008_VALDEZ_Travel Nurse Adventure– Alaska pt. 2

The Route: Anchorage-Mantanuska Glacier-Valdez-Anchorage via Glenn Highway (route 1) to Richardson Highway (route  4).

Days: 3

The trip to Valdez was enhanced by the presence of a friend from home joining me and my co-worker. The goal: to create a “real” Alaskan adventure, seeing and doing as much as we could on a short amount of time. Don’t worry: we succeeded!

First stop: Glacier View to hike on Mantanuska Glacier. Though I had seen quite a few since my arrival here in May, many visible from just the highway, walking on one was a new dynamic. Though access to this glacier is 24hrs and $30/person entrance fee if venturing on your own, we chose to pay for a guide with Mantanuska Glacier Adventures so that we could pay the entrance fee, rent micro spikes, and learn about glaciers from a guide all in one. An added bonus is that tour guides know the good places to go, where not to step, and get quote unquote exclusive access to certain areas as the trail marked for solo hikers is marked specifically to try to maintain safety and so doesn’t venture to every corner. Needless to say, we got our money’s worth. Our guide, Michelle, was awesome– knowledgeable, funny, and friendly. She made us feel like rock stars while we posed for photo ops and, due to our ability, she took us farther/deeper into the glacier than she does most groups. Starting out it seemed like we were walking along a dirt path to get the the glacier. We were pleasantly surprised to learn that we were walking on a layer of ice miles deep with rocks and sediment from high up in the mountains dusted across the glacier– there only because the movement of the glacier took it along for the ride. Some areas you can even scrape your boot across the surface and see the sheet of ice below. The micro spikes were a must as we hiked. I couldn’t imagine doing it without. We traversed the mud and rocks and eventually made our way into the blue ice where we saw admired mulans (vertical well-like shafts where water enters from the surface and acts as a drainage system), threw rocks down deep crevasses, and drank from a glacial waterfall. We ended with a short wade out to mermaid rock for one last photo shoot.

The drive to Valdez was equally impressionable. The mountains of Wrangell- St. Elias National Park is in the background for the majority of the first part of the drive. The road twists and turns and eventually narrows a bit. We eventually came across Worthington Glacier falling seemingly onto the highway ahead of us. A few turns later we emerged through Thompson Pass into a wide clearing of mountains and a ridge jutting out to the right. Purposefully, there is a pull-off immediately after emerging. It is well worth the stop– this clearing was both majestic and picturesque.

The next milestone along the drive was Keystone Canyon. What a wonder!! Waterfalls galore with one powering down right beside the road, it’s mist able to reach out (Bridal Veil Falls). I am a huge fan of waterfalls, so I was in heaven. In the same location is the historic site where they started to build a railroad in 1906 that ended unsuccessfully due to a gunfight.

Finally, we made it to Valdez, and, after a quick dinner at Fat Mermaid we called it a night to prep for the next day: wildlife glacier cruise. With few options as far as tours go, we went with Stan Stephens’ Columbia Glacier tour ($109+taxes/person). A cup of Kaladi Brothers joe in hand from a cute cafe called Latte Dah (I see what you did there!), we were ready to go. Starting out warm but on the chilly side, we saw otters almost immediately. Next came porpoises playfully skipping along our boat and sea lions relaxing along the coast. Then we caught a bald eagle perched on top of an iceberg. As we neared the massive Columbia Glacier, the air felt frozen and the water filled quickly with icebergs that eventually turned into an ice barrier through which the ferry couldn’t pass. We were so grateful that we brought layers! Temperature aside, the view was magnificent. Columbia Glacier is the second largest glacier in North America. NBD!

The evening was spent in town getting dinner at Nat Shack, ice cream at Northern Treats, and drinks at The Boardroom where we were pleasantly surprised by the shenanigans of a live rock band at 10pm. Before that we visited the Maxine and Jesse Whitney Museum to learn about and admire the collection of native art and artifacts. Though the town is small and follows suit with the majority of other towns in Alaska, it was pleasant enough and we enjoyed ourselves plenty.

