom they both trust and respect. While in retail, I spent time developing materials on composting awareness, as UIHC began a composting program about two months ago for food waste and other compostable materials (including our new  compostable to-go containers, cups, etc.) We also standardized a few new recipes for possible inclusion in the summer menus of the various cafeterias. Patient services consisted primarily of observation, but it was good to see the entire process of the patient menu (which is a la carte/room service style at UIHC), formula preparation and delivery, and sanitation, in addition to the actual managerial aspects of the various areas.

                One thing I’m realizing, in all of these experiences, is that I am still unsure of what I really want to do, which is frustrating to an individual who wants to serve in a way that fills the biggest need possible while using my talents. I enjoy each area of dietetics and honestly could see myself working as a clinical dietitian, a food service manager, a professor, or a community-based R.D. I am ever-reminded of my love for people, of all ages, ethnicities, shapes, sizes, and sorts. I know that I am passionate about investing in their lives and serving the needs of others. At the same time, I am very much academically minded, organized, and in many ways fit the mold of the stereotypical dietitian. Obviously, this makes deciding on a career path a little difficult. Also, there is often a nagging fear in the back of my mind that I’m not doing enough to serve others, or that I don’t know where I best fit. Try as I might to assure myself that I’m where I’m meant to be and that there are many avenues to achieve this end, I must admit that these thoughts still occur. But, I’ve decided to rest in the fact that God must have made me this way for a reason, that this reason will become evident at the right time (and not before), and, meanwhile, my job is to follow His lead.

                So, as I enter into the end of the last phase of my internship, I plan to enjoy these moments as much as possible, with as little worrying as possible. Currently, I am working on special projects with managerial staff. Along with two other interns, our present project is developing and revamping website content for various departmental webpages. All these things that you don’t realize have to actually be done by someone….until you’re the one doing them. J On the non-work side, I just got back from my first trip to the Iowa City Farmer’s Market, which was fun. Definitely will be going back again later in the growing season. Also, I’m doing a color run this weekend with a few other interns, for which I am super excited! Hopefully all that dye will come off before graduation…..

                I wish you all a great and lovely day, my friends! No matter if you’re feeling depressed, unsure, happy, sad, or otherwise, rejoice in the fact that we have a Father who loves us. A lot. And has a plan for us. And made us for the sole purpose of glorifying Him and enjoying Him forever. I don’t know about you, but being reminded of that fact always makes my current situation seem ever so much better.

Anticipation and provision, forever and always

      April 1^st isn’t exactly a big day to most people. I mean, there’s the April Fool’s Day component, but otherwise, it’s just another day. [Sidenote: April Fool’s Day has always annoyed me. Why purposely lie to or trick people? I guess it’s just not my style]. Back on topic now, April 1^st is a pretty big day for me. One year ago today, I found out whether or not I would be able to become a registered dietitian. Prior to that day, I had no idea what I was doing after graduation, where I would be living, when I would be moving (if I was accepted into a program), who I would be living with, which program I would (hopefully!) be attending…. You get the picture. The best of senior year stress rolled into one day.

     This story has a happy ending, however. April 1^st, 2012 was match day, a phenomenon unknown to anyone who is not a dietetics major or somehow connected to one.  Once I was able to eventually log in to the online matching site for D&D Digital (the system through which applicants and dietetic internships rank each other), I was able to find that I matched to the dietetic internship at UIHC, my top pick!

      Now for a brief history on why exactly all this was so important. First, it is required that a supervised practice internship (typically about one year in duration) be completed after obtainment of a bachelor’s degree in dietetics or other approved area  in order to be eligible to sit for the registration examination for dietitians. You can only match to one program (hence the matching website), even if you apply to more than one program. You rank your programs, the programs rank you, and as the applicant you hope that they align somewhere.  Oh, and, every applicants logs in to the matching site at the same time to find out if they matched or not. Add in the fact that, last year, 53% of applicants did not receive a spot (it’s a long-standing problem that there are not enough dietetic internships for the number of new grads each year), it’s a stressful day at best. So, the odds are decently good that you may not be able to become a dietitian after putting in 4+ years of work. There are options, of course, including reapplying, but this is obviously not ideal.

