| That look in your eyes |
[13 May 2012|09:56pm] |
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Originally published at Perches in the Soul. You can comment here or there. At the end of my palliative care rotation, I helped the professor clean up after our project presentations. He looked at me, I looked at him. He makes an awkward allusion to my disability and the story I had just shared about my friend Laura. I tell him I have a genetic form of degenerative joint disease. He pauses, his eyes are kind and for a moment we share something that is rare outside of my tribe. “You really understand, you get all of this.” he gestures beyond the pile of projects, reflections ranging from photographs to scripture to paintings representing our palliative care experience ranging from the sacred to the mundane.
“….Yes.” I took my project from the pile and walked to my car in the fading November sunshine. Shivering.
At the time I was 24 year old and slowly and painfully coming to grips with my failing joints and tasting the bitter, raw fear and trepidation of my own fragility and mortality. I met a lady with RA who was in her 70s, going blind and had no hand function earlier that year and she had shattered any illusions I had of somehow being through the “worst of it” with all my childhood surgeries. Then there was my 28 yo Romanian friend who died and a year later there would be the 18 yo with muscular dystrophy who was my first pediatric death on my watch.
I savor life differently. I savor work differently. I savor normalcy like cooking good food, wearing clean clothes, brushing my hair, going to church, buying my own groceries, paying bills, good conversations. I savor and fight for weekends with my family, taking that road trip my sister and I have talked about for years even though its expensive, moving to Africa for a season I savor them and don’t waste time because I know that my destiny according to society was to live in my parents’ basement and because as anyone with a progressive disease knows, I never know how long anything is going to last. My new hips could last 30 years or they could last 6 more months.
Its a crap shoot. Its a gamble. Its anyone’s best guess.
So yes, I get it.
But don’t fool yourself, it doesn’t always make me a better doctor.
20 something yo with a neuromuscular disease that most people die from in their late teens who isn’t eating anymore, in constant pain and at one point last night said ” I want a ventilator, I’m going to die tonight.” I couldn’t control his anxiety, I couldn’t seem to calm his breathing and I couldn’t seem to tell him the truth which is he is dying. He knows, I know, his family knows it (although adamantly deny it), God knows it. Everyone knows it. But we are not talking about it.
I get that too. Because I don’t talk about it either. I don’t talk about what life will be for me when I am in my 50-60s and the hips fail or my hand arthritis is so bad i can’t palpate babies’ bellies anymore much cook, clean, drive, etc. I don;t talk about how I sometimes worry about burdening my sisters or if i was to get married with this. And i don’t talk about how much sometimes it sucks and how scary it is to watch your body fail you and become steadily more deformed with your body attempts to grow bone or muscle to support what it can’t repair which is the crappy cartilage all the while when all your friends are having babies and wearing skimpy wedding dresses that show off their beautifully unmarred bodies. How I am happy for them but somehow all the more painfully aware that I will never be like them and my participation in their world is fragile.
I don’t REALLY get it, I don’t claim to know his experience, I ‘ve only had a taste of the feast he has been forced to ingest. But the taste is enough to know that the other thing is while all of us medical people wonder how WE GOT HERE medically, why no one managed to talk this family into a plan, to know this young adult’s wishes….the tribe part of me that can look into his eyes and for just a moment stand in the abyss with him knows that we are here because not talking is what’s been expected of us, for the sake of normalcy, for the sake of sanity. Talking about losing function or dying young is just not what we want to talk about around the dinner table or even the examination table. Its not the RIGHT thing to do but its what makes everyone else comfortable.
I wanted so badly to make it better for my patient, I called palliative care, I lingered at the bedside. I prayed. I whispered to Laura to please care for him when he goes.
Because this is where the pollyanna, cute little kid in a wheelchair, chronic illness, Jerry’s Kids, Life time Origninal movie, inspirational memoir, NICU baby, special olympics thing ends.
This is the hard stuff. The ugly stuff, the things that keep us up at night, the things that challenge our sense of right and wrong. But for those of us who live with a taste or with feast of it, its the stuff we so desperately want to not bear alone. Don’t ignore us, don’t pretend it doesn’t happen.
So walk with us….look at us…take a moment and get it. Just a moment.
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| Lies |
[13 May 2012|09:13pm] |
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Originally published at Perches in the Soul. You can comment here or there. In my last post I said I hated the ICU.
I lied.
I actually love it. The medicine is acute, fascinating and finally teaching me all the physiology that never quite added up for me in my textbooks.
Second Lie:
I do care about what happens job wise in 13 months. And as I brave as I sound. I have only begun to come to terms with how hard it will be to leave a place like where i work. I would leave the best all around children hospital in the world, anywhere is going to be a change. Moving to Africa will be bit like academic suicide or at least feel like it. Above all its kind of scary even though its a dream.
there I told the truth
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| Post Residency Bucket List |
[01 May 2012|06:44pm] |
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Originally published at Perches in the Soul. You can comment here or there. Well the ICU is mostly what I expected. I think my biggest problem in medicine is I am just over doing things I do not find super educational (there is learning to be had in the ICU but its hard to do when your role is to do paperwork and field pages for flush orders) and that resemble slave labor (I barely touched actual children…I wrote orders all night long…you could train a computer to do my job)…. Ready to be a human being again.
While becoming a doctor has been the fulfillment of a dream. Its not the only dream I have. And in 13 months for better or for worse. I will be done with my required education related to that dream. Thank GOD.
What I want to do in terms of earning money to eat and maintain health insurance in 14 months is unclear exactly. And honestly I have gotten to the point I just don’t care (I mean do obviously I have sent out countless global health applications and tried relentlessly to create my own academic peds/global health fellowship but in the end as long as I get to take care of kids for some percentage of my day to day life, I don’t care the details much anymore).
What I really want to talk about is everything else I am going to do….
I have the following list thus far:
~Sleeping on a regular basis like every night… or at least at some point during the 24 hour period. Beyond being overseas (which is different), I am going to do my utmost to never work in house 24 hour+ call again.
~Finding a church/community that will not stone me for being a pacifist, a children’s/minority/disability rights activist, for thinking women have a role in church beyond raising babies BUT still believe in Jesus….
~On a related note, becoming a part of/forming/etc a Christian woman’s ministry where talk about something other than getting married and raising babies (both of which I would like to do but that I think are not actually my reason for existence (which is of course, glorifying God)).
~I would like to live in intentional community FOR REAL. Not just sort of halfheartedly
~Going back to Romania, find Aurel, Christine and Rapheal. And even if it requires 12 hours on a train, go see Laura’s Grave. Pray there and thank her for the vision she gave me in our short time together. Tell her I became a physician and that I carry her with me every time I speak for our people.
~Going back to East Africa and I would like to take my family with me.
~Live Abroad for at least 6 months but up to forever subject to God, my cartilage and all these other things.
~Writing THE BOOK that I have been talking about for 10 years even if it means I have to tell the truth about how bad medical school was at times
~Spending at least an entire week in the Outer Banks at my Grandfather’s where I eat fresh sea food every night, go sailing with my Granddaddy, losing myself in the Elizabethen Gardens and then waking up and doing it all over again.
~Spending a week with my Paternal Grandparents either on a road trip (they love to drive across country) or at their home. Learn to cook from my Grandmama (again!) and talk theology and writing with my Grandpapa.