The drive back to Anchorage was equally eventful. We stopped at the Solomon Gulch Hatchery and learned about salmon migration and the incubation of their eggs. Next we hiked Valdez Goat Trail, also known as Bridal Falls Trail, which branches from the Pack or Wagon Trail. An easy 4mi roundtrip trek along the Richardson Highway, this trail features 2 outlooks and a massive waterfall at the end and is a must see for anyone looking for a shorter hike near town. Next we stopped again at the portion of Thompson Pass that overlooks the valley from a rocky vantage point. We had to get the photos that we didn’t get on the way down!

Though held up slightly by traffic, the rest of the ride to Anchorage was smooth and sunny. We had such amazing luck on this adventure– even spotting 3 moose on the side of the road. Truly, a must-do drive for anyone visiting Alaska.

004_What It Do, Anyways?

Laymen
and soldiers
Alike,
please understand me.
-
A drowning frontline.

Despite so many important and interesting topics to discuss, I’ve decided that it wouldn’t make much sense to move forward without addressing the elephant in the room. Just what do we do in the ED anyways?? I’ve come to realize that there is a lot of confusion regarding what an emergency department is actually for, the environment in which it functions best, and why a place that is so chaotic is the frontline for saving life and limb. The most insightful revelation, though, is that it is not just people who have no ties to healthcare who are confused. Other nurses throughout the hospital are often just as fed up with ED nurses as are patients who have been waiting six hours to be seen. I’m hoping that this post will help bring at least some clarity to patients as well as to fellow RNs.

To start: what is an emergency department for? Though this might sound very obvious, it actually isn’t. And I mean no degradation in my response. Said simply, an emergency department is for emergencies. But emergencies come in all shapes, sizes, and severities. One person may consider a set of circumstances to be minor given personality traits and the environment in which he or she was raised. Another person might not tolerate pain as well as his or her neighbor. Some people have severe psychological pain associated with their physical pain. Some incidences and illnesses impact one’s livelihood more intensely than others, prompting a seeming need for emergent care. So, here, simplicity is not so helpful. That said, it isn’t truly realistic for one entity to tackle that large variety of care. We have cardiologists who specialize in the heart. Orthopedics who specialize in bones. Nephrologists who specialize in the kidneys. And so forth. The crucial point, here, is that emergency medicine is also a specialty, and, more specifically, a specialty of acute care. And within this specialty we have further sub-specialties. Besides the basic positions  including beside nurses, PCTs, advanced practice providers, and doctors, an emergency department is made up of people who specialize in even more specific areas of emergency care– imagine a type of Henry Ford assembly line– so that one person can concentrate on one aspect of care in a quick and efficient manner and follow it through to the end. Triage, trauma surgeons, stroke teams, MI teams, anesthesia, respiratory therapists, registration, ECG techs, phlebotomists, CT/X-ray/US/MRI, transportation, environmental services. We are each trained in our specific sub-specialty of emergency care. When an alert is called overhead, we arrive to the room, we gather our supplies, and we get to work. Because each sub-specialty has been defined and that definition has been agreed upon nationwide, every person in that trauma room knows exactly what to expect– what my job is, what his job is, why that man or woman at the head of the bed, to whom to ask this question. No two people are running around trying to get the same thing done. No one is unsure who is in charge. Does this get messy at times? Of course– we are all still human and a person is dying before our very eyes. But, in theory and time again proven in practice, the clearer the rules, the less room for error, the faster we can get er’ done. We have been trained to treat acute situations such as strokes, heart attacks, vehicle accidents, and sepsis, to name a few. Our definition of an emergency is, therefore, quite narrow. Our definition of an emergency is more along the lines of “are you dying right now or could you die within the next few hours without immediate intervention.” When reading that back, it feels kind of dramatic, right? But it’s a real thing. There are some conditions that just cannot wait.