      So, I mention all this because, for me, today is a celebration of God’s faithfulness. He gave me opportunities to not only attend the college I wanted to and study the area that interested me the most, but also allowed me to have jobs, volunteer opportunities, an academic mindset, leadership roles, research, etc., that helped make me a stronger applicant for internship positions. He providentially provided for me to come to Iowa City, a place that I never would have dreamed of coming to prior to two years ago. In fact, I wasn’t initially interested in the program here and planned to stay in the Chicago area. I was actually pretty stubborn about it and only looked closer at Iowa out of respect for my mother. Funny how things change. As it stands now, I’m in the midst of a program I love with people that I like, I’ve been able to experience and learn more than I ever imagined, made new friends, become a part of a great church, continue to work at Hy-Vee….the list could go on for a really long time. All this became a reality starting one year ago. And for this, I am grateful to the One who made it possible. I’m also thankful for the four dear friends/roommates who put up with the anxious and distracted Martha of one year ago, who truly shared in my pain. They probably deserve a medal for their support. J

     And now, one year later, I must admit that I was in a very similar place of not-knowing-what-I’m-doing-next until last Thursday. You think you’ll know what you’re doing sooner when you get older, but I’m adjusting to the fact that this is not the case. (I give all you wiser souls permission to laugh at the young adult mindset present before you). Irregardless , I found out last week that I was officially accepted into the master of public health program (MPH) at Iowa! This means that, not only do I get to finish up my masters over the next year, but I also get to stay here! I have an interview this week for a teaching assistant position, which would be great, and also possibilities for another part-time RD job opportunity. No, I don’t have all the details worked out, but at least I have a general plan. And, just like last year, I’m excited, thankful, and utterly blessed.

      So, I’ve been realizing that this blog has turned into more of a life story than just internship-related things, so just let me know if there is ever something you’re dying to know about my program. J I finished up staff relief last week in inpatient pediatrics/pediatric ICU, and have thus completed the 5 months of clinical work required in my program. I still can’t quite believe that I won’t see another patient as an intern. As of today, I am now in community rotations, which is as it sounds. We work with dietitians involved with schools, Hy-Vee, prisons, nursing homes, etc., which will be interesting. We’re definitely in the home stretch to June 7^th, however, which is crazy in and of itself….

     Thanks for reading my ramblings on thankfulness! As always, God providentially provides and blesses us with more than we ever deserve. Senior dietetic students and other applicants who may be reading this, know that I’m praying for you as this week unfolds. April 7^th will indeed answer many questions for you, irregardless of the outcome. In the meantime, try to freak out as little as possible and rest in the fact that God has your back. Always.

Happy RD Day!

Happy Registered Dietitian Day! Yes, this is an actual day, albeit one that it is not as popular as other calendar holidays. Nonetheless, it is important to recognize the role that dietitian's play in our nation's health and wellness. As you can see from the above graphic, RDs are advocates, something that was repeatedly reinforced to me during undergraduate courses and now I have seen in action during my time as a dietetic intern. That means that, while I'm not the one ultimately calling the shots for my clients/patients, I am responsible for presenting their wishes and opinions, as well as overall championing what is best for their nutritional health. To do this properly, I have to be well educated, base my recommendations in current, evidence-based research, and, most importantly, have spent time with the individual. I promise, RDs do more than it may seem at first glance!

Given that today is RD Day, and even though probably none of these individuals read my blog, I wanted to thank the many dietitians who have been part of my education and learning to this point. From job shadowing in high school to didactic learning in undergrad to now my supervised internship, I am incredibly grateful for all of the knowledgeable, friendly dietitians who have been willing to teach and mentor me in the dietetics profession. While I know that there is ever-more to learn, I do feel confident in my abilities in becoming a dietitian this summer, thanks to all these individuals.