~Spend some time with parents. Going on a Father/Daughter trip with my Dad that has NOTHING to do with trying to become a disabled doctor/pioneer/take some nasty exam. Hang out with my Mom, listen to her and not spending the entirely of time together with me venting about how much my blank rotation the previous month was the worst thing that ever happened…./her caring for me after some life altering, horribly stressful (for all involved you imagine watching your first born go under anesthesia 25 times+ ) and painful medical procedure.
~Go back to AAMC with protest signs/hunger strike if necessary and say they need to get over their able-ish and put a disabled physician on the committee for disability (GOD FORBID we actually have representation) and be a some what gracious but fierce activist with impeccable credentials (you can’t argue that I am just a med student any more, I will be a board certified pediatrician from of the top programs in the world). (this may or may not be related to the BOOK project)
~GO on a trip with just Emily and Victoria. Even if its just to a Holiday Inn in Vinton (which is like 10 minutes from our parents’ home)
~Go on a medical mission trip with Jessica
~Go visit my friends in Oregon
~See the Grand Canyon (actually going next month a year early)
~Really learn how to cook rather than occasionally dabbling
~Go on a silent prayer retreat
~Write some travel writing type essasys
~Go to Ireland
~Get the Sacred Tuesday Group back together for a crazy retreat/reunion/celebration somewhere (ANYWHERE)
~Help write some transition related stuff for kids with skeletal dysplasia (ok so nearly work related…but I have come to the stunning conclusion I might be the only human being currently alive who actually can/wants to do this)
~Read SMART books that are not about medicine
~Relearn all the theology/religion major stuff that I have suppressed in order to make room for the Krebs Cycle and organic chemistry (worthless)
~Need some sort of theater in my life again beyond the annual Long Family insanity known as MY MOM’S CHILDREN THEATER PLAY WEEKEND
~Figure out my opinion about about the laundry issues of social/theological issues that have come up in the last 7 years that I have not had time to research or pray about fully.
~Successfully plan and care for a garden without having either things die due to neglect or never getting it in all the way due to time constraints
~Go to the San Diego Zoo
~Read all the books on my list (really long)
~Learn to play an instrument (even if Emily says there is no hope for my deaf little ears)
~Buy a hammock, lay in it.
~Go through the phone book of where-ever I am living particularly if its a large city and eat all the different ethnic food restaurants from Albanian to Zambian.
~Make a recipe book of all my favorite Romanian/Russian/British/Scottish/Chinese/Kenyan/etc dishes that I have accumulated over the years from all my travels
~Take a photography class or at least dabble more officially
Longer term goals:
~Get married
~If that doesn’t work out, adopt anyway
~Scrapbook/Journal/DO better keeping up documenting
that’s it for now but this list will be growing over the next 13 months. Stay tuned.
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| True Story…Best weekend…. |
[22 Apr 2012|09:02pm] |
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Originally published at Perches in the Soul. You can comment here or there. 1. I only live 5.5 hours from Asheville….I swear life will never be the same.
2. Mountains calm and center me.
3. As much drama on and off the stage….Parables was one of the greatest things that ever happened to me. The people are my second family (along with Sacred Tuesday crowd). I can walk into a room with two parables one of whom I have barely seen in the last four years…and pick up right where we left off. Within 5 mins we can discuss death, books, chest tubes, Jesus and Africa. Its like coming home after a long trip.
(side note…10 mins in someone says…so do you want a team to go to Africa…because I think we should go….!!!!!!!!!!!!!!!! (squeal)….much prayer and contemplation)
4. I fail at relationships of the romantic variety. If I have one more guy-girl relationship that turns into an awkward guy-girl friendship I will need therapy because i will no longer be able to hold myself in from doing something I will regret (like hitting people). OH MY HECK. I am going to die an old maid (but with the greatest friends).
5. There are functional churches that love people, Jesus, are made up of multiple races, political ideals and generations….they just don’t exist in this CITY. But there is hope that at some point in my life I might live somewhere that has such a place.
6. Used book stores are AMAZING. (WHERE ARE THE USED BOOK STORES IN THE MIDWEST?!?!?!!?!?!?)
7. I need to talk about non medical things more often.
8. Board Games….why did I give you up? (MED SCHOOL…booo!)
9. Theology…..why did I stop studying you? (MED SCHOOL!! booo!)
10. Can we do this again next weekend??? if only.
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| Stolen Idenity |
[22 Apr 2012|08:50pm] |
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Originally published at Perches in the Soul. You can comment here or there. When I was in medical school, every day was HELLO…(awkward stare)….yes I am the token med student in a wheelchair. Can we get past this? Because every where I went (even peds) we talked about this continuously.
Then I came here i was doctor and no one really ever asked any questions.
and for a while it was amazing. Very liberating. To make matters even more amazing, I had a new hip and was walking more and more and more till I worked my way to a second hip.
Then somewhere in the mist of a new hip…3 straight months of ICU/step down units in the middle of a midwest winter….I awoke from my liberation to realize.
oh crap.
while I do not want to be a primary care doc or a developmentalist or a geneticist….I am gonna be bummed if disabled children are not part of my career personally and professionally.
It took me another month and two weeks of developmental peds and a few very persistent children for me to say that aloud but here we are.
This is going to greatly complicate life.
oh well. here we go. I need a pediatrics job that lets me A. be a hospitalist, B. Teach, C. Go abroad and D. work with kids with disabilities.
here’s to the impossible…
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| the man on the stairs |
[06 Apr 2012|09:37am] |
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Originally published at Perches in the Soul. You can comment here or there. I was driving to work the other morning. Along the way, I pass a Gothic style Catholic cathedral. When I first moved here the churches fascinated me, gone were the simple clean lines of the little NC Baptist and Methodist churches on every other corner that all look the same. In each little neighborhood of my city there is a prominent church, most of them are Catholic although there are some lovely Protestant ones as well. Each has its own style, culture and heritage. They are nearly gaudy with their buttresses, carvings and stain glassed windows. Reminiscent of a time in our history where each neighborhood would have have been a village, often of immigrants transplanted from the old world to the new. They built their new village as a piece of old world culture and design in the wilds of a new territory. Perhaps the church would have been the center of comings and goings, many had schools attached to them Now several of the churches have FOR SALE signs on them, although some are still active they are hardly full and most of time when I drive past them they are silent as statues. The steeples blend into the strange hybrid of Old city, when she was what Longfellow called the Queen of the West, a cultural and commercial center at the turn of the century and NEW city with modern high rises, Billboard ADs and homeless people. I admit half the time I don’t even notice the churches anymore.
In the tendrils of early morning sunshine, a few neighborhoods down the road toward work, in front of the large cathedral, there kneeling on the stone steps was an elderly African American man praying. He was dressed all in blue, it looked like a uniform, perhaps even the navy uniforms of the hospital janitors. I stopped at the stop light and couldn’t help watching. I wondered what brought him so early to the steps of this massive church, I wondered why he did not go inside? Was it closed? Did he not feel well dressed? Did he feel he would not be welcomed inside? Was there not a service till later and he had to go to work just like I did? Was it because it was holy week? Suddenly, he crossed himself repeatably, great emotion filled his face. Was it because he had some great supplication for God? Was someone ill, dying or in peril? Had he done something he was ashamed of, was he begging for forgiveness? Was this his confession? Or maybe they were tears of joy? Was he overwhelmed by the presence of God?
I felt embarrassed like I was spying on someone private conversation like when you walk into an exam room and your colleague has just told Ms. Jones their child has leukemia and you just needed an otoscope tip. I wondered about my fellow drivers around me, commuting downtown to work, what did they see? What did they think? Did they notice this Man crying his heart out on the stairs?