So why am I saying all of this? First, let me speak to my patients. The faster pace makes for what appears to be chaos. Just like you are having an “emergency,” so is everyone else who has come here today. No one emergency is more important than another. But some emergencies are more time-sensitive. The emergency department looks at time-sensitivity, amount of pain, number of resources required, and length of wait as main factors in deciding who gets seen next. You may have been waiting for two hours already, and “that guy” gets a room first. Unfortunately, that means that “that guy” is in the midst of a more time-sensitive situation that you are. “That guy” might be having a heart attack as we speak. Or a stroke. Or his blood pressure may be so low that he is hardly perfusing his body. That doesn’t mean that ED providers and nurses don’t believe that you are in pain or also have an emergency. We don’t like feeling ill or throwing up any more than you do. But this is where the definition of emergency comes into play. Providing emergency departments with a narrow definition of specialty only works if the department is properly resourced in that manner. The rise of urgent cares helps facilitate this. Have you been feeling weak, fatigued, throwing up, diarrhea, and unable to tolerate food or drink for the past few days? Are you unsure how good it would be to wait it out any longer? Are you otherwise healthy without many significant medical diagnoses? Perhaps an urgent care is the correct place for you to rehydrate, rest, and ensure your electrolytes are in balance.

That said, sometimes the closest urgent care isn’t open at the time you need help. Maybe you don’t have one near you at all. Maybe you are just unsure and think that the ED would be the safest place for you. The nurse who first greets you in the emergency department is called the triage nurse. His or her job is to determine the severity of each person as they come in and label them a 1-5, if using the fairly recently revised and improved ESI triage scale. Very, very simply put, 1 means you are actively dying– bleeding out from a car accident, pulseless from a heart attack, etc. 5 means you require very few emergency department resources for your care and are not in a situation that would cause you to die anytime in the foreseeable future– this could be a cut requiring stitches, etc. Triage nurses take into account your past medical history, your pain level, and your vital signs when making a decision. All emergency departments hope for more 1-3s and fewer 4s and 5s by having the 4s and 5s seen at urgent cares. This would decrease the number of people waiting for care, would decrease the amount of resources being used overall (including the time and energy of employees), and would decrease the overall stress and chaos felt throughout the department. But a triage nurse would never turn you away. If you feel that you need to be there, they will put you on the list. Not only is it against federal EMTALA law to turn someone away, but it is unethical to do so.

So, to handle this influx of emergencies on a daily basis, we as providers work as quickly and diligently as we can. As a general rule, there is no running in the ED. Running symbolizes panic. Panic hinders critical thinking and attention to detail. We don’t run. But we do haul ass. We work as quickly as we can on as many patients as our hospital determines safe for us to do so at once. We don’t want you waiting in the waiting room any longer than you have to. We don’t like to see you in pain. We don’t like to feel like we are failing you. To do that we rush from room to room performing task after task. We attempt to keep up on labs and imaging as they result. We attempt to make you comfortable while you await your diagnosis. We attempt to get to know you. But just as we have a narrow definition of care, we also have a narrowly defined goal: to put out as many fires as possible while maintaining as much dignity, autonomy, and comfort as possible. Our goal is not to get familiar with your life story. Our goal is not to treat your chronic issues. Our goal is not to stay with you during a lengthy admission. We stabilize and we send out. This concept is pertinent for fellow RNs. ED nurses often know very little about their patients in comparison to the amount of knowledge nurses on in-patient units come to acquire after taking over care. This often surprises in-patient nurses when it is time for us to give report. A skeleton report is the best ED nurses are often able to give. We can change locations within the department as often as every four hours to cater to department needs. Working in the ED requires flexibility and constant re-prioritization depending on which kinds of emergencies walk through our doors or are brought in by ambulance. The downside is that this kind of flexibility does not allow for consistency. I often give report on patients I have been assigned to for two hours and have only seen once. I don’t study the charts. I browse for outliers and interventions only. I don’t remember where the IV is. It doesn’t matter for my goals of care. When I get in the room, I use the one that’s available and I leave. I’m often not sure the urine output or number of bowel movements unless it’s pertinent to that patient’s current acute situation. I often can’t clean up the chart as much as I would like to before the patient goes up to the unit. Ugh. It sounds so bratty when written down. But I just can’t achieve my goals and your goals at the same time. I just can’t. I’m on to the next fire. I plan to do and know as many things as possible– don’t get me wrong! But how does that saying go: “the best laid plans…” Patients keep coming in, keeping getting upset for waiting, keep requiring more orders be filled. And everything keeps getting delayed for those 1s and 2s that suddenly appear.