And, as you are also probably unaware, March is National Nutrition Month (NNM)! Celebrated each year, the theme for 2013 (the 40th anniversary of NNM) is "Eat Right. Your Way. Every Day," focusing on the choices we all make each and every day in regards to our diets. There is not a set in stone diet that is appropriate for every individual, nor is every day going to be a model of optimum nutrition. Rather, it is about making healthier choices and, overall, consuming a balanced, varied diet.

NNM has been a switch for me this year. I've been accustomed to being a NNM champion during undergrad, organizing promotional materials, booths, activities, etc. This year, my only involvement has been assisting in planning a health fair for hospital staff, patients, and families with the other interns. Irregardless, it should be fun, and it is nice to have a bigger budget for materials and giveaways. :) The fair is today, which is appropriate given that it is also RD Day!

So, here's to nutrition, health, and dietitians! Next RD Day, I'll be able to celebrate for real!
 

A season of reflection

     Maybe it’s the weather. Maybe it’s because we are in the season of Lent. Maybe I’m just worn out from everything. Maybe my brain is overloaded from being in 7 different high-level care areas in 7 weeks. Maybe I’m overly anxious because I have no idea what my life holds after June 8^th. Maybe it’s because I’ve at long last reached my almost-breaking point. But, I’ve been in a funk for the past week or so, and have honestly felt alternately depressed, inadequate, down on myself for feeling these things, questioned my choice of careers, and then am once again back to normal. Nothing like roller coaster emotions! While I’m not sure what’s been going on, I know that having a low-key weekend has helped immensely, the snow and sunshine are lovely, and being outside truly makes Martha a much happier person.

     I don’t mention these things to be a downer, or to draw attention to myself, or to make you all start thinking something is terribly wrong with me. Because, quite simply, none of these things are true. Rather, as you all know, I’m an honest person and I also know that many people struggle with similar things on a regular basis. So, in sharing my struggles, I hope to encourage those of you who have been feeling the same way. We are normal, I promise! And, best part is, God is still in control, and loves us even though we truly are a mess (even at our finest moments).

     Enough of my philosophizing. Time for updates all around! Lots of rotations, per my usual. J

Pediatric ICU Once again, I LOVE peds! I enjoyed being able to complete assessments of older kiddos (versus the tiny neonates), observe a new diabetic education for a young child, do an obesity education on my own, and interact with the peds care teams. I was once again reminded of how important it is to build camaraderie with patients, considering myself successful when I cracked a smile out of a previously stone-faced teenaged male patient. And, as always, the RD’s in this area (as in every area I have been in) are absolutely amazing. I only hope to one day be as knowledgeable as they!

Behavioral Health Off to psychology! I chose this rotation because I’ve always been interested in eating disorders (EDO), and UIHC has both partial and in-patient programs for EDO. Substance abuse and in-patient psychology are also part of this area, but the primary focus was EDO. Even though I was not as involved in counseling and assessment (due to the nature of EDO treatment), I nonetheless learned so much about EDOs and this patient population. It was interesting to see how interviewing, presenting information, etc., have to be altered in this area, due to the many other diagnoses and issues experienced by these individuals. Truly, my heart was daily saddened at what I observed (especially with the young patients) and the hurts that were visible on these patients’ faces from past abuse, neglect. etc.  In the end, I’m thankful that individuals seek treatment from these disorders, and that dietitians are able to help them restore their bodies.

Medical ICU Shocking, I know, another ICU. J This ICU is an incredibly busy area, admitting patients with conditions such as diabetic ketoacidosis, lung conditions, substance abuse, etc. Always changing and ever challenging. Naively, I didn’t realize that lung disease was such a common issue, or overdoses either, for that matter, but this rotation opened my eyes to both. The MICU dietitian was a nurse before becoming an RD and thus is a great teacher for how to physically assess patients (examining hair for nutrient deficiencies, examining skin for edema severity, etc.). Also, given that she has a minor in biochemistry, she has immense physiological knowledge, which I thoroughly enjoyed. I just wish I could have soaked up more of her wisdom!