What about the people inside? Where were the priests? Where were the nuns who taught at the school next store? Were the children inside looking out their windows at the man on the stairs? Were they wiser than me, knowing not to intrude on this man’s pleading?
In Eastern Europe, the gates and stairs of the Orthodox Churches were filled with beggars, elderly people and disabled people who begged for money of the priest and the church goes. I remember in one of my bitter moments of frustration with the culture, the lack of care of the forgotten children who would be baptized but never cared for by the churches, I felt far more comfortable on the stairs then inside. I arrogantly thought Jesus would too. I thought to myself now years later, that I was right Jesus was with the beggars, the prostitutes on the stairs and the unwanted more than the religious authorities. I knew even that Jesus and later the apostles had interacted with the beggars at the Temple’s gates. What I lacked at 19 yo was the insight into the people that lived on the steps of my church. The fact there was many in America who because of their heritage, the color of their skin, their language, their sexual orientation, their bank account, their addiction, etc, etc were not welcome either because of stigma, hypocrisy or fear in our sacred spaces. God welcomed them but we do not.
Even more, I lacked the understanding that we all belong on the stairs of heaven, none of us measure up not due to our social classification but because of our selfishness.. All of us should be sobbing amongst our transgressions and the ugliness of our hearts on the stairs. Holy week is a celebration of grace. Jesus welcomes us through his loving self-sacrifice inside the gates. Jesus came down the stairs to invite us but he also still sits there. He is there on the stairs and when we invite the others on the stairs to share in his grace and compassion, we invite him to be among us.
I prayed a short prayer at the red light for the man on the stairs. A prayer of gratitude for his example, for his courage and for grace, for our shared celebration of Holy Week that I knew I would remember far more than the third refrain of the UP FROM THE GRAVE HE AROSE on Easter Sunday. I prayed that Christ would sit with him on the stairs and meet him in the heart of whatever his circumstance. And that he would sit on the stairs with me, as I confessed my unworthiness, my failings and my need for him.
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| The Brown Sandals that I immediately regretted |
[26 Mar 2012|05:55pm] |
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Originally published at Perches in the Soul. You can comment here or there. My feet are funny shaped. At some point in college I participated in my first foot washing in which I found myself keenly aware that my feet were not so beautiful rather then brought the good news or not. I knew that wasn’t the point but the human inside of me couldn’t quite get past it.
I can remember the thrill of NEW shoes for school each year. I would go with my Mom on a special shopping trip before school started. We would go to Stride Rite , The Navy Exchange or JC Penny’s and we would find sneakers and then a pair School/church shoes. My all time favorite was a pair of black Mary Janes that had faint embroidery on the toe of tic-tac-toe in light green and red. I got them just in time to start 2nd Grade. This was also the phase where I refused to wear pants, only dresses. I would accept leggings if it was cold out of necessity. So there I was in my early 90s bright colored dress and leggings and black Mary Janes. In hindsight, sort of dorky but at the time those little shoes made me feel so grown up.
Somewhere around the age of 9 or 10 when my growth plates were bending in unfortunate directions and I was coming to grips with the reality of chronic pain. Shoes started being a source of great angst. This was also the time when shoes were changing and no longer was it cool enough to wear my black Mary Janes or My Little Pony Sneakers. No longer could I wear what my classmates wore. All the girls were wearing jelly shoes or canvas shoes with no support. We would go to shoe store after shoe store, nothing would fit except for Velcro sort of sneakers that the kindergarteners were wearing and not the middle schoolers.
I went through a combat boot phase in sixth grade. They were a statement and in middle school that seems to be the goal of foot wear. But they also offered my poor ankles some support. This again in hindsight was a fashion low point of my life in which I wore Christian T-shirts (that said things like Got Jesus?) and baggy jeans and combat boots. One of the security guards who drove me around in the golf cart to band and lunch (which were a bit of a hike) commented that my choice foot wear was probably not the best thing for my feet. I was horrified being a Type-A people please-er of adults in my world. Thus ended the combat boot stage. Looking back, he probably did me a favor.
In high school, they started introducing the concept of FORMAL WEAR. I knew I was in deep trouble the first time I went shopping for shoes for my first prom. Strapy, stringy, heeled plastic things that cost 70 dollars and were a tibia fracture waiting to happen. My sweet mother dyed ballet slippers for me. They had no support but they matched my dress. I survived without any ER visits. Then there was the uncovered shoulder ISSUE (previously described) in which I showed my keloided scars to the world. I was not a fan. As if I needed to be more of a freak show.
I then went through an extended phase where I just decided I hated dressing up. Sad thinking that in elementary school, I wanted to dress up and be girly EVERY DAY. I decided I was going to be a hippee who wore peasant boluses, carpi pants or longish skirts and grow my hair (already longer than most girls) longer. This sustained me through the beginnings of college where I at least in part to thanks my mother and sister switched the hippee skirts for cuter knee length numbers for the Carolina sunshine.
I vividly remember kicking and screaming my junior year of college when all my friends and I decided to go to the Non-Greek formal. My roommates had to nearly hold me down to put my hair up and do my make up. WE have pictures and evidence of this. I wore mary janes that I also wore to interview for medical school in. As for interviews, I was so grateful for the stylish gray paint suit for interviews. my grandmother and I found in an expensive store in the big Mall in Norfolk that covered most of my shoes and all of my shoulders.
Then came weddings. It was prom on steroids except now the pictures will actually matter beyond the age of 18, someone will be looking at them for the next 50 years. And those people are my closest friends. The first wedding I was in had brown dresses which while I did not love, I loved that I could wear small brown flats without concern. Then I was in two weddings where I was thankfully allowed to wear black and red and thus black flats.
In medical school everyone got cute Danskos and such for the wards. None of which I could get my feet in. I became mildly obessessed with KEEN shoes. Black and Brown Mary Janes that I wore to pieces in Kenyan Mud. I wore black chaco sandals to my doctorate hooding partly by accident (left my black flats in the car) and partly out of sheer spite of professional shoe wear.
Then came this year. Summer wedding. Yellow dress. My big toe on the left has this gout like bunion on the metatarsal joint that makes even ballet flats uncomfortable. Again the strappy, string, heeled things are going to be a disaster. My friend tells me you can wear anything but CHACOS. I go to the comfortable shoe store here and to my horror the only thing they have is a pair of brown Chaco flip flops. I was post call, on my way home for the weekend which included a dress fitting. I was out of time. So I bought them. They didn’t look like CHACOs. They look liked brown flip flops. 20 minutes later I was already regretting spending so much money on ugly flip flops. My Southern Bell (on occasion) mother gritted her teeth when she saw them. She would later tell me that she had already decided that there was NO WAY I was walking down the aisle in those horrible shoes. I reminded her that at least they were not combat boots. I got fitted for the dress in the shoes. And then promptly returned them when I got back to OHIO.
I decided at this point I was going to go bare foot. Meanwhile, my PT here when I got my initial post op eval was MORTIFIED that I made it through life so long without orthotics. I told her I had PTSD from such things as a child. She chided me, throwing the whole MD thing at me. I relented and found she was right my feet felt better. On the up side, I recently discovered that I could wear wedges when I was given a pair of Allergia shoes for work. I loved them so much I bought a second pair in another color. For the first time in my life, people complemented me on my foot wear! I felt strangely like I had in second grade over those dorky tic-tac toe mary janes! So proud and grown up. Oddly, one would think I would get past this, not so much.