As we progress as a culture and adapt to leaning on urgent cares more and more, the hope is that emergency departments will “slow down.” Yes, we always need more staff. 6 patients to 1 nurse is not only unsafe, but it’s inefficient. My feet only move one at a time. My brain can only perform one task at a time, even if I am in the middle of several. I can only answer one call light at a time. But we don’t need emergency departments to become more like in-patient units or long-term care facilities or chronic pain clinics. Emergency departments are good at what they do. Someone has to be on the frontlines, putting out the fires, and getting people to the right places for the best outcomes. But please understand that we aren’t that place. We won’t heal you. We won’t fix you. We will stabilize you and help you get to the unit or the out-patient appointment that will. We yearn for a better community understanding of what we do and why so that we can be used properly and therefore function properly.

Xoxo

The Frontline

001_Adventure Awaits

The
Door behind me.
The
Road ahead is calling.
Adventure
awaits.

I left my hometown of Rochester, NY on May 4th to pursue a career in travel nursing. Formally a staff nurse in the local emergency department, I’ve decided that there is too much in the world still yet to see and experience. From landscapes to cultures to illness, I want to absorb it all and base my world view on a broader spectrum and describe it with a more fruitful vocabulary. So, where to first? Alaska. I KNOW! I can picture no better way to spend my summer than with 22hrs of sunshine daily and a glacier in my backyard. High temperatures in the 60s is… alright, but I’ll take what I can get because Rochester has been nothing but clouds, rain, and early May snow-showers. So my first ever blog is a detailed account of my adventure before the adventure, purposefully naming favorite places and specific experiences. This one is mainly for me. Goodbye Rochester. Goodbye family and friends. Hello Alaskan strangers!

First Goodbye: Rochester

The first, and hardest, goodbye was to my family and friends in Rochester. Involving several small get-togethers at my apartment as well as several more one-on-one’s at bars and restaurants , I was overcome with gratitude at the people I had gathered in my life. Even my cousin from hours away came through to wish me good luck. Saying goodbye to my hometown AGAIN  has been one of the most important parts of this journey for me. The first time I was in a hurry to grow up and become someone. This time, I was in no rush. I am a fully formed human with many aspirations but I have a brighter head on my shoulders and stronger roots in the ground. I’ve never been one to feel strongly about a place. I’ve never needed to be physically near my family. The itch in me to run off somewhere new, fueled by fear and positive intentions, has always been too powerful to ignore. So I often set off at record speed, hardly looking behind me to see how it affected my family and those I left behind. But this time was different. This time I made sure to see as many family members as I could, as many friends as I could, as many times as I could, by whatever means possible. The morning of my departure, I walked onto my front porch, the metal knob cold in my hand as I closed the door behind me. I had checked and rechecked the house several times. My father waited patiently in the car. I paced up and down the porch steps, running through everything in my mind, checking off boxes that had already been checked. I was reluctant to leave, though. The clock read 6am. The longer we waited the more we were pushing it for a 7:40am departure and the later it would make my dad who had work at 7am. We both knew this. But what we were waiting for was too important. It was my last Rochester goodbye. After a week or more of missing each other, my brother and I had still not met up to say goodbye. It was a long shot, but I remembered that he usually gets out of work around when I would be leaving for the airport. He said he’d try to get out on time. The sound of his tires pulling into my driveway nearly brought tears to my eyes. If it hadn’t worked out, I guess it wouldn’t have been a big deal. Our lives would have kept going. The world would have kept spinning. But there’s something unique about a sibling relationship. A total stranger in many rights but the one who understands why you are the way you are in a way that no one else can. I guess I could say that hugging my brother goodbye in the nick of time, wishing him well, and asking that he stay in touch was no big deal. Except that it was the biggest deal of all.