Surgical Cardiology My last clinical rotation before staff relief! Looking back, I wish I would have done more cardiology, but I honestly didn’t think I would enjoy it and thus didn’t pursue it at the time. However, I really enjoyed this area and am glad for the knowledge I was able to gain. The surgeries done at UIHC are intensive (left ventricular assist devices, coronary artery bypass grafts, heart transplants, ECMO, etc.) and dietary precautions with such patients follow suit. Many biochemical, medication-related, and lifestyle factors to consider, resulting in challenging and yet rewarding assessments.  I was also able to interact more with the diet techs and menu system, which made me feel like I was able to make more of a difference in these patients’ lives. Additionally, my RD previously worked in renal for many years, so I was glad to be able to gain even a little of expertise in this area. Oh, and, the other cardiology dietitian’s name is Martha. Enough said.

      As much as I enjoyed these rotations, in the last three I particularly noticed a common theme: Lack of hope. From my EDO patients who were struggling with so much, to my MICU patients who tried to overdose one or more times, to my cardiology patients who (often) had been making poor lifestyle choices and now have to deal with the consequences, I’ve been left daily pondering just how much these people need Christ. Don’t get me wrong, I’m not saying that I think we need to overtly evangelize while treating patients, or that medical treatment isn’t necessary (because it is). What I have realized is just how dark, dreary, and, at the cost of being repetitive, lacking in hope this world is without Him.

     So, friends, I encourage you to ponder just how much Christ has given us, even in the little things, and realize how completely lost and helpless we are without Him. That’s what Lent is for, reflecting on our absolute depravity and need for God’s grace. During this season, I charge you to reflect on these things, looking forward to the celebration of our Savior’s resurrection.

      Staff relief starts tomorrow! I’m blessed to have received my choices, which consist of two weeks in NICU and two weeks in in-patient peds. I know it will be intense, I will be doing lots of research at home, and I will be daily (and hourly, for that matter), challenged. However, I’m still excited for this opportunity to learn and gain more experience in these areas.

P.S. I ran a 4 mile race today, the Chili Chase in Davenport, IA, in a little under 34 minutes (not sure of the official results yet), which was under my goal time. This was probably due to training with someone who runs significantly faster than my usual speed. Yay for a running buddy! In the end, my time was good enough to be in the top 40 women finishers and receive a sweet new stainless steel travel mug to that effect. Perfect for use during my 7 AM mornings in the NICU. J

Rotations, Rotations, Rotations

1) I am in denial of the fact that I am already three weeks into this semester. Time flies!

2) As usual, I’m behind at updating on my rotations…which means I’m now restricting myself to one paragraph per rotation due to having five (yes, five) on which to report.

      To give you a better understanding of my life this semester, we change clinical rotations each week for seven weeks this semester, which is great due to giving lots of experiences and challenging due to switching areas every five days. I’ll start staff relief in February (so excited!), but more on that when it happens.

     So, here are my brief synopses on my rotations as of late:

Production/Catering 

This rotation was just as it sounds, with lots of hands-on work in the kitchen, primarily due to being there during the holiday season. We also were able to see cook-chill, a unique operation in which food is cooked, bagged, rapidly cooled in special equipment, being then able to be safely stored in refrigeration for a few weeks. My fellow intern and I were also able to assist with catering functions, work on cost analysis and new ideas for daycare menus, observe the receiving process of food items, and many other tasks (such as pre-plating holiday meals for 500+ people. No big deal). Additionally, five other interns and I planned, prepared, and hosted a holiday appreciation meal event for the Food and Nutrition Services workers. Our theme was Candy Land and it turned out splendidly. Even better, Child Life Services at the hospital are going to use all of our decorations for the pediatric patients!