With this in mind, I prepared myself mentally for another go shopping again to look at spring wedding shoes. There had to be something out there, if I could find professional shoes that were NOT so bad, maybe there was hope. One pretty spring afternoon walk resulted in the purchase of a somewhat NOT awful pair of sparkly sandals with a slight wedge. My mother approved via cell phone pictures!!! Even my bunion approved with the adjustable straps. I breathed a sign of relief that the pain of shoe buying was over for another year. Already plotting that I could wear the SAME shoes for the Indian wedding I am scheduled to be in next Spring. Maybe I can make it two years if I didn’t wear them in Africa.
As I walked out the of shoe store, I looked down at my feet in CHACOs no less. And I smiled, you know they are funny shaped and they cant wear shoes to save their little soles. But they have grown on me. We’ve been through a lot together. They have gotten me where I have wanted to go, where I have needed to go without cartilage and against the laws of bio-mechanics. Yes they are calloused, crooked and lumpy but they also tell my story with their stronger contours. They tell a story of faithfulness even in the mist of suffering. And maybe that is the point. Maybe I have beautiful feet that tell a beautiful story after all.
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| Changes |
[05 Mar 2012|06:03am] |
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Originally published at Perches in the Soul. You can comment here or there. I usually am quite adaptable being a Navy Brat and a Gimp.
But on my third month’s of sleep deprivation in a ROW, I am anxious and a wee bit strung out. Easily in a state of anxiety. Somewhere in the mist of all that I finally got the courage to try out different churches.
My second try, I met a Kenyan and a Ukrainian, we talked East African tribes, Swahili , sekuma (food item) and the Belarussian dictators, freedom of speech and about my Romanian babies. It was like coming home by remembering leaving home. The Americans I met were nice too. The church is less than a mile from my current one.
The Kenyan and I are getting together and making Kenyan food next Saturday so why do I feel anxious and why oh why do I feel sad about leaving a place that really not supported me well and/or theologically fed me entirely. Is it just because its March and Im exhausted? Is the Sam’s Purse situation? Is it the people I am leaving behind, one family in particular who is one of my best friends from the residency program?
or is it that I should just be the voice of change for the next 14 months and just stay where I am because no place is perfect? And either way I have new Kenyan friends….
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| Body Language |
[23 Feb 2012|06:12am] |
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Originally published at Perches in the Soul. You can comment here or there. I would love to tell you that I always love my body.
That I appreciate my scars for the story they tell.
That I value the oddly shaped contours of my poor long bones.
That I love the strange angles that my contracted ankles and elbows grace me with.
But I would be lying.
But then again I have been lying a lot today.
All three of my best friends are getting married in the next 18 months. Today I went to get fitted for my first of several bridesmaid dresses at the infamous David’s Bridal which has never been my favorite. The dress is sleek, asymmetrical, one shoulder empire waist canary colored gown. My shoulders have some impressive scars. My elbows are awkwardly angled. All around me are girls with shoulders with no scars, with normal contours. And for a moment I feel naked, exposed and ancient.
I rip the dress off, buy it (ugh!) and run home. My best friend who knew I was going dress shopping calls me all excited. I try so hard to keep up the level of excitement because its her wedding. And I want her to be happy. She nearly drags it out of me, I dance around the issue a bit, mumbilng a bit. She tells me I can return the dress, I can wear a shawl. She is upset. I tell her its fine. SO FINE. DOn’t worry about it, its not her, its not the dress its just me.
My disability mentor Bliss tells me that I should embrace my body and I wholeheartedly agree.
Its the practice that sometimes hard, especially when you are in your 20s and have to wear frequent formal wear not designed for anyone but especially not for bodies that are different than average.
One of my friends here who has Marfan’s and some other skeletal issues has had some “work” done on several scars. I wish I had her courage, however, the whole starving children in Africa and my intense PTSD/extreme dislike for being a surgical patient rule this out. She tells me either way that my feelings are normal. I want them to be normal but I also dislike the idea of hating the body I have.
Because in my head I agree with Bliss, bodies are beautiful in all shapes, sizes and with many marks and contours that tell our stories. So I pray God gives me grace to love my body and help others love theirs.
i’m getting married in chacos and capri pants.
OK so maybe not capri pants but chacos and a dress that drapes my shoulders a bit and doesn’t make me feel like a member of an alien race.
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| The Dream Revisited |
[23 Feb 2012|06:00am] |
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Originally published at Perches in the Soul. You can comment here or there. Publishing old saved drafts….
from July…although hauntingly still true.
Long ago and far away I spent my summers wandering the streets of Bucharest playing with street kids, finding babies in back rooms of crumbling, stifling Soviet bloc hospitals. These summers defined me and it was here the dream was born to be a really excellent activist and pediatrician who could save babies from disease and from the poverty and stigma that they live under. Then somewhere along the way I got caught up in a dream to study at a world class childrens hospital and caught up in all the academic rigmarole and danced the dance and sang the songs and won my way into a place that is so far removed from the that dream that sometimes I still wake up and have to remind myself that I am not living in an alternate universe.
I am bruntout on the alternate universe. I am tired of staying up all night. I am tired of parents telling me they want me touch their children with my inexperienced, tired hands. I am tired of getting e-mails in my box that I only reviewed 9 systems in my review of system rather than 10 and the ED attending can’t get paid if I only have 9 in my note. I am tired fighting to put checks in an imaginary series of check boxes to fit some sort of magical mold that an elite pediatric resident is supposed to fit. And I keep waking up with a start because in my dreams I am doing what I have done every summer for the past 7 years up till this one, riding buses and fighting for forgotten children. Suddenly in stead of falling in love with academic medicine or fellowship or something will give my pre-existing condition gimpy self sustainable health insurance I am missing as if I have lost my first love. As if we are painfully separated by a dream not deferred but given up and revised.
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| The sorrow may last for the night….but J O Y comes in the morning |
[22 Feb 2012|06:09am] |
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Originally published at Perches in the Soul. You can comment here or there. Child birth.
Let me tell you its messy for the mom, for the family, for the baby, for the doctor, etc. And not just physically messy. I delivered four babies and received about 40-60ish now (the pediatrician who resuscitates the baby in the delivery room or just dries them off depending how messy it all is).
Its painful and sometimes the sorrow in that room from things not going the way we all hoped is bottomless.
Pregnancy is painful. Parenting is painful.
Believe while I don’t know personally, I live so close to it on a daily basis ,I know.
Last night I went to the woman’s bible study. Because it was Monday and my Roommate is interviewing and eating grits (for the first time) in Charleston, SC. She called me and said Amy, how did you ever leave the 60 degrees in Feb, the friendliness and the laid back, sit on your porch and watch the world go by kind of place.? I told her I have no idea what came over me. Basically I was homesick and lonely so I went to bible study even after telling myself that a bible study that looked at biblical womanhood in a church that currently loves Mark Driscoll a wee bit too much was a BAD BAD idea for me.
The passage we looked at was 1 Timothy 2, the part where we talk about not braiding our hair, not wearing gold or pearls and that we will be saved through childbearing. We spent 45 minutes talking about the pain of womanhood from menstruation to labor to motherhood. Don’t get me wrong, there are times where being a girl is not awesome but there was this sense of shame in the room. Shame about not controlling our emotions, shame about how painful pregnancy, childbirth, etc is. I finally just came out and said what was flashing in my brain not out of anger but because I just couldn’t bear to watch the other ladies sit there squirming. And because I have worked 95+ hours in the last week and there is no filter anymore, there is just words.