Second Goodbye: NYC

The city that never sleeps. Where I met some of my very best friends. The place that introduced to me both Buddhism and molly. Only a one-day stop, but always worth it. My favorite place to eat: Peacefood Cafe. I leave with a grasshopper cookie in hand and a smile on my face every time. Though a slightly disappointing mani-pedi from Haven ensued, the trip was necessary. There is a certain energy about New York. A certain unspoken understanding among pedestrians that we are all unique, all artists, all on this Earth for a purpose. As cheesy as it sounds, there’s a vibration in the air that is contagious. I hold my head higher. I walk taller. My back straighter. I feel the value of hard work and creativity.

A quick visit with a friend currently studying for law school exams beautifully captured the essence of true friendship. I feel emotional when she thanks me for making time to see her during my busy schedule. MY busy schedule! Such a sweetheart.

After an enlightening discussion with my Dharma teacher about habits and human nature and an elegant Epsom salt bath, I was more than ready for bed. The problem: I was too wired to sleep! #theworst. I tossed and turned for at least five hours and before I knew it, my alarm rang 2:30am and I was dreading life. Luckily for me, my host and dear friend sensed my rising, brewed a pot of coffee despite my protestation, and saw me off. I left New York feeling truly loved. My former home. My former love. No pictures or shenanigans. A quiet hello and a somber goodbye as I officially leave the East coast for the foreseeable future.

Shortly after a swift and expensive Lyft, I found myself at my gate with leftover tofu scramble and a coffee in hand. A grin across my lips, silently bragging, I enjoyed my time being EARLY to the airport. No scrambling for this girl! AND my vegan food made it through security. Because I would have held up the TSA line to eat that tofu. No chance I was throwing that out… lol.

Third Goodbye: Las Vegas

But first, get the rental car. Now, when I tell you that it was a process, I mean it was a PROCESS! Three shuttles later we arrive at Fox Enterprise. And that’s three shuttles where I had to lug around two suitcases and a bag wearing 4 layers of clothing which I had to wear in order to keep my checked bag under 50lbs. Which, if we can go back for a moment– how dare they start charging for both carry-on space and checked luggage! They cram us in like sardines and then have the audacity to charge us for space that just last year was free. I hate being taken advantage of. Who travels without a carry on?? But I guess that’s the point… I digress.

And so, with sweat dripping from my brow and my shirt(s) sticking to my clammy back, my Las Vegas travel companion and I were finally sitting in the rental and ready to leave the lot. The agenda for day 1 comprised of day-drinking and hotel lobby spotting. We ate brunch at Vegenation, one of my favorite Las Vegas spots, and it did not disappoint. It is a self-proclaimed mission for me to try each vegan restaurant’s version of buffalo wings and to rate them. My travel companion eagerly agreed to join the cause. :p. Per our expert opinion, Vegenation gets high marks for both taste and texture. After landing at Luxor and struggling to figure out how to self-park, we took in the impressive display of Egyptian art and got dressed for our first day on the Strip. Since everyone says that day clubs are “uniquely Vegas” and “the place to be,” we made that our first stop. We felt awkward and too old to be at Marquee Day Club, though. Kids in their early 20s were hitting on us and there was no where available to sit down or even place our belongings while we danced. We paid $16 a piece for gin and sodas and there was a clump of hair in the pool. Suffice it to say, we will be trying out a different spot next time. Next came dinner at A Slice of Vegas where we shared a most delicious pie of vegan BBQ pizza and rated their cauliflower wings as “good” but not surpassing those from Vegenation. Their distinctly cauliflower taste was refreshing though, we agreed. Visiting the hotel lobbies at night was a highlight and always proves worthy of one’s time. Having been to Las Vegas before, I was familiar with Caesars Palace and Bellagio and I did not regret seeing them again. Magnificent works of art detailed the main entrances, the casinos, and the shops playing with negative space and various themes. My newfound favorite: The Venetian. I love museums, especially art museums with paintings, so I found this to be a wonderful adaptation.