Mother’s Milk Bank of Iowa
Each intern at UIHC has the opportunity to spend a week at the Mother’s Milk Bank of Iowa, a facility of UIHC in which donor breast milk from eligible nursing moms is procured, properly stored, pasteurized, and shipped to neonatal intensive care units and eligible infants across the Midwest. I was able to pasteurize milk, assist with packing milk for shipping, learn more about milk banks, and help “log” milk (a system for keeping record of how much milk is donated per donor, how much donor milk is on hand, etc.). Before this rotation, I didn’t realize that such operations were unique (only 11 in the United States) and governed by strict food safety protocol and contamination checks. Overall, however, I now understand how important milk banks are for infant health. The benefits of breast milk are numerous, and through MMB, premature infants (whose own mother’s milk may not have come in yet or who have inadequate milk expression for their baby’s needs) are still able to receive all of the benefits of breast milk.

Sidenote: Please “like” the MMB of Iowa on Facebook! Such establishments truly save lives and getting the word out that MMBs exist is important.

Outpatient Nutrition Clinic
My first rotation of 2013 was at the outpatient nutrition clinic, now housed at Iowa River Landing (the new outpatient clinic for the University of Iowa). Even though it was a slow week while I was there, I was still able to observe the two outpatient dietitians counsel a variety of patients. I also completed my first solo diabetic education, so I was pretty excited. J I really enjoyed seeing patients from so many different walks of life, and, as I have mentioned before, assist them in changing their lifestyles to healthier behaviors. Even though many individuals are referred to such clinics by their physician, I still feel that they are farther along in their readiness to change than someone who is recovering at the hospital, making the educations much more personal and in-depth (due to greater availability of time). Also, the outpatient dietitians are true educators, appreciated and valued by their clients. I was able to learn so much through observing and working with these R.D.s.

Trauma/Burn
Definitely a switch from outpatient, but interesting nonetheless. UIHC has a specific intensive care-style unit for burn patients, in which hydrotherapy (cleaning of the wounds), excision of the wounds, etc., are all performed. Due to my naiveté, I didn’t realize the prevalence of frostbite, with my week in this unit consisting of many assessments of individual’s with TMAs (transmetatarsal [toe] amputations) and leg amputations. Also saddening, I followed some pediatric patients, who sustained burns through freak accidents and common home happenings gone wrong. Definitely an intriguing patient population, one with heightened calorie and protein needs, which is great for an R.D.! I do enjoy helping people find more foods to eat instead of encouraging moderation and restriction.

Neonatal Intensive Care Unit (NICU)
I finish my NICU rotation tomorrow and truly am left in awe of what I have seen in this unit. Babies that are as young as 24 weeks gestation are admitted to this unit and treated until they are able to go home and continue normal growth and development. While most all of the infants are premature, some are also term babies who have genetic abnormalities, critical health conditions, etc. Nutrition is, obviously, a huge component of proper growth and development, making the two R.D.’s who work in this five bay, 76 bed unit an integral part of the care team. Truly, these women are absolutely phenomenal and I am beyond impressed with their clinical knowledge, judgment, and ability to assist in treating these babies. Not possessing previous exposure to premature infants, it had not occurred to me that they are unable to consume foods orally for some time (due to having immature sucking reflexes), thus necessitating enteral (into the gut, if it is medically appropriate) and/or parenteral (into the veins) nutrition support. The calculations for such recommendations are, shall we say, complicated, and so many factors must be considered that are not as critical in the world of adult nutrition. However, I have absolutely loved this rotation, probably due to its complexity and the necessity of a strong science background in order to properly assess and help treat these “kiddos” (what the patients are fondly called on the unit).

      As always, I’ve managed to bore you all to tears with my lengthy updates. ;) Now, onwards and upwards to the pediatric intensive care unit (PICU) next week! Oh, and, our grad classes start again this upcoming week, too. Busy times in the life of a UIHC intern. :)