There is no mold of a perfect woman in Christ, its not the secular mold, its not the evangelical mold (gasp). This should be liberating not condemning. My comment actually was not poorly received, the word liberating caused some general discomfort (tragic…read Galatians…please). Now I will give this church credit while I have never been to the men’s bible study naturally I have heard the sermon excerpts geared toward guys and they are equally hard on men which is a refreshing change in some ways from the norm. So I don’t think this is one of those “Its all Eve’s fault” kind of things. Yet I still don’t think most of those ladies left convicted and liberated. Just convicted and guilty,
The elephant in the room….is when Paul says women will be saved through childbearing, I don’t think he meant the literal practice, I think he was using it as a metaphor. This is especially important because we take the rest of the passage as metaphoric (we still braid our hair and wear jewelery) , I don’t love the lets pick the metaphors out of literal sentence game…either this is a literal passage or its not. Don’t dance around it to the parts you like.
Child bearing results in children and for someone who spends a lot of time with babies….95 hours in the last 7 days. Babies are complicated and messy and yes they can even bring us pain. But for the 40-60 mothers who I passed their child to them for the first time….it was pure joy. A joy that I don’t think happens to men in the same way and I don’t think there are many better pictures of unconditional love. Being a woman means we have a special understanding of this because we have the capacity to bear children and experience this.So yes we (men too) are saved through childbearing…through unconditional love, the kind of love that lays down one’s life for one child or one friend.
kind of like Jesus.
Perfect love drives out all fear, drives out sin and pain and brokenness. That’s the gospel. God has made a curse into something beautiful.
but we didn’t talk about that. and my 95+ hour work brain couldn’t articulate as well I wanted to in the moment.
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| A Good Death |
[09 Feb 2012|06:22pm] |
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Originally published at Perches in the Soul. You can comment here or there. Nights in the NICU anywhere is to stand in the strange gap between heaven and earth. Everyone is coming and going somewhere.
In Africa, we would run our list prior to call and come across a name of a baby who was struggling or had an infection we could not beat, there were no ventilators or was just too small, too early for us to give it a fighting chance with what we had. We would say, Baby so and so is going home tonight. It doesn’t meant we won’t try, it doesn’t mean we haven’t racked our brains of what we can do with with what we have. But we know our limitations and we also know that us beating on the chest of a premature new born who needs a ventilator we don’t have is not going to help anyone.
Home is an evangelical phrase that is a reference to a verse in Paul’s letters that talks about being citizens of heaven and not of earth.
But I like it because it implies that death is not just about leaving, its also about going. Babies don’t have the need for our theology and politics but they remember where they came from.
In America, when a baby is dying in the NICU, we stand around running through every physiological rotation, we throw every drug we can think of, we call in the surgeons, who join the circle around the bedside, we try experiments, we give blood, fluids like we have unlimited resources, we switch around ventilators left and right, we talk about the baby in the circle as some academic enigma whose body is just not doing what we tell it to do. The parents hover just inside the circle. Most are stoic, looking at the baby back to our circle, trying to decipher our academic whispers. We tell them the truth, we tell them the baby is going to die.
In Africa, the mothers visit every two hours to breast feed or pump to feed through a feeding tube. They are devoted beyond belief. We don’t mess around when a baby is dying, Mom will sit by the bedside in vigil, holding the baby, loving the baby. Other than making the baby comfortable we don’t interfere. In some ways, its the worse feeling in the world as a physician and in other ways its liberating to be able to give the baby and their family that moment.
Last night, we had a baby that had had every thing we had to offer who was dying, this went on for about 7-8 hours. The mother was alone, young, she didn’t seem to understand what we were saying when we told her, her daughter was dying. She went home to sleep 20 mins afterwards. Perhaps it was the crowd of onlookers, the 25 people standing around still intervening. It didn’t look like the end, it looked like the middle of the battle. I called the chaplain and we called her back. It took no less than 45 minutes to change the tubes around enough so that Mom could hold the baby. I am watching the monitor the whole time and watching the baby heart rate drop alarmingly fast. By the time Mom got to hold the baby the baby was purple and no longer had detectable pulses, we were breathing for the baby. But the baby was gone.
Why did we wait I cried out internally? What in the name of all that is good were we doing?????? WHY is she still on the dam monitor? If we hadn’t waited till past the 11th hour, we could have found a private room for this Mom, we could have let her hold her, sing to her, cry, call her family. She never held her child alive or if she did it was for seconds to minutes. What really mattered here? We knew 8 hours ago that we were pulling for straws. What were the extraordinary measures here?
Instead, she held a dead baby for about 45 minutes in the middle of a NICU pod with the sickest patients so with people constantly in and out. Even with screens….it was hellish. And the moment heaven meets earth should haven’t to be. It doesn’t have to be like this.
I am not saying the agony of what I don’t have in Africa is better but the agony of having everything except for the one thing that really matters in America is haunting. Its haunting because we have lost a grip on life in our attempts to foil death.
Either way the baby dies, its about how they die.
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| Confessions, awkward prayers, awakened possibilities |
[02 Feb 2012|04:12pm] |
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Originally published at Perches in the Soul. You can comment here or there. Well I told someone exactly how I feel in terms of being a bad evangelical.
It was not my pastor. It was a kind man about my parents’ age who is also a bad evangelical who runs an intentional community. I am not quite where he is, in that I am pretty sure he simply sees Jesus as a moral teacher. But I so greatly appreciated his story, his life and his willingness to listen to my story.
He told me that he had built his career as a missionary and now has very little to show for it because now he has evolved into a liberal that is no longer accepted in evangelical circles. His biggest advice was to not end up that way. It will be different from me as a physician but still very good advice.
Literally 15 mins after that I sat in a strange yellow room on a sofa saying I wanted prayer for the choices I had to make. Two things were abundantly clear to me in that moment. This guy who is my pastor really doesn’t know me so well and well as a result its awkward. And then I also realized that while he and I on paper have similar theology, our application of that theology is completely different. I handed them my reference form and ran to PT.
So I stand in the middle of these two extremes. And for now that is ok. The reality is for now I am a liberal evangelical and I am ok with that.
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| Confessions |
[26 Jan 2012|06:12pm] |
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Originally published at Perches in the Soul. You can comment here or there. I don’t like Mark Driscoll.
I like Rob Bell including his new book. (not that new any more.)
Although I don’t think either of them are heretics or the end all of preachers.
I don’t really love Campus Crusade in fact it makes me cringe.
I don’t like George Bush all that much.
Although I don’t think Obama is the end all and be all.
I think women can be ministers. In fact some of the most influential ministers of my life are women.
I dont hate gay people.
I actually have very little in common with other white middle class 20 year olds who grew up in evangelical homes. Who Knew?
Growing up looking different makes you think different. Living in the lowest caste in society for periods of time (Eastern Europe) makes you realize most of us dont get a lot of choice in the cards we get dealt socioeconomically. Trying to pretend like this didn’t happen to me is like being in high school and trying to fit in. I just can’t do it anymore.
I am not sure what I was thinking when I moved here and joined my current church but I think I was high on the novelty of a new adventure and didn’t read the fine print. But now 18 months in, I realize, what the heck was I was thinking?
The timing is insane….I am in the mist of applying to mission agencies. I need references. But I can’t live the lie any more.
So Monday, I am going to try something different, something very similar to the direction the community in NC I was a part of was going. Its just dinner. Near my home with people who like Jesus. People from all walks of life, I can promise you I will be the only doctor although perhaps not the only disabled person.