Day 2 was a mix of planning meets spontaneity. Inspired by the addition of one more friend, we ventured to an art piece that she had seen on Instagram: Seven Magic Mountains. Created by Swiss artist, Ugo Rondinone, as a “creative expression of human presence in the desert” (see link, homepage), this public art display is located in the Ivanpah Valley just 10miles south of Las Vegas and open for viewing until 2021. I realized at this moment that a theme in my life is appreciating art in it’s varying modes of expression. Even when being spontaneous, it somehow involves artwork. I am not upset by this revelation. The three of us girls then continued North to take in Red Rock Canyon. We entered with my National Parks Pass, which I highly recommend purchasing. At only $80, this pass is good for one full year from the month of purchase and allows one vehicle free entry into all federal lands including national parks and forests. The only caveat is that only two signatures are allowed on the back of the card, meaning that one of those two people must be present, with photo ID, in order to use the pass. Since purchasing in April of 2019, I have already saved $50 on entrance fees– one more entrance and I will have broken even on the cost of the pass! And so, back to Red Rock Canyon, it was beautiful, yadda yadda. What can I say? I’m a sucker for nature and am continuously blown away by it’s history and marvel at the notion of how it all comes to be. The sun dances across bold dashes of bright red rock that was produced thousands of years ago by iron deposits. We hike for a short while, meeting bugs and flowers scattered along the way, and we talk about all of the topics. Three girls enjoying nature. What more could we ask for?? Well, I’m glad you asked! Because, in stark contrast, for dinner we find ourselves back in Vegas enjoying a meal at Carson Kitchen (where I eat the most amazing rainbow carrots w/ sautéed chickpeas and quinoa that I have ever eaten in my whole life and have yet to stop thinking about!) and taking a tour of Old Town which is nothing like what we expected (which, in all fairness, we didn’t do much research about it in the first place so expectations were minimal). For several blocks that are pedestrian only, we walked and we people-watched. Some were drinking and laughing, impersonators of all types were present, and a different band was playing on each block ranging from country to rock. Luckily, we quickly found ourselves tired and heading back to the hotel. Part of me feels sad but drinking and nightlife have not found their way into my #thisis30!

Seven Magic Mountains (Left); Red Rock Canyon (Right)

Day 3 was sketchy but ultimately very successful. It was soon discovered that my friend and I are not great planners or communicators. We had narrowed down our goals to Grand Canyon in the morning/afternoon and Hoover Dam in the evening. Typical us, we didn’t check closing times or leave early enough. It all started when I woke up 30 minutes late on only 6 hours of sleep. I shortened my workout to a 20 minute run and was out the door as fast as I could be. With a Starbucks oatmeal (made with soy milk, I added almond slices and a banana) and a soy latte in hand, we set out. Only problem was that it was already 9:30am and we had planned to hit the road closer to 8am after factoring in gym, breakfast, and traffic. So we trudged along through the desert, driving past more desert and then past more desert passing cows and small communities here and there. The view was obviously breathtaking but so different from New York. No pine trees line the roads and obstruct the view. Just an endless distance. And speaking of distance: The Grand Canyon. After 4.5 hours of driving, we finally made it. Dark clouds rolled closer and closer to the rim, so I scrambled as quickly, AND SAFELY, as possible to nearest edge, took a few photos, and we ran back to the car with rain dripping down our necks. Having spent only an hour, I know that this national park warrants much more and I vow to myself that I will return with my boyfriend for the scenic drive around the rim and an overnight hike. After this short but inspirational visit, we reluctantly headed home because we found out too late that the Hoover Dam closes at 5pm and the hike to the nearby hot spring is 3 hours roundtrip…