And I am hoping that I can be a part of a faith community and have some integrity.
As for my references….Im not sure what to do yet. I am praying about it.
Pray for me.
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| No really, I want to leave and by leave I mean…oh snark it |
[24 Jan 2012|07:48pm] |
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Originally published at Perches in the Soul. You can comment here or there. So its here the first global health application….
and I panicked. I am also ill with some RSV like illness.
Suddenly in the last week, I have looked around realized I have it made.
I have a brilliant mentor who has actually succeeded in founding a clinic in one of the most violent neighborhoods in America that is celebrating nearly 20 years. Not to mention his work in Africa. Not to mention, he actually seems to think I am great. He is sending me to Malawi this July.
I work at the best childrens hospital in the world. No really….people come from EVERYWHERE to be here. Every day we have applicants who are interviewing dying to come here. The learning here is amazing, the teaching opportunities are amazing.
Today I went to see my uber boss, to ask about writing a program director letter for me for my fellowship applications. He hugged me and said “I brought you here….of course I will write you a letter for whatever you want.”
Yes its cold here, yes its on the wrong side of my beloved mountains, yes people here look at me funny when I say “yll” but by golly I don’t think leaving is what I want.
I want to go to Africa but I think if I could have my cake and eat it too. I want to be a fellow from here. This is where I want to represent.
…..never mind that the fellowship only exists on paper. And there is no actual money set aside.
I can dream, can’t I…
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| Evangelical FAIL |
[16 Jan 2012|09:16am] |
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Originally published at Perches in the Soul. You can comment here or there. The other day we were doing what residents do best. Fantasize about having a better schedule. Our colleague BOB seemed to have won the jackpot, he had the last two weeks of Dec off and then an extra five days including News Years for a family wedding.
JANE, another colleague says, “I think BOB got that schedule because he had JESUS on his side.”
I laugh and said, well I go to the same church and it didn’t work for me.
JANE and JOAN stare for a moment.
JANE says, “I didn’t know you were an evangelical” But she said it in such a way that it was like I didn’t know you smoked or I didn’t know you throw rocks at puppies on the weekends…..
“UM, well yeah….maybe a bit more laid back.” I flounder wanting desperately to explain I didn’t love BUSH, Im a pacifist, I haven’t bombed any abortion clinics, I watch trashy TV sometimes, I read Harry Potter and yes in my less thoughtful moments I use off color words I learned from my naval heritage.
JANE smiles, “Yeah, well I love Bob, I was just joking around.”
Then one of us got paged.
….two weeks latter….
Two weeks later I am out with GABI who I have been friends with for a while but whom I find myself having a series of deep and more personal conversations with. GABI tells me she is something akin to gnostic. She impressed I know what that means and we start talking world religions. I am holding my own. Then she comes right out and says it:
“So you love Jesus? You’re a Christian?”
I explain that in all my studies what impressed me the most was the incarnation that God would come down and live as we do to provide a vehicle to get us out of a spiritual life the equivalent of a TO DO LIST which we could never complete and that its all about the relationship with GOD that we can have through knowing and believing in Christ.
This question was easy.
It was the series of next questions that I found myself sweating a bit.
“So how do you feel about missionaries?” (which is a big question if you look at historically and currently) (or as I like to say do you mean in the JOSEPH CONRAD’s HEART OF DARKNESS sense?)
I start with HEART OF DARKNESS and colonialism and move on down to my own experiences. I end with saying what I believe in the context of a relationship is quite different than the HEART OF DARKNESS sense. She nods and talks about how Church NGOs do a lot of good.
“So do you think, Christianity is the only path to heaven? DO you believe in a literal hell?”
(these are loaded questions: If the answer is YES and YES you are condemning 5 billion humans on earth today to hell).
I believe in Christ (note that I separate Christ and the gospel from Christianity which is a human construct) is the truth and the path. However, I don’t really know how it all works out. Only God truly knows people’s hearts and knowledge. As for Hell, Milton and Dante seem to know a lot more about it than I do because other than a parable or two in the Gospels and some heavily loaded metaphor in Revelation, Hell is not described in detail in scripture. I know it will be separate from GOD which sounds terrible but in the spiritual sense not so much the physical sense.
At this point, GABI who is also a physician interrupts me and says “When I think of Hell, I think of homeless schizophrenics at war with their selves and living cast off from any sense of human contact.”
I nod, who knows, maybe HELL is like that. I continue…
As for who goes to whatever it is, well again GOD only knows. The party line Billy Graham crusade answer is that its a punch ticket kind of thing, you go through the right prayer, life style change or whatnot and you get the right ticket punch. Over the millennium Christians have made up all kinds of ideas of loopholes. Babies for example apparently are innocent so if they die, its OK they get to go without a ticket, developmentally disabled people too (a babe in Arms kind of ticket). These babe in arms kind of tickets are made up, they are not in scripture, we don’t know what happens. Now, do I honestly believe that God sends babies to Hell? My understanding of God is somewhat different than that, so NO I don’t believe that. But I don’t how it works. So do I believe that folks in some dark jungle who never heard about Dante or JESUS go to hell? My church peers would say that’s on us to some degree for not going as missionaries. Do I think God will send them to hell? Again I do not know. I don’t know what that looks like. I also don’t know exactly what will happen to all the people pre-Jesus. I don’t know. SO do I believe people, go to hell, YES but I don’t know who or where or what exactly it is.
As for Heaven, some believe the Kingdom of God will come to earth over time as we build it, some believe we will go to it. I think the former is ambitious and maybe a bit impossible but I think the Gospels are pretty clear about trying anyway. While I am interested in hell, I am far more interested in what we do now to mirror heaven and spread its seeds in the mud and mire of the hellish elements of now.
I explain as well that while I believe in things absolutely, I live with mystery in my faith, of unanswered questions and gratitude to a GOD who is big enough to be mysterious to my human mind. I live with unanswered questions, with faith and I am OK with that.
My friend seems impressed. We drank our tea and then we go home. I think she expected me to start reading Romans out loud and pray the sinner’s prayer and give her a tract. Because I am evangelical, right?
As I go home that night, I think what would my friends from church say if they listened to this conversation? What would BOB say? What would they say if they heard me admit that I don’t have all the answers? Would they have done the same? Some would have, but I think most would have stayed within safety of the party line where we have the answers. I think they would think that I lost my religion.
Am I failed evangelical? Have I gone native in all my intellectual quests of reading the Koran, the Mormons, the Buddhists, the Baptists, the Skeptics and the Gnostics, dissecting the layers of culture, history, human creativity from the raw text, from what we call religion? Do I believe in nothing because I “tolerate” and analyze everything?
NO.
I do believe in something, actually its quite akin to what I believed when I told my parents I wanted to be baptized when I was five before I knew about all of the other stuff we tacked on to the truth. I believe in the love of a GOD who would love me even though I hit my sisters Emily and Tori every day and some times wish I could go back to being three when I was an only child. A GOD who created the trees, the deer behind our house that left footprints in the snow, my cat, the moon, the stars Daddy taught me the names of, a GOD who created an elaborate plan to love me me despite the my wrongs. The plan included sending someone he loved like I loved my parents and my paternal grandparents (and mostly Emily and Tori), a piece of himself who suffered through annoying little siblings and stuff and in the end died pretty awfully and somehow in something that seemed at the time a lot like magic came back alive to get the rest of us before he went ON so we could all still be friends with God.
GABI says her husband and I have little girl and boy souls, we still believe the same as we did when we were children.
I would say that’s actually quite biblical and I am OK with that.
What has changed somewhere between church camp and now is that the religious brainwashing has melted gradually over the Serengeti grasses, my ferocious appetite for books and reading, the wails of orphaned, neglected Romanian babies, long nights of organic chemistry followed by ethics and human rights essays in college and blood dripping off my gloves, sweat and tears running down my face as I beat on a child’s chest trying to save their life, I lost my religion.
And found JESUS.
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| Peace and Pediatrics |
[07 Jan 2012|06:32pm] |
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Originally published at Perches in the Soul. You can comment here or there. My intern on nights with me this past week was a south spoken Syrian. He spent two years working to get a visa to come and study pediatrics here. He wants to be a pediatric cardiologist. He will be one of the only in the entire nation and even surrounding nations when he goes home.
He left Syria in the mist of a near civil war where every day there are reports of people dying. The Arab Spring of 2011 has not ended well in his homeland.
But for now, he is here with me taking care of ward of children who have succumbed to the various demons of winter.
Late one night, we admitted a Somali toddlerl for observation after drinking some cleaner. When the ED called to tell us about her, both of us got excited. Me because I took care of Somali refugees in Kenya and him because many Somali folks speak Arabic.
After we had her settled in, we found ourselves walking for midnight shack in the cafeteria. We talk about the famine in Somalia that no one is talking about, the children who are dying. How our pediatrician hearts break for the children who are caught in the crossfire of country at war with self and a divided world who cant seem to understand each other. The West has turned their back on Somalia because they harbor terrorists. But the terrorists who have friends in high places elsewhere are not dying, its the women and children.
Our conversation turns to the ground that divides us. How hard it was for him to get a visa because he is from the other half. How many of my countrymen suspect something of this quiet soft spoken pediatrician because of his passport and his religion. They haven’t heard his heart for children who are dying of repairable heart defects or watched him play trains with a terrified 3 yo to soothe him. And how his countrymen suspect something of me as an American, as a Christian, as a Navy brat, as a global health doctor surely, surely she is an imperialist. Surely she wants the whole world to be like America. Surely she must be like that man in FL who burned the Koran (which apparently is a popular viral you tube like video in the Middle East). They don’t know that I took an Islam class, read the Koran and that my best friend from medical school is a Muslim. They don’t know that in the end I love the diversity of the world and dress like a Kenyan, cover my head in Eastern Europe and am mildly horrified at how viral McDonalds is much less the rest of my culture.
And our conversation stops for a quiet reflective moment.
In the end, we conclude. It all comes down to pediatrics.
No really it does.
We want a better world for our children. A safer world. A more peaceful world. A world where our children are not hungry, are not sick, go to school and grow up free.
We smile. We eat our snacks and rush back to the havoc of the wards in the winter.
If only we could put aside our fear, our pride, put down our guns and realize for a moment just how simple it really is.
It renewed my desire to be a global pediatrician, to be part of the solution.
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| Joy in the Morning |
[01 Dec 2011|10:49am] |
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Originally published at Perches in the Soul. You can comment here or there. Three years ago when I was in the mist of my third year of medical school. I went through a 2 month period where I rarely slept more than a few hours at a time. It wasn’t the call schedule, it wasn’t the stress of residency applications or Step 2, it wasnt even entirely the pain that gnawed my left side at times to the point of tears. It was the creeping waves of anxiety of a young doctor to be who knew exactly what was happening to her in exquisite detail. In my minds eye I could see the holes in the cartilage, in which glistening white bone lay naked and scraped. The dying cartilage and wounded bone making something akin to broken glass in a small tight dark space lacking adequate blood supply for even the chance of healing despite my immune system attempts, in the end the immune responders led to an army of inflammation and pain. I dreamed about this. Then I would dream of the OR a place that as a med student I always felt like an escaped patient masquerading as a young student doctor to be. I had a recurrent dream that I was found out, carried down the hall, stripped of my scrubs and then rolled back to the OR screaming that I was just not ready but no one heard me.
Here I was excelling in medical school, living my dream, planning my first trip to Africa and having no idea if I would be physically able to continue in a few months, years. I finally found the courage to get x-rays, a kind rheumatology fellow who I frankly owe my sanity to paged me and went over the films with me gently. He talked me into a steroid shot in which a the radiologist furthered my anxiety with talk of strange anatomy and bone density. I made an appointment with the hip surgeon who I had met several years earlier and wrung my hands as I studied for Step 2, started my residency essays. The visit upset me even though I knew what was coming and gave me the strange transition of me explaining to my anxious mother what the doctors were saying. He gave me another steroid shot that was amazingly effective and I lived with denial for a summer, went to Romania and pretended that everything was ok. Perfected my residency essay, then my peds AI hit me like a freight train and my denial started to crumble. My first patient died of pneumonia related to muscular dystrophy in an all night vigil of wailing parents and I was reminded of my sweet Romanian friend whose similar death had rocked my world in college. Our parallel diseases differed in two major ways, there was a palliative yet potentially close to curative treatment for the symptoms of mine and even when I had no cartilage left…I wouldn’t die. Visions of a beloved elderly patient with RA who had movement in her hands, was going blind and couldn’t get out of bed flashed through my brain…could I live with that reality? Visions of the synthetic hip failing because of my bone density and knowing that once we took my femoral head they was no going back, if the prosthesis failed, I wouldn’t walk again. After the on call vigil, I drove home to the mountains then onward to get a steroid shot.
Within in weeks, I could no longer deny it, the shot failed. I wasn’t sleeping now because of the pain. It was everything I could do to keep the facade that I was just another medical student. I called my surgeon’s PA and cried in the child psych copy room and told her I wanted to do the surgery now. (yes I had a nervous break down on the pysch floor…fun yes). Things fell into place, the surgeon fit me in (I am sure he was shaking his head thinking finally I was ready a year ago, this girl is nuts). I passed Step 2, got my first residency interview and with tachycardia to the 120s, lectured my anesthesiologist on the decreased number of DVTs with spinals opposed to general as they rolled me into the OR.
I was a neurotic post-operative patient but I went back to medical school three weeks later, line danced at 5 weeks, interviewed for residency at 6 weeks, Kenya at 16 weeks and by the time match day came I was taking the steps two at a time for the first time in my life.
I went through a similar period of denial and anxiety although much milder, fought to get steroid shots in Cincy( Part II, Part III). Epic fail, telling my chief resident was near to the copy room incident. This time the PA tried to comfort me that even though there was a boat load of hardware in the hip, they would figure it out and I would be ok. I nearly lost my insurance coverage, took the Step 3 and then spoke in DC the week before. By the time I got to the OR I found myself in a much better place than the previous time, believing that somehow the hip would work despite the hardware weakened bone and that I would walk out of this better than ever. I found myself telling everyone (yay versed) my bucket list of things I wanted to do with two shiny hips (I remember this prior to heavier sedation but apparently I kept right on going although I don’t remember it). I woke up to the news that miracles of miracles the hardware had not prevented them from using the best kind of hip as expected and I had a 30 year lease at minimal. I was texting everyone I knew in the PACU and thanking everyone from the jainator to God for my incredible good fortune. My family and I survived me with five weeks of unplanned toe touch weight bearing while the hardware holes healed despite a funeral, a mild incision infection and general angst on the part of a sibling.