Day 4 was only a half-day in town. We treated ourselves to a $50 buffet at Caesars which, unfortunately, I enjoyed but don’t find worth the money. We squeezed as much as we could out of the last few hours in Vegas by partaking in some much needed tanning and relaxation at the pool of The Mirage and mentally prepared for another 4 hour drive. This time to Los Angeles.

Final Goodbye: Los Angeles

As the last vacation spot before my final destination, I indulged in the Smokin’ dish for dinner and the Content dish for breakfast at Café Gratitude— one of my all-time favorite vegan restaurants, I snapped photos of the Hollywood Sign and visited the Hollywood Walk of Fame, and I experienced hot yoga at Modo Yoga in Venice, CA. The sky was cloudy and the weather cool, not at all what I was expecting, so my dreams of soaking in the sun on an LA beach will have to come true during another visit.

Other highlights of this goodbye  included partaking in a cup of coffee at the large and workspace oriented café, Intelligentsia, and dinner at Plant Food & Wine, an upscale restaurant deserving of it’s pricy menu. I ordered the kelp noodles, avocado tikka, and tiramisu and nearly landed myself in a food coma it was so delicious. Abbott Kinney Blvd is a main hub for all things shopping and dining. A bustling street full of energy and opportunity while also maintaining a suburban feel. From there I enjoyed a 12min walk West to Venice Beach. Due to the clouds and breeze, parts of the boardwalk were virtually empty, several shops were closed, and I felt as though I had a treasure all to myself. I snapped a few more photos and took a moment to collect my thoughts and call my mother– the first time since leaving Rochester. She “walked” me around and kept me company while I was alone. A common activity that my parents have engaged in several times during my past adventures. Though 30 years old this year, I still look forward to my parents. What a blessing. The only downside to my visit to Venice Beach was my exposure to the number of homeless that live or hang out there. It made me so sad and brought back quick bursts of memories of the many homeless men and women I had cared for in the emergency department– often quite ineffective care given what these individuals really need.

This experience was in stark contrast to the one I had at Santa Monica Pier. Though the weather was more or less the same the following day, this visit to the beach was met with many more people enjoying the ferris wheel, playing arcade games, and sitting in the sand. People were dancing for tips and selling hand-made art. And I has happy to find the same energy a few blocks away at the pedestrian-only shopping area. Greeted by a statue of a rhino spewing out water into a pond, I fed off of the atmosphere around me until it was time to finally say goodbye to my Las Vegas companion and head back to Venice.

A final goodbye proved pivotal when it revealed itself as actually several hellos. The former NYC friend who is now my LA friend invited me to her early birthday party: bowling. I don’t really enjoy bowling (though I do have to admit that I’m not half bad when I get into the swing of it), but I wouldn’t miss it for the world. Initially overwhelming, I quickly warmed up to several of my friend’s friends and co-workers and it soon dawned on my why it was so important that this spontaneous event had transpired. I had seen my LA friend several times since my arrival, so it wasn’t necessarily so important that I could partake in this particular activity with her. Instead, my friend’s gift to me was the gift of meeting strangers. Going to her party and meeting new people helped me recognize in real time how the world will keep going despite me moving to Alaska. How there will always be opportunities to meet old friends and make new ones, If only I am willing to take them. How the time to make new friends is always now, and not just when I arrive at a new destination.

My goodbyes have been so meaningful, so fruitful. I am so humbled. I am so grateful. I am so scared. As my Uber inches toward LAX, the L.A. lights blinding me and the L.A. traffic smothering me, I have to accept that, from here on out, it will be mostly HELLOs.