And I find myself at 5 weeks post op sitting in an exam room across the hall from where this all began three years ago with the visit (see above). The PA comes in and asks me when I am going back to Africa? She hands me the films with a grin. There they are, healing perfectly. Her optimism is infectious and suddenly as I remember how fragile it all seemed three years ago.I think back though to my first pediatric death and of my sweet friend Laura who died of a similar diseases (dying muscles and connective tissue…I have dying cartilage and connective tissue) and how in some strange way of the disability tribe I feel I owe them, they expect me not to waste this, to live with reckless abandon.
I am overcome by gratitude this time sans versed. Nearly in tears. The attending comes in says my name, kisses my cheek and says “You’re Done!” He grabs his cell and proceeds to call my pediatric ortho to tell him the good news. (yay for transition..although it was kind of a weird move) He draws me my “life plan” which includes one more visit at 6 months, then no more visits for 2 years. It doesn’t seem real. No more hip pain, no more hip precautions, an inch taller (much to my sister’s dismay) I can throw away my crutches, 6 weeks of PT and then welcome to the rest of my life.
Mom and I drive back down the familiar spine of our beloved mountains, a little giddy despite the recent family sorrow, amazed at marvels of modern medicine, of grace and of the incredible joy of sweet relief and the sweet ability to dream.
Praise God.
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| Going Home |
[11 Oct 2011|11:52am] |
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Originally published at Perches in the Soul. You can comment here or there. I gave my annual lecture at Wake Forest last week. It was a beautiful tapestry of beginnings and endings of my life.
Becoming a disabled physician is one of the greatest things I have done in my life but it also was among the most painful. Being told that you have no right to be here either in attitude or in voice is not pleasant. Being a pioneer is life defining but it also emotionally and psychologically exhausting. At the end of my time at Wake Forest there was a series of unfortunate events, attempt to fix it and the epic fail. I left some what devastated but determined to go out into the world of medicine and make my difference with or without my esteemed Alma mater’s support. Because while I may have failed in some regard as a pioneer I did what I set out to do which is become a physician.
I heard rumors last year that they had interviewed a disabled applicant here and there. I rolled my eyes and dreamed of telling them of going elsewhere although knowing that there were no safe places for us in the world of medicine as student doctors. I went home and lectured last year and was welcomed like somewhat of a returning hero which was odd and bit over the top.
Then I heard nothing for a long time. I grew as a young physician in an environment where I am not entirely at home but am safe from the constant pecking at my heart that I will never be good enough although I have relapses. I suture, I LP, I travel back to KENYA and take attending call, I get my first job offer, I move to a house and no longer feel like I am camping in exile. I move on.
But I return home again to give lecture to another group of young student doctors who meet the cut that I apparently never quite made. I am again welcomed. As I walk into the classroom I see something that nearly takes mybreath away. There is a student on front row sitting with a place at the table literally (the classroom was not wheelchair accessible till my second or third year) in a power chair. I have tears in my eyes. In all my moving on, I had forgotten how much this matters to me, how deeply I was hurt and even though I had gotten the diploma, how much I felt like I had lost an equally important battle.
But in fact I won. We won.
I corner the Dean and demand why no one told me, he smiles sheepishly. I though you knew, he tells me. I thought you knew. I welcome the new student, she has heard so about me. She thanks me for paving the way. She applied at 31 schools, Wake Forest was the only one that accepted her despite her double degrees, top grades, from a dare I say more famous Carolinan institution with a unspeakable mascot that is percuilar shade of blue in Durham. They chose me, she says, and I know its partly because of you. She has dreams of working with our tribe, of impacting children. According to her anatomy professor she is top of her class.(a better student than I ever was…hehehe)
I give my lecture, I think the best I have ever done. The Dean says I have grown into a public speaker in my own right from being a terrified first year medical student. I look at him and I try politely to tell him that I no longer have anything to fear.
It didn’t end there, I had glorious Carolina afternoon catching up with friends, mentors and basking in the sunshine. I sit and drink tea and laugh late into the night with old dear friends as we talk theology, justice, nostalgia and wit.
The next day, the Dean of Faculty (Dr BIGSHOT) calls me and asks me to come see him (he was out of town the day before). I show up in jeans in his formal office, he hugs me. He immediately turns to the young woman I met the day before, isn’t it great he says. He goes on to tell me about what happened after I left. He confronted the ED doctors who were fighting so hard to change our standards. In a faculty meeting, they gave presentation. They argued that if you asked 50 people out on the street if you want their doctor to run to a code, they would say yes. Dr. B said, “Yes and 50 years ago people would have said they wanted their doctor to be white and male.” That was the end of that he tells me.
We talk of global health and he gives me the finest career advice I had despite my esteemed current employer. He tells me, pack your suitcase and go to Kenya you will figure the rest out as you go along.  He encourages me to follow my dreams and not be confined by the mold of the academic rat race in less I wanted to be.
But as I leave what sticks with me is that its rare in our lives that we are allowed to know the extent of impact we have on our piece of world. I will never be able to put this on my CV or even discuss in an interview. I will never get an award for it or get my name published in a top journal. But I will go to my grave knowing that I was privileged enough to change a few hearts in regards of my tribe. I was able to at least for now make a safe place for disabled student doctors to study and grow and find their piece of the world to change.
A few days later in the mist of my ED shift, I got an e-mail from the Dean who told me that he overheard some first years talking about my lecture and how they would never use the word inspirational again (ha!) and how I had changed the way they think.
The movement goes on.
I tried so hard to be a good pioneer so people would wake up and take notice and now for the last year and half I did everything to just conform so that I could just be another physician. I realize both are only fragments of the woman God has me becoming. And finally after five years of wandering and feeling a little lost, I came home to myself an feel a sense of contentment.
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| Make New Friends but keep the old…. |
[19 Sep 2011|08:51pm] |
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Originally published at Perches in the Soul. You can comment here or there. The sermon on Sunday was on good friends.
The kind of friends who you can show up dripping wet on their door step after the worst day and they will let you in, let you cry a bit, tell you to clear off the laundry from the sofa and rest or hand you a crying baby and to get busy (which ever seems the right reaction). The kind who tell you the truth both good and bad. And the kind of friends that point you to Christ and speak wisdom into your life.
I am blessed young woman. Because at quick count I can count about 10 friends like that in my life.
Then the sermon went on to making your life where you are, finding those friends where you are and locally because thats how the local church was. The elder argued that we cant live elsewhere. We have to live here and now.
I shifted uncomfortably. I have tried very, very hard to build roots like that here. But frankly they just have not dug deep. I go to things post-call, I go to things when I am so sleepy I can’t stay awake, I am in a small group, I go to social events, I go to church and I have done these things for a year an half but the people who are the friends that keep me sane are not here.
One out the 10 are local and they followed me here from NC. You may ask how I make this work. How I deal with my best friends being far way? How I keep myself accountable? How I keep myself sane? Well when you grew up all over the US and plan on living all over the world…you learn fast.
I felt guilty about this and then I just realized you know this is a season of my life. God knows I have tried and he seems to have brought people into my life for the right seasons. I have faith he has done the same here.
Maybe its not the 15 people in my small group, maybe its the 6 amazing young women in my residency program who I spend consistent time with. Maybe its the children who steal my heart, maybe its the preparation for having my friends a continent a way.
Here’s the truth. I am a little bit more of a Paul/Priscilla kind of figure than a Lydia or Mary/Martha. Jesus have multiple friends in different cities. I am a nomad by birth and by calling.
So make new friends, invest in where you are, yes. But keep the old.